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Background: Medical students are at risk of poor mental health and burnout compared to general population age- and education-matched peers, which has future implications for patient care. Research has suggested that demographic factors can predict mental illness and burnout among medical students. However, less is known about predictors of mental health and how they compare to predictors of burnout, and few studies have examined multiple demographics simultaneously. Objectives: This study examined and compared demographic predictors (gender, ethnicity, age, level of education, year of study and proposed specialty) of mental health and burnout in first to fourth year Canadian medical students. Method: Medical students (n = 129) completed online surveys comprised of validated questionnaires. Results: Multiple regression indicated that third year [Beta] = -0.243, p = 0.013) negatively predicted mental health (R[superscript 2] = 15.0%). Female gender ([Beta] = 0.242, p = 0.005), 'other' ethnicities ([Beta] = 0.189, p = 0.028), third year ([Beta] = 0.391, p < 0.001) and fourth year ([Beta] = 0.212, p = 0.023) positively predicted burnout (R[superscript 2] = 32.7%). Female gender and fourth year predicted mental health and burnout differently. 'Other' ethnicity, second year and third year predicted mental health and burnout similarly. Conclusion: Findings fill gaps in the literature and may inform medical stakeholders in developing targeted programmes for improving medical students' mental health and burnout. Medical students with greater well-being can progress into physicians who will be more likely to promote well-being in their patients.

The purpose of this mixed-method study was to (1) examine the effect of an adapted physical activity program, Fitness Access McGill (FAM), on leisure-time physical activity (LTPA), autonomous and controlled motivation, and the basic psychological needs of self-determination theory among university students/staff with a physical disability and/or chronic conditions, and (2) explore participants' experiences after completing FAM. Nineteen participants completed validated questionnaires for all study outcomes pre- and post-FAM. Nine participants partook in a 30–60 min semi-structured interview conducted within three months of completing FAM. Quantitative data were analyzed using repeated measures effect size calculations. Qualitative data were analyzed using directed content analysis. Participants reported an increase in total LTPA (dRMpooled = 0.58), with the greatest positive change on strenuous intensity (dRMpooled = 0.81). Large effects were found for changes in autonomous motivation (dRMpooled = 0.52), autonomy (dRMpooled = 0.79), competence (dRMpooled = 0.79), and relatedness (dRMpooled = 0.89). Participants reported FAM being supportive towards their psychological needs, the development of a LTPA routine, and enhanced overall well-being. Future research can be built upon this study to develop a robust understanding as to how need-supportive, adapted LTPA programs could be implemented within community settings or out-patient rehabilitation to support exercise engagement, physical health and overall well-being among adults with disabilities. [ABSTRACT FROM AUTHOR]

This study aimed to understand the experiences of compassion fatigue and compassion fatigue resilience among peer mentors within Canadian spinal cord injury (SCI) community service organizations. Eight experienced peer mentors completed two online daily diary reflections and participated in one semistructured interview. Using abductive thematic analysis, constructs within the compassion fatigue resilience model and self-compassion theory guided our interpretation of the peer mentors' experiences. We found consequences associated with compassion fatigue and compassion fatigue resilience and describe the internal and external factors contributing to each. Peer mentors whose experiences aligned with compassion fatigue felt physically, psychologically, and emotionally exhausted. These feelings appeared to have a negative influence on the peer mentors' perception of their effectiveness, affecting their ability to help their mentees or even leading them to avoid their mentees altogether. Factors such as shared lived experience, exposure to mentee suffering/stress, traumatic memories, lack of self-compassion, and other mentorship/life demands contributed to peer mentors' compassion fatigue. Conversely, factors such as self-care, self-compassion, detachment from mentee suffering/stress, satisfaction from mentoring, and social support promoted resilience to compassion fatigue. Compassion fatigue (resilience) was experienced by peer mentors as being a complex and multifaceted process including both internal and external factors. These findings highlight warning signs of compassion fatigue among peer mentors and identify the factors—and their interrelationships—that could build resilience to combat this fatigue. Organizations can use the information to tailor self-compassion programs for SCI peer mentorship. [ABSTRACT FROM AUTHOR]

Community-based exercise programs for persons with disabilities promote greater quantity of leisure-time physical activity (LTPA) participation among their members, perhaps because of the quality experiences fostered by the program. This study aimed to explore the relationship between quality and quantity of physical activity participation in the context of community-based exercise programming and the role that gender plays in this relationship. Adults with physical disabilities (N = 91; Mage = 55, 49 men) from three community-based exercise programs across Canada completed a survey asking about quality participation (Measure of Experiential Aspects of Participation [MeEAP]) and LTPA. Structural equation modeling was used to examine the relationship between MeEAP scores and LTPA. Quality participation was not related to LTPA, even with gender included as a moderator. Men reported higher levels of LTPA and quality participation than women, highlighting gender differences that should be considered when researching and designing exercise programs for individuals with disabilities. [ABSTRACT FROM AUTHOR]

