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Therapeutic alliance

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https://www.readbyqxmd.com/read/28424542/why-do-psychiatric-patients-stop-antipsychotic-medication-a-systematic-review-of-reasons-for-nonadherence-to-medication-in-patients-with-serious-mental-illness
#1
REVIEW
Dawn I Velligan, Martha Sajatovic, Ainslie Hatch, Pavel Kramata, John P Docherty
BACKGROUND: Antipsychotic medication reduces the severity of serious mental illness (SMI) and improves patient outcomes only when medicines were taken as prescribed. Nonadherence to the treatment of SMI increases the risk of relapse and hospitalization and reduces the quality of life. It is necessary to understand the factors influencing nonadherence to medication in order to identify appropriate interventions. This systematic review assessed the published evidence on modifiable reasons for nonadherence to antipsychotic medication in patients with SMI...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28421880/interactive-dynamics-among-therapist-interventions-therapeutic-alliance-and-metacognition-in-the-early-stages-of-the-psychotherapeutic-process
#2
Francesca Locati, Germano Rossi, Laura Parolin
OBJECTIVE: Several authors have identified a bidirectional link between patient metacognitive functioning and the therapeutic alliance. Specifically, metacognition might be enhanced by a positive alliance with the clinician, whereas metacognitive deficits might impede the alliance. Interestingly, the therapist's technical interventions might influence both therapeutic alliance and metacognitive functioning. However, little is known about the interactions between these dimensions. The aim of the present study is to explore these interactions more fully in the earliest phase of the therapeutic process...
April 19, 2017: Psychotherapy Research: Journal of the Society for Psychotherapy Research
https://www.readbyqxmd.com/read/28418507/use-of-bayesian-decision-analysis-to-minimize-harm-in-patient-centered-randomized-clinical-trials-in-oncology
#3
Vahid Montazerhodjat, Shomesh E Chaudhuri, Daniel J Sargent, Andrew W Lo
Importance: Randomized clinical trials (RCTs) currently apply the same statistical threshold of alpha = 2.5% for controlling for false-positive results or type 1 error, regardless of the burden of disease or patient preferences. Is there an objective and systematic framework for designing RCTs that incorporates these considerations on a case-by-case basis? Objective: To apply Bayesian decision analysis (BDA) to cancer therapeutics to choose an alpha and sample size that minimize the potential harm to current and future patients under both null and alternative hypotheses...
April 13, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28416023/the-new-childhood-arthritis-and-rheumatology-research-alliance-carra-registry-design-rationale-and-characteristics-of-patients-enrolled-in-the-first-12%C3%A2-months
#4
Timothy Beukelman, Yukiko Kimura, Norman T Ilowite, Kelly Mieszkalski, Marc D Natter, Grendel Burrell, Brian Best, Jason Jones, Laura E Schanberg
BACKGROUND: Herein we describe the history, design, and rationale of the new Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and present the characteristics of patients with juvenile idiopathic arthritis (JIA) enrolled in the first 12 months of operation. METHODS: The CARRA Registry began prospectively collecting data in the United States and Canada in July 2015 to evaluate the safety of therapeutic agents in persons with childhood-onset rheumatic disease, initially restricted to JIA...
April 17, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28413219/contemporary-biopsychosocial-exercise-prescription-for-chronic-low-back-pain-questioning-core-stability-programs-and-considering-context
#5
Peter Stilwell, Katherine Harman
This commentary explores the importance of considering the biopsychosocial model and contextual factors when prescribing exercise. Diverse exercise programs for patients with chronic low back pain (CLBP) produce similar outcomes, without one specific exercise protocol demonstrating clear superiority. One clear barrier to positive outcomes is poor exercise adherence. We suggest that there are certain common contextual factors present in all exercise prescription scenarios that may impact adherence and health-related outcomes...
March 2017: Journal of the Canadian Chiropractic Association
https://www.readbyqxmd.com/read/28411772/psychocutaneous-disease-pharmacotherapy-and-psychotherapy
#6
REVIEW
Helena Kuhn, Constance Mennella, Michelle Magid, Caroline Stamu-O'Brien, George Kroumpouzos
Building a strong therapeutic alliance with the patient is of utmost importance in the management of psychocutaneous disease. Optimal management of psychocutaneous disease includes both pharmacotherapy and psychotherapy. This article reviews psychotropic medications currently used for psychocutaneous disease, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics, with a discussion of relevant dosing regimens and adverse effects. Pruritus management is addressed. In addition, basic and complex forms of psychotherapy, such as cognitive-behavioral therapy and habit-reversal training, are described...
