Search

The purpose of this study was to examine the relationship between Health Action Process Approach (HAPA) postintentional constructs (maintenance self-efficacy, recovery self-efficacy, action planning, coping planning) and medication adherence among phase II cardiac rehabilitation (CR) patients. Purposive sampling was used to recruit 91 phase II CR patients age 50 years and over. All respondents completed paper and pencil questionnaire examining HAPA postintentional constructs (action planning, coping planning, maintenance self-efficacy, recovery self-efficacy), medication adherence, and demographic characteristics. Validity and reliability were confirmed for all scales included in the questionnaire. Descriptive statistics were used to describe respondents’ characteristics. Bivariate statistics (correlation, Mann-Whitney U-test, Kruskal Wallis test) were used to examine associations between medication adherence and each HAPA postintention construct as well as medication adherence and respondent demographic characteristics. Better medication adherence was associated with greater maintenance self-efficacy (r = −.290, p = .006) and better action planning skills (r = −.233,p = .027) and coping planning skills (r = −.277,p = .008) as indicated by higher scores on the maintenance self-efficacy, action planning, and coping planning scales. There was no significant linear relationship between medication adherence and recovery self-efficacy (r = −.103,p = .335) or medication adherence and any of the respondents’ demographic characteristics (p > .05). Only maintenance self-efficacy remained significant in a multivariate model predicting medication adherence. Greater maintenance self-efficacy was associated with increased medication adherence; health professionals working in CR settings might consider opportunities to enhance maintenance self-efficacy for medication adherence. Additional research is needed to identify strategies for promoting maintenance self-efficacy for medication adherence. [ABSTRACT FROM AUTHOR]

Purpose: Assessment of distress and well-being of patients with cancer is not always documented or addressed in a clinical visit, reflecting a need for improved psychosocial screening. Methods: A multidisciplinary team completed process mapping for emotional distress assessment in two clinics. Barriers were identified through cause-and-effect analysis, and an intervention was chosen. Patient-reported outcomes were collected over 6 months using the validated National Comprehensive Cancer Network Emotional Distress Thermometer (EDT) paper tool. The American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) measures were compared before and after intervention. Results: During 6 months, a total of 864 tools were collected from 1,344 patients in two ambulatory clinics (64%). Electronic medical record documentation of distress increased from 19.2% to 34% during the 6 months before and after intervention. QOPI measures showed an increase in emotional well-being documentation. Of 29 new and 835 return patients, 62% indicated mild distress (EDT, 0 to 3), 18% moderate (EDT, 4 to 6), and 11 % severe (EDT, 7 to 10). The average distress score of new patients was significantly higher than that of return patients (5.39 [n = 26] v 2.52 [n = 754]; P < .001). The top problems for patients with moderate and severe distress were worry, fatigue, pain, and nervousness; depression and sadness were particularly noted in patients reporting severe distress. Eleven percent of patients were referred to the social worker on site. Conclusion: A pilot intervention collecting Patient-reported outcomes in two ambulatory clinics led to increase in psychosocial distress screening followed by sustained improvement, indicated by both process and QOPI measures. [ABSTRACT FROM AUTHOR]

Isocyanates, the essential cross-linking chemicals used to make polyurethane, are potent sensitizers and a common cause of occupational asthma. In addition, isocyanate (NCO) skin contact may contribute to the development of isocyanate asthma. Prior work has shown that unbound NCO can persist on recently spray coated auto body parts after appearing dry. The purpose of this study was to assess whether isocyanate skin exposure can result from handling such surfaces. Quantitative surface and skin wipe sampling for total NCO was performed on test panels sprayed with aliphatic isocyanate coatings, and on paired skin samples obtained from participants who had rubbed the recently dried surfaces. Surface and skin samples, obtained from 18 workers in five auto body shops, were prepared following NIOSH method 5525 (modified for skin samples), and isocyanate species derived from hexamethylene diisocyanate and isophorone diisocyanate were analyzed using high-performance liquid chromatography with ultraviolet and fluorescence detectors. Quantifiable unbound NCO species were detected on 84.2% of all sprayed surfaces sampled after initially considered dry. Only 7 out of a total of 104 (6.7%) non-compounded skin samples obtained after contact with the recently dried coatings had detectable quantities of free NCO. The 7 positive samples, all obtained at the initial sampling time (t0), had a geometric mean of O. 016 µg NCO cm-2 (range: 0.002-0.88 µg NCO cm-2). Only I of 12 (8.3%) of skin samples obtained after compounding contained detectable free NCO. The risk of substantial human isocyanate skin exposure from contact with the dry appearing (yet not fully cured) isocyanate coatings evaluated in this study appears to be low, although other isocyanate coatings and tasks may pose a greater risk of NCO skin exposure. [ABSTRACT FROM AUTHOR]

There is a lack of information concerning adults with autism spectrum disorder (ASD), especially with regards to their access to health care. A paper and electronic survey was sent to 1,580 primary care physicians in Connecticut. 346 respondents returned a survey and provided care to adults with an ASD. This physician survey provides data on adults with ASD such as: reasons for physician visits, living arrangements, employment status, and any services they are receiving. Responses revealed inadequate training in the care of adults with an ASD and physicians interest in obtaining additional training. The ability to provide a medical home for adults with autism will need to address effective strategies to train current and future physicians. [ABSTRACT FROM AUTHOR]

This study examined adolescent paternity through structured interviews with their social workers. It adds to the literature by exploring if there were young men involved with the child protection services (CPS) system who are fathers, identifying their unique needs, and beginning discussions on working with these young men. CPS social workers from six area offices and one juvenile detention facility completed surveys for each father on their caseload. A 3.5% rate of adolescent paternity was observed across these offices. Information about the nature of the young men's involvement with CPS, their involvement with their children, and their unique needs as fathers are provided. This paper also identifies some practice and policy implications for adolescent fathers and CPS charged with their care. [ABSTRACT FROM AUTHOR]