BackgroundGlobally, 1 in 3 adults live with multiple chronic conditions. Thus, effective interventions are needed to prevent and manage these chronic conditions and to reduce the associated health care costs. Teaching effective self-management practices to people with chronic diseases is one strategy to address the burden of chronic conditions. With the increasing availability of and access to the internet, the implementation of web-based peer support programs has become increasingly common. ObjectiveThe purpose of this scoping review is to synthesize existing literature and key characteristics of web-based peer support programs for persons with chronic conditions. MethodsThis scoping review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching MEDLINE, CINAHL, Embase, PsycINFO, and the Physiotherapy Evidence Database. Chronic diseases identified by the Public Health Agency of Canada were included. Our review was limited to peer support interventions delivered on the web. Peers providing support had to have the chronic condition that they were providing support for. The information abstracted included the year of publication, country of study, purpose of the study, participant population, key characteristics of the intervention, outcome measures, and results. ResultsAfter duplicates were removed, 12,641 articles were screened. Data abstraction was completed for 41 articles. There was a lack of participant diversity in the included studies, specifically with respect to the conditions studied. There was a lack of studies with older participants aged ≥70 years. There was inconsistency in how the interventions were described in terms of the duration and frequency of the interventions. Informational, emotional, and appraisal support were implemented in the studied interventions. Few studies used a randomized controlled trial design. A total of 4 of the 6 randomized controlled trials reported positive and significant results, including decreased emotional distress and increased health service navigation, self-efficacy, social participation, and constructive attitudes and approaches. Among the qualitative studies included in this review, there were several positive experiences related to participating in a web-based peer support intervention, including increased compassion and improved attitudes toward the individual’s chronic condition, access to information, and empowerment. ConclusionsThere is limited recent, high-level evidence on web-based peer support interventions. Where evidence exists, significant improvements in social participation, self-efficacy, and health-directed activity were demonstrated. Some studies incorporated a theoretical framework, and all forms of peer support—emotional, informational, and appraisal support—were identified in the studies included in this review. We recommend further research on web-based peer support in more diverse patient groups (eg, for older adults and chronic conditions outside of cancer, cardiovascular disease, and HIV or AIDS). Key gaps in the area of web-based peer support will serve to inform the development and implementation of future programs.

Introduction: Community-based spinal cord injury (SCI) organizations deliver peer mentorship programs in rehabilitation settings. Little is known on how these programs are delivered through the collaboration between community-based SCI organizations and rehabilitation institutions. This study aimed to identify barriers, facilitators, and collaboration processes within a SCI peer mentorship program provided by a community-based organization at a rehabilitation center. Methods: A qualitative case study design was applied. Seven participants were recruited, including two mentees, two mentors, one program director of the community-based SCI organization, and two healthcare professionals of the rehabilitation center. Each participant completed a one-on-one interview. Data were analyzed inductively and deductively based on the Consolidated Framework for Implementation Research (CFIR). Results: Ten factors were identified to influence the delivery of the peer mentorship program, including nine CFIR constructs. Successful delivery of the program required strong, collaborative inter-professional relationships between health professionals and community organizational staff (e.g., peer mentors) as facilitators; whereas potential cost, minimal patient needs, and limited mentor resources were found to be barriers. Engaging health professionals by initiating communications, reflecting and evaluating the program collectively with health professionals were important collaboration processes for the community-based organization to maintain effective partnership with the rehabilitation center. Discussion: The collaboration processes and strategies to addressing/leveraging the barriers and facilitators may inform evidence-based practice to establish and optimize the delivery of SCI peer mentorship programs in various rehabilitation settings. [ABSTRACT FROM AUTHOR]

Community-based physical activity opportunities have been shown to help adults with physical disabilities improve their participation in daily activities and reduce social isolation. Despite the known benefits, substantial barriers and challenges inhibit accessibility to these physical activity opportunities. To facilitate the co-construction of strategies to overcome accessibility issues pertaining to community-based physical activity opportunities. In total, 45 individuals with physical disabilities, patients at a rehabilitation hospital, staff members of disability organizations, staff of local or provincial government agencies/departments, kinesiologists, occupational therapists, graduate students, and peer mentors participated in one of four World Cafés held in their respective cities. World Café is a methodology for fostering collaborative, solution-focused conversation that aims to solve problems through collective intelligence. Participants were divided into groups of three to four people and invited to engage in evolving rounds of discussions responding to prompts about accessibility to physical activity in their communities. Transcripts were analyzed using content analysis. In total, 17 strategies were identified, addressing 5 areas: representation and visibility (e.g. prioritize hiring people with a disability), finances (e.g. reduce direct costs for participants), connection and social support (e.g. foster social networks that provide informational support), education and programming (e.g. enhance awareness of existing services and resources), and government programs and policies (e.g. enforce accessibility standards for indoor and outdoor spaces). The findings of this study provide strategies and practical applications for community programs and governments to consider for increasing access to physical activity opportunities for people with physical disabilities. [ABSTRACT FROM AUTHOR]

