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المصدر: Journal of Religion and Health. 53:604-613
مصطلحات موضوعية: Male, Religion and Psychology, medicine.medical_specialty, Adolescent, Urban Population, media_common.quotation_subject, Context (language use), Article, Midwestern United States, Interviews as Topic, Surveys and Questionnaires, Intervention (counseling), Spirituality, medicine, Humans, Qualitative Research, General Nursing, media_common, Asthma, Physician-Patient Relations, Public health, Religion and Medicine, Religious studies, Patient Preference, General Medicine, medicine.disease, Prayer, Religion, Adolescent Behavior, Female, Thematic analysis, Psychology, Qualitative research, Clinical psychology
الوصف: This qualitative study examined the preferences of urban adolescents with asthma for including religious/spiritual (R/S) inquiry in a variety of hypothetical clinical encounters. Twenty-one urban adolescents (M age = 15.6 years, 52 % female, 81 % African American) with asthma participated in a semi-structured interview. Interviews were transcribed and underwent a thematic analysis. R/S preferences were contextual rather than personal, driven by: (1) acuity of the hypothetical clinical context; (2) nature of the patient–provider relationship; and (3) level of R/S intervention/inquiry. Most adolescents welcomed prayer if near death, but did not see the relevance of R/S in a routine office visit.
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المؤلفون: Emily M. O’Bryan, Christina M. Luberto, Alison C. McLeish, Sian Cotton, Carolyn J. Mingione
المصدر: Mindfulness. 5:373-380
مصطلحات موضوعية: Self-efficacy, Coping (psychology), Health (social science), Mindfulness, Social Psychology, Independent samples, Developmental and Educational Psychology, Psychological intervention, Experimental and Cognitive Psychology, Path analysis (statistics), Psychology, Applied Psychology, Clinical psychology
الوصف: We examined coping self-efficacy as one potential mediator of the relationship between four specific mindfulness skills (observing, describing, acting with awareness, and accepting without judgment) and emotion regulation difficulties. Participants were 180 undergraduate students (Mage = 21.13; 71 % female; 82 % Caucasian) who completed self-report measures for course credit. Pearson correlations, independent samples t test, and ANOVAs were used to examine bivariate relationships between study variables. Simple mediation was examined in a path analysis framework by testing the indirect effect of mindfulness skills on emotion regulation difficulties through coping self-efficacy. Results indicated that a greater use of describing, acting with awareness, and accepting without judgment were associated with greater coping self-efficacy, and coping self-efficacy partially mediated the relationship between each of those skills and emotion regulation difficulties (indirect effects: b weight = −0.26 to −0.29, p < 0.01). The mindfulness skill of observing was not related to coping self-efficacy or emotion regulation difficulties. Findings suggest that coping self-efficacy partially explains the relationships between mindfulness and emotion regulation difficulties. Clinicians administering mindfulness-based interventions should be aware of the role of coping self-efficacy in the relationship between mindfulness and emotion regulation.
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المؤلفون: Gary L. McPhail, Daniel H. Grossoehme, Sian Cotton
المصدر: Journal of Health Care Chaplaincy. 19:22-32
مصطلحات موضوعية: Adult, Complementary Therapies, Male, Parents, medicine.medical_specialty, Health (social science), Adolescent, Cystic Fibrosis, media_common.quotation_subject, Faith healing, Alternative medicine, Pastoral Care, Article, Young Adult, Nursing, Professional-Family Relations, Pastoral care, Humans, Medicine, Child, Qualitative Research, media_common, Modalities, business.industry, Religious studies, Cognitive reframing, Middle Aged, Prayer, Clinical Psychology, Child, Preschool, Family medicine, Female, business, Faith Healing, Aromatherapy, Qualitative research
الوصف: Complementary and alternative medicine (CAM) use, including spiritual modalities, is common in pediatric chronic diseases. However, few users discuss CAM treatments with their child's physician. Semi-structured interviews of 25 parents of children who have cystic fibrosis (CF) were completed. Primary themes were identified by thematic analyses. Most parents (19/25) used at least one CAM modality with their child. Only two reported discussing CAM use with their child's pulmonologist. Most reported prayer as helpful (81%) and multi-faceted, including individual and group prayer; using aromatherapy or scented candles as an adjunct for relaxation; and the child's sleeping with a blessed prayer. Parents ascribed sacred significance to natural oral supplements. CAM use is relevant to the majority of participating parents of children under age 13 with CF. Chaplains can play a significant role by reframing prayer's integration into chronic disease care, co-creating rituals with pediatric patients, and mediating conversations between parents and providers.