May 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28411327/racial-differences-in-mental-health-recovery-among-veterans-with-serious-mental-illness
#7
Mana K Ali, Samantha M Hack, Clayton H Brown, Deborah Medoff, Lijuan Fang, Elizabeth A Klingaman, Stephanie G Park, Lisa B Dixon, Julie A Kreyenbuhl
Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner...
April 14, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28406727/the-experience-of-patients-with-alcohol-misuse-after-surviving-a-critical-illness-a-qualitative-study
#8
Brendan J Clark, Jacqueline Jones, K Diandra Reed, Rachel Marie Hodapp, Ivor S Douglas, David Van Pelt, Ellen L Burnham, Marc Moss
RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28397700/narcotic-bowel-syndrome
#9
REVIEW
Adam D Farmer, Jayne Gallagher, Caroline Bruckner-Holt, Qasim Aziz
Narcotic bowel syndrome is characterised by worsening abdominal pain in the context of escalating or continuous opioid therapy. Although narcotic bowel syndrome is rarely diagnosed, given the current epidemic of opioid use, it is likely to be under-recognised. The underlying pathophysiological mechanisms of narcotic bowel syndrome are incompletely understood; however, opioid-induced hyperalgesia is likely to be a central facet. The putative mechanisms of hyperalgesia include activation of bimodal opioid regulatory systems, counter-regulatory mechanisms, neuroinflammation, opioid facilitation, and interactions of the N-methyl D-aspartate receptor with opioids at the level of the spinal cord...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28382545/identifying-the-determinants-of-perceived-quality-in-outpatient-child-and-adolescent-mental-health-services-from-the-perspectives-of-parents-and-patients
#10
Carole Kapp, Thomas Perlini, Tiffanie Jeanneret, Philippe Stéphan, Alejandro Rojas-Urrego, Manuel Macias, Olivier Halfon, Laurent Holzer, Sébastien Urben
This cross-sectional survey adopting a multiple-informant perspective explores the factors that influence perceived quality (i.e., therapeutic alliance and satisfaction) in an outpatient setting within child and adolescent mental health services (CAMHS). A total of 1433 participants (parents, n = 770, and patients, n = 663) attending or having attended (drop-out) outpatient units participated in the study. The outcome measures were satisfaction (Client Satisfaction Questionnaire) and the therapeutic alliance (Helping Alliance Questionnaire)...
April 5, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/28376219/intrinsic-subtype-and-therapeutic-response-among-her2-positive-breast-tumors-from-the-ncctg-alliance-n9831-trial
#11
Edith A Perez, Karla V Ballman, Afshin Mashadi-Hossein, Kathleen S Tenner, Jennifer M Kachergus, Nadine Norton, Brian M Necela, Jennifer M Carr, Sean Ferree, Charles M Perou, Frederick Baehner, Maggie Chon U Cheang, E Aubrey Thompson
Background: Genomic data from human epidermal growth factor receptor 2-positive (HER2+) tumors were analyzed to assess the association between intrinsic subtype and clinical outcome in a large, well-annotated patient cohort. Methods: Samples from the NCCTG (Alliance) N9831 trial were analyzed using the Prosigna algorithm on the NanoString platform to define intrinsic subtype, risk of recurrence scores, and risk categories for 1392 HER2+ tumors. Subtypes were evaluated for recurrence-free survival (RFS) using Kaplan-Meier and Cox model analysis following adjuvant chemotherapy (n = 484) or chemotherapy plus trastuzumab (n = 908)...
February 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28371947/-from-technical-terminology-to-prejudicial-plattitudes-a-cognitive-analysis-of-jargon-in-psychiatric-institutions
#12
Daniel Nischk, Philippe Merz
Within psychiatric institutions it is common to label psychiatric patients with a broad array of technical terms from different domains. However, through their nonreflective usage technical terms gradually become "fuzzy" in content, enriched with normative evaluations and finally reificated as "real" entities. This evolvement of meaning may foster a schematic and biased understanding of mental patients, threaten the validity of psychiatric diagnoses and negatively influence the therapeutic process. Becoming familiar with the underlying cognitive mechanisms, frequent supervision and the provision of context factors that permit the development of a close therapeutic alliance can help to alleviate these potential dangers to efficient psychiatric therapy...
April 3, 2017: Psychiatrische Praxis
https://www.readbyqxmd.com/read/28363798/how-to-unveil-chronic-respiratory-diseases-in-clinical-practice-a-model-of-alliance-between-general-practitioners-and-pulmonologists
#13
Alida Benfante, Riccardo Messina, Vito Milