Search

Introduction: Behavioral Activation (BA) is a short-term cognitive behavioral therapy modality that stimulates activities that increase patients' reinforcement experiences. Recent research verified the effect of brief BA. However, despite the short intervention time per session, BA is difficult to implement during hospitalization due to its long implementation period. Objectives: To evaluate the clinical effectiveness of a brief BA program for people with depression in an inpatient setting. Methods: This study employed a single-group pre-post design. Fifteen patients who met the inclusion criteria participated in the trial after providing oral and written informed consent. In addition to their usual care, participants received four weekly sessions administered by a nurse. The primary outcome measures included the Beck Depression Inventory (BDI-II), which indicated patients' subjective depression severity. Clinical outcomes were measured at preintervention, immediate postintervention, and one-month postintervention. Results: Fourteen participants completed the BA program and were receptive to treatment. For the primary endpoint, BDI-II, there was an improvement in scores (25.60 to 22.73 to 22.06) between the baseline, postintervention, and 1-month postassessment, but not a significant change. For EQ VAS score, there was no significant change, but there was an improvement in EQ VAS score (51.53 to 52.20 to 55.13) between the baseline, postintervention, and 1-month postassessment. The mean total Global Assessment of Functioning score increased from 40.20 to 57.00 across the pre- and postassessment points (p <.0001). Conclusion: The study comprised a brief BA intervention, with results suggesting that participants could complete the program without feeling burdened. Although there was no significant improvement in the general outcome, depression levels, and other outcomes improved. Thus, while there is a need to rethink BA intervention, this program may be a practical approach to improving depression and other outcomes. [ABSTRACT FROM AUTHOR]

Positive relationships between volume and outcome have been seen in several surgical and medical conditions, resulting in more centralized and specialized care structures. Currently, there is a scarcity of literature involving the volume–outcome relationship in pulmonary embolism (PE). Using a state-wide dataset that encapsulates all non-federal admissions in New York State, we performed a retrospective cohort study on admitted patients with a diagnosis of PE. A total of 70,443 cases were separated into volume groups stratified by hospital quartile. Continuous and categorical variables were compared between cohorts. Multivariable regression analysis was conducted to assess predictors of 1-year mortality, 30-day all-cause readmission, 30-day PE-related readmission, length of stay, and total charges. Of the 205 facilities that were included, 128 (62%) were labeled low volume, 39 (19%) medium volume, 23 (11%) high volume, and 15 (7%) very high volume. Multivariable analysis showed that very high volume was associated with decreased 30-day PE-related readmission (OR 0.64; 95% CI, 0.55 to 0.73), decreased 30-day all-cause readmission (OR 0.84; 95% CI, 0.79 to 0.89), decreased 1-year mortality (OR 0.85; 95% CI, 0.80 to 0.91), decreased total charges (OR 0.96; 95% CI, 0.94 to 0.98), and decreased length of stay (OR 0.94; 95% CI, 0.92 to 0.96). In summary, facilities with higher volumes of acute PE were found to have less 30-day PE-related readmissions, less all-cause readmissions, shorter length of stay, decreased 1-year mortality, and decreased total charges. [ABSTRACT FROM AUTHOR]