AECC University College Research
https://aecc.archive.knowledgearc.net/handle/123456789/18
2024-03-28T17:14:42Z
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The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic
https://aecc.archive.knowledgearc.net/handle/123456789/281
The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic
Ivanova, Dima; Newell, Dave; Field, Jonathan; Bishop, Felicity L.
Background: The clinician-patient relationship has consistently been found to predict treatment success in both physical and mental health settings. This relationship has been operationalised in the literature as "Working Alliance," which consists of three key components: patient-clinician agreement on the goals of care, agreement on the tasks required to achieve those goals, and the establishment of a strong bond. While research has demonstrated the impact of working alliance in physical health settings, it often measures working alliance early in patients' care journeys. However, no primary research has investigated how early working alliance develops between patients and chiropractors. Evidence suggests that musculoskeletal practitioners may require further training to feel confident in establishing working alliance. Therefore, this study aims to explore the development of working alliance in the early stages of chiropractic care from the patients' perspective to inform evidence-based practice.
Methods: Participants for this qualitative study were recruited from a teaching clinic at a specialised healthcare professions training university in the United Kingdom between September 2022 and April 2023. A total of 25 adult patients completed semi-structured interviews during the early stages of their care. The interview transcripts were analysed using Reflexive Thematic Analysis, from a critical realist stance.
Results: The findings highlight that an early working alliance entails the gradual development of patients' confidence in their decision to seek help from trainee chiropractors to alleviate their symptoms. The four themes describe the impact of the clinical context on patients' expectations, the trainee chiropractors' qualities that participants considered important for early working alliance, the role of explanations, and the interplay between pain and early working alliance.
Conclusions: Establishing an early trainee chiropractor-patient working alliance involves a process of building patients' confidence in the trainee chiropractors' expertise, identifying the correct goals of care, and recognising the value of the proposed treatment plan. Factors shaping this process include the context of the care journey, patients' perceptions of trainee chiropractors' qualities, their bodily sensations, their expectations, their past experiences, and their satisfaction with trainee chiropractors' explanations.
Keywords: Chiropractor-patient relationship; Confidence; Context; Expectations; Expertise; Explanations; Pain; Therapeutic Alliance; Trust; Working Alliance.
Available under License - Creative Commons Attribution: https://creativecommons.org/licenses/by/4.0/
2024-03-21T00:00:00Z
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The effectiveness of psychiatric genetic counseling training: An analysis of 13 international workshops
https://aecc.archive.knowledgearc.net/handle/123456789/280
The effectiveness of psychiatric genetic counseling training: An analysis of 13 international workshops
Mack, Tiera; Batallones, Rolan; Morris, Emily; Inglis, Angela; Moldovan, Ramona; McGhee, Kevin; Zimmerman, Kip D.; Austin, Jehannine
Studies have consistently shown that psychiatric genetic counseling (pGC) helps people with psychiatric conditions by increasing empowerment and self-efficacy, and addressing emotions like guilt. Yet, it is not routinely provided. Genetic counselors and trainees express low confidence in their ability to provide meaningful pGC, especially in the absence of adequate training. Therefore, to address this gap a “Psychiatric Genetic Counseling for Genetic Counselors” (PG4GC) workshop was developed and delivered to 13 groups of participants (primarily qualified genetic counselors and trainees) between 2015 and 2023 (10 workshops were delivered in-person, and three virtually). Participants completed quantitative questionnaires both before and after completing the workshop to assess their comfort, knowledge, behavior, and feeling of being equipped to provide pGC. In total, 232 individuals completed the pre-workshop questionnaire and 154 completed the post-workshop questionnaire. Participants felt more comfortable, knowledgeable, and equipped to provide pGC, and reported being more likely to address psychiatric concerns after the workshop, regardless of whether they were trainees or practicing professionals and whether they completed the workshop in-person or virtually. This study suggests that the PG4GC workshop is an effective educational tool in pGC training that may aid in broader implementation of the service.