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المؤلفون: Judith R. Ragsdale, John P. Clancy, Michael Seid, Sian Cotton, Daniel H. Grossoehme, Melenie A. Meyers, Patricia M. Joseph
المصدر: Journal of Health Care Chaplaincy. 18:110-120
مصطلحات موضوعية: Adult, Male, Religion and Psychology, Coping (psychology), Health (social science), Cystic Fibrosis, Treatment adherence, Health outcomes, Article, Grounded theory, Adaptation, Psychological, Spirituality, Humans, Qualitative Research, Motivation, Stressor, Religious studies, Cognitive reframing, Middle Aged, Clinical Psychology, Patient Compliance, Female, Psychological Theory, Psychology, Qualitative research, Clinical psychology
الوصف: Chronic illness is a significant stressor; the majority of Americans cope utilizing spirituality. Numerous studies demonstrate links between spiritual coping and health outcomes. The purpose of this study was to determine whether persons diagnosed with cystic fibrosis (CF) as adults use spirituality to cope and influence disease management. Semi-structured interviews were completed and analyzed using grounded theory. Data saturation was reached following twelve interviews (83% female); representing 100% participation of those approached and 48% of eligible adults. Persons with late-life CF diagnoses used spirituality to make meaning, understanding themselves in a collaborative partnership with their pulmonologist and God. Supporting themes were: (a) God's intervention depended on treatment adherence and (b) spiritual meaning was constructed through positively reframing their experience. The constructed meaning differed from that of adult parents of children with CF. Late-life diagnosed adults focused on personal responsibility for health. Clinical and research implications for chaplains are presented.
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المصدر: Journal of Asthma. 49:409-415
مصطلحات موضوعية: Complementary Therapies, Male, Pulmonary and Respiratory Medicine, Gerontology, medicine.medical_specialty, Adolescent, Urban Population, Alternative medicine, Severity of Illness Index, Quality of life, medicine, Humans, Immunology and Allergy, Anti-Asthmatic Agents, Longitudinal Studies, Psychiatry, Depression (differential diagnoses), Asthma, business.industry, medicine.disease, Mental health, Black or African American, Religion, Cross-Sectional Studies, Mental Health, Socioeconomic Factors, Pediatrics, Perinatology and Child Health, Quality of Life, Anxiety, Female, Observational study, medicine.symptom, business, Psychosocial
الوصف: Objective. Many adolescents with asthma use complementary and alternative medicine (CAM) for asthma symptom management. The purpose of this study was to investigate cross-sectional and longitudinal differences in psychosocial health outcomes between high and low CAM users among urban adolescents with asthma. Methods. Adolescents (Time 1: N = 151, Time 2: N = 131) completed self-report measures regarding the use of 10 CAM modalities, mental health, and health-related quality of life (HRQoL) following two clinic visits 1 year apart as part of a larger observational study. Multivariable regression analyses using backward elimination examined relationships between CAM use at Time 1 and outcomes at Time 1 and Time 2, controlling for key covariates and, in longitudinal analyses, Time 1 functioning. Results. Participants (M(age) = 15.8, SD = 1.85) were primarily African-American (n = 129 [85%]) and female (n = 91 [60%]) adolescents with asthma. High and low CAM users differed significantly in terms of several psychosocial health outcomes, both cross-sectionally and longitudinally. In cross-sectional multivariable analyses, greater frequency of praying was associated with better psychosocial HRQoL (R(2) = 0.22). No longitudinal relationships remained significant in multivariable analyses. Conclusions. Specific CAM techniques are differentially associated with psychosocial outcomes, indicating the importance of examining CAM modalities individually. Greater frequency of praying was cross-sectionally associated with better psychosocial HRQoL. When controlling for key covariates, CAM use was not associated with psychosocial outcomes over time. Further research should examine the effects of CAM use in controlled research settings.