This study aimed to: (1) develop a coding manual to characterize topics discussed and conversation techniques used during peer mentorship conversations between people with spinal cord injury (SCI); (2) assess the reliability of the manual; and (3) apply the manual to characterize conversations. The study was conducted in partnership with three Canadian provincial SCI organizations. Twenty-five phone conversations between SCI peer mentors and mentees were audio-recorded and transcribed verbatim. Ten transcripts were inductively analyzed to develop a coding manual identifying topics and techniques used during the conversations. Inductive technique codes were combined and deductively linked to motivational interviewing and behaviour change techniques. Two coders independently applied the coding manual to all transcripts. Code frequencies were calculated. The coding manual included 14 topics and 31 techniques. The most frequently coded topics were personal information, recreational programs, and chronic health services for mentors and mentees. The most frequently coded techniques were giving personal information, social smoothers, and closed question for mentors; and giving personal information, social smoothers, and sharing perspective for mentees. This research provides insights into topics and techniques used during real-world peer mentorship conversations. Findings may be valuable for understanding and improving SCI peer mentorship programs. SCI peer mentorship conversations address a wide range of rehabilitation topics ranging from acute care to living in the community. Identification of the topics discussed, and techniques used in SCI peer mentorship conversations can help to inform formalized efforts to train and educate acute and community-based rehabilitation professionals. Identifying commonly discussed topics in SCI peer mentorship conversation may help to ensure that peer mentors are equipped with the necessary knowledge and resources, or the development of those resources be prioritized. Developing a method to characterize the topics discussed and techniques used during SCI peer mentorship conversations may aid in designing methods to evaluate how rehabilitation professionals provide support to people with SCI. [ABSTRACT FROM AUTHOR]

To explore sexuality after spinal cord injury (SCI) from the perspectives of individuals with SCI and their romantic partners. A sample of 8 Canadian adults with SCI (6 men, 2 women) and their partners participated in this study (N = 16). Semi-structured dyadic and individual interviews were conducted, discussions surrounding sexuality and intimacy were extracted, and a qualitative description of the interview data was performed using thematic analysis. Three major themes were identified: the changing definition of sex; emotions; and practical support. Couples' conversations around the changing definition of sex after SCI addressed the taboo topic of sexuality and the importance of communication between couples, peers, and healthcare providers. Emotions included fears of losing intimacy, embarrassment in managing bladder and bowel interference, and acceptance in balancing being a romantic partner and a caregiver. Finally, couples reported challenges accessing practical support including medical interventions and sexual health nurses, but saw value in peer mentorship programs. Couples explored a changing definition of sex following SCI that was complicated by the taboo nature of discussing sexuality, experienced a range of emotions throughout the recovery process, and had difficulties navigating the healthcare system for appropriate support. Healthcare professionals should promote discussion and provide support for sexuality following SCI, but during initial rehabilitation may be too early. Healthcare providers should prepare people with SCI and their partners for the inevitable trial-and-error process involved in sexual rehabilitation. Rehabilitation professionals could direct couples to SCI peer mentorship programs to help normalize the experiences and emotions of sexual rehabilitation. [ABSTRACT FROM AUTHOR]

Identifying as a regular exerciser has been found to effectively alter stereotypes related to warmth and competence for adults with a physical disability; however, it remains unclear how sport participation can influence this trend. Therefore, this study aimed to examine warmth and competence perceptions of adults with a physical disability portrayed as elite and nonelite athletes relative to other athletic and nonathletic subgroups of adults with and without a physical disability in the context of the stereotype content model. Using survey data from able-bodied participants (N = 302), cluster analyses were applied to a behaviors from intergroup affect and stereotypes map for displaying the intersection of warmth and competence perceptions. The results demonstrated that adults with a physical disability who are described as elite athletes (i.e., Paralympians) are clustered with high warmth and high competence, similar to their able-bodied athletic counterparts (i.e., Olympians). The findings suggest that perceiving athletic and elite sport statuses for adults with a physical disability may counter the stereotypes commonly applied to this group. [ABSTRACT FROM AUTHOR]