© 2024 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics published by Wiley Periodicals LLC.
Available under License - Creative Commons Attribution: https://creativecommons.org/licenses/by-nc/4.0/
2024-03-21T00:00:00Z
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Disc degeneration and cervical spine intervertebral motion: A cross-sectional study in patients with neck pain and matched healthy controls
https://aecc.archive.knowledgearc.net/handle/123456789/279
Disc degeneration and cervical spine intervertebral motion: A cross-sectional study in patients with neck pain and matched healthy controls
Branney, Jonathan; Breen, Alexander; du Rose, Alister; Mowlem, Philip; Breen, Alan
While neck pain can be defined in clinical terms, in most cases the underlying pathophysiology is largely unknown. Regional cervical spine range of motion is often found to be reduced in patients with neck pain compared to persons without pain although it is not clear if the decreased range is cause or effect. Less is known about the role of intervertebral kinematics and how that might be related to the presence of disc degeneration. In this study, the prevalence of intervertebral disc degeneration and continuous cervical intervertebral motion were both measured utilizing quantitative fluoroscopy (QF) in patients with subacute or chronic neck pain (n = 29) and gender-matched healthy controls (n = 30). A composite disc degeneration (CDD) score was calculated for each participant from the first, neutral, lateral fluoroscopic image. Intervertebral motion sharing parameters of motion-sharing inequality (MSI) and motion-sharing variability (MSV) were derived from the active cervical motion sequences obtained while patients were seated. The objective was to determine if average age, CDD, MSI, and MSV values were correlated and if there were differences in these variables between the neck pain group and the healthy control group. Correlation analysis was conducted for age, CDD, MSI, and MSV in each group. Age was moderately correlated with MSV in cervical spine extension in patients only (r = 0.63, p < 0.001). There were no significant differences in the prevalence of disc degeneration (CDD) between patients, who had on average mild pain and related disability, and healthy controls (median CDD 2 both groups, p = 0.94). There were also no significant differences in either flexion or extension intervertebral motion-sharing inequality or variability (MSI or MSV) between groups as measured during active cervical motion.
Available under License - Creative Commons Attribution: https://creativecommons.org/licenses/by/4.0/
2024-03-19T00:00:00Z
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Prevalence of co-occurrence of physical frailty and malnutrition and its associated factors among community-dwelling older adults in a rural district, Malaysia
https://aecc.archive.knowledgearc.net/handle/123456789/278
Prevalence of co-occurrence of physical frailty and malnutrition and its associated factors among community-dwelling older adults in a rural district, Malaysia
Mustaffa, Musastika; Hairi, Noran Nagiah; Majid, Hazreen Abdul; Choo, Wan Yuen; Hairi, Farizah Mohd; Peramalah, Devi; Kandiben, Shathanapriya; Ali, Zainudin Mohd; Razak, Inayah Abdul; Ismail, Norliana; Sooryanarayana, Rajini; Ahmad, Nur Sakinah; Bulgiba, Awang
Frailty and malnutrition commonly co-occur but remains undetected and untreated in community settings. This study aimed to determine the prevalence of co-occurring frailty and malnutrition, and its associated factors among community-dwelling older adults in a rural setting in Malaysia. A cross-sectional study was conducted among adults aged ≥ 60 residing in Kuala Pilah district, Negeri Sembilan, Malaysia. Physical frailty and nutritional status were assessed using the Fried phenotype and the Mini Nutritional Assessment (MNA), respectively. Among 1855 participants, 6.4% had co-occurring frailty and at-risk/malnutrition and 11.3% had co-occurring prefrailty and at-risk/malnutrition. Older age, fair-to-poor self-rated health, long-term disease, polypharmacy, activities of daily living (ADLs) and instrumental ADLs’ disabilities, cognitive impairment, and poor social support were associated with higher odds of co-occurring frailty and malnutrition. Therefore, beside early identification, targeted intervention is crucial to prevent or delay the progression of frailty and malnutrition in this population.
2024-03-14T00:00:00Z