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المؤلفون: Hedy S. Wald, Jamie S. Padmore, Sian Cotton, Aviad Haramati, Peggy A. Weissinger
المصدر: Medical Teacher. 39:671-672
مصطلحات موضوعية: Medical education, 020205 medical informatics, media_common.quotation_subject, MEDLINE, Empathy, 02 engineering and technology, General Medicine, Burnout, Education, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Costs and Cost Analysis, 0202 electrical engineering, electronic engineering, information engineering, Humans, 030212 general & internal medicine, Psychology, media_common
الوصف: Dear SirWe thank Drs. van Venrooij and Barnhoorn for their thoughtful comments. Certainly, we agree that the first step to addressing the issue of medical student burnout is to “acknowledge the pro...
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المؤلفون: Jamie S. Padmore, Sian Cotton, Hedy S. Wald, Peggy A. Weissinger, Aviad Haramati
المصدر: Medical Teacher. 39:118-119
مصطلحات موضوعية: 020205 medical informatics, Best practice, media_common.quotation_subject, Psychological intervention, Empathy, 02 engineering and technology, Burnout, Education, 03 medical and health sciences, 0302 clinical medicine, Nursing, 0202 electrical engineering, electronic engineering, information engineering, Humans, 030212 general & internal medicine, Burnout, Professional, Curriculum, media_common, Medical education, General Medicine, Congresses as Topic, Certainty, Well-being, Psychological resilience, Psychology, Stress, Psychological
الوصف: The high prevalence of physician burnout is of great concern and may begin with observed declines in empathy and increases in stress and burnout in medical and health professions students. While underlying causes have been described, there is less certainty on how to create effective interventions in curricula and workplace. In October 2015, The Center for Innovation and Leadership in Education (CENTILE) at Georgetown University, together with MedStar Health, Georgetown's clinical partner, and six academic institutions sponsored a conference in Washington, DC. The goal was to discuss the current state of stress and burnout in the health professions, and to share best practices on strategies to promote resilience, empathy and well-being in students, residents, faculty and practitioners across health professions. In this issue of Medical Teacher, three articles address pertinent themes of the conference. Maslach and Leiter provide insights into burnout and strategies to alleviate it. Ekman and Krasner discuss various types of empathy and how neuroscience can be used to effectively cultivate empathy. In the third paper, Kreitzer and Klatt highlight three successful curricular interventions that foster self-awareness and boost resilience. Ultimately, effective strategies will be needed to address this issue at both the individual and organizational levels.
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المؤلفون: Daniel H. Grossoehme, C. Jeffrey Jacobson, Michael Seid, Rhonda VanDyke, Judith R. Ragsdale, Sian Cotton
المصدر: Mental Health, Religion & Culture. 14:423-432
مصطلحات موضوعية: Coping (psychology), Hospital setting, media_common.quotation_subject, Stressor, Cognition, Prayer, Psychiatry and Mental health, Clinical Psychology, Chapel, Psychology, Social psychology, computer, computer.programming_language, media_common
الوصف: Hospitalised children represent a threatened future to parents. Such stressors call forth people's coping styles. Some individuals cope religiously or spiritually, and religious coping through prayer may be utilised. A sample of prayers written in a paediatric hospital chapel was coded by styles of religious coping evident within them. Styles associated with coping to gain control of their situation and with coping by seeking comfort from God were present. Seeking to cope for gaining control of a situation was more common than seeking comfort from God during the event. Written prayers did not contain evidence of coping by making meaning. Regression analysis showed that the probability of writing a prayer to gain control decreased over time and a trend towards increasing probability of writing a prayer expressing coping by seeking God's comfort. Clinical implications are discussed. Future research should include a larger sample and cognitive interviews with prayer writers.
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المؤلفون: Sian Cotton, Jerren C. Weekes, Meghan E. McGrady
المصدر: Journal of the National Medical Association. 103:392-399
مصطلحات موضوعية: Male, medicine.medical_specialty, Adolescent, Urban Population, Substance-Related Disorders, Population, Black People, Logistic regression, Insurance Coverage, Risk Factors, Surveys and Questionnaires, Humans, Medicine, Longitudinal Studies, education, Asthma, education.field_of_study, Chi-Square Distribution, biology, business.industry, General Medicine, Odds ratio, biology.organism_classification, medicine.disease, Surgery, Substance abuse, Logistic Models, ROC Curve, El Niño, Female, Cannabis, business, Negroid, Demography
الوصف: The physical and psychological consequences of asthma, a chronic respiratory disease disproportionately affecting black urban adolescents, may be amplified by substance use, yet studies have not assessed rates or predictors of substance use in this at-risk population. Therefore, this study examined rates of substance use and mental health/ asthma-related predictors of use among 110 black urban adolescents with asthma. Participants completed study questionnaires at baseline and 11 to 14 months post baseline. The mean age of the sample was 15.8 (SD +/- 1.85), 66 (60%) were female, and 82 (74%) of the participants had intermittent/mild persistent asthma. At follow-up, 37 (34%) participants endorsed using at least 1 substance in the past 30 days, including cannabis (n = 18 [16%]), cigarettes (n = 13 [12%]), and/or alcohol (n = 23 [21%]). The substance use variables were dichotomized for analyses (1 = use, 0 = nonuse). Logistic regression results indicated that older age (odds ratio [OR], 1.83; p.05) was significantly associated with cigarette use and had a marginally significant (p = .06) association with cannabis use at follow-up. Increased anxiety symptoms were significantly associated with alcohol use (OR, 1.12; p.05) and cannabis use (OR, 0.90; p.05) at follow-up. Targeting adolescents earlier, those with anxiety difficulties, and those who report early substance initiation may improve prevention/intervention efforts for substance use reduction in this population. Asthma-related factors were not significantly associated with substance use. Future studies should assess the relationship between other asthma-related variables, as well as social and community factors, and substance use among black adolescents with asthma.
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المؤلفون: Michael S. Yi, Christina M. Luberto, Sian Cotton, Joel Tsevat
المصدر: Journal of Asthma. 48:531-538
مصطلحات موضوعية: Complementary Therapies, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Clinical variables, Adolescent, Urban Population, Culture, Alternative medicine, Patient characteristics, Logistic regression, Risk Assessment, Severity of Illness Index, Sex Factors, Predictive Value of Tests, Surveys and Questionnaires, Ethnicity, medicine, Humans, Immunology and Allergy, Longitudinal Studies, Ohio, Asthma, Modalities, Symptom management, business.industry, Racial Groups, Age Factors, Patient Acceptance of Health Care, medicine.disease, Logistic Models, Treatment Outcome, Adolescent Behavior, Family medicine, Multivariate Analysis, Pediatrics, Perinatology and Child Health, Female, Patient Participation, business, Attitude to Health, Follow-Up Studies
الوصف: Up to 80% of adolescents with asthma have used complementary and alternative medicine (CAM) for symptom management. However, little is known about patient characteristics associated with CAM factors other than use. Previous studies recommend provider-patient discussion of CAM use, although few adolescents with asthma disclose their CAM use to their providers. To inform clinical interactions, this study examined prevalence and predictors of CAM use, consideration of use, disclosure of use, and perceived efficacy of use, in urban adolescents with asthma.Adolescents with asthma (N = 151) recruited from a children's hospital completed questionnaires addressing demographic and clinical variables and 10 CAM modalities. Response frequencies to four questions assessing CAM use, consideration of use, disclosure, and perceived efficacy were calculated for each modality. Multivariable logistic regression analyses examined characteristics associated with responses to each question for the two most commonly used CAM modalities.Participants' mean age was 15.8 (SD = 1.8), 60% were female and 85% were African-American. Seventy-one percent reported using CAM for symptom management in the past month. Relaxation (64%) and prayer (61%) were the most frequently reported modalities and were perceived to be the most efficacious. Adolescents most commonly reported considering using relaxation (85%) and prayer (80%) for future symptom management. Participants were most likely to disclose their use of yoga (59%) and diet (57%), and least likely to disclose prayer (33%) and guided imagery (36%) to providers. In multivariable analyses, older adolescents (OR = 1.27, p.05) and African-Americans (OR = 2.76, p.05) were more likely to use relaxation. Adolescents with more frequent asthma symptoms (OR = 0.98, p.05) were more likely to use prayer. African-Americans were more likely to report using prayer (OR = 3.47, p.05) and consider using prayer (OR = 7.98, p.01) in the future for symptom management.Many urban adolescents used and would consider using CAM, specifically relaxation and prayer, for asthma symptom management. African-Americans, older adolescents, and those with more frequent symptoms were more likely to use and/or consider using CAM. Providers caring for urban adolescents with asthma should discuss CAM with patients, particularly those identified as likely to use CAM. Future studies should examine relationships between CAM use and health outcomes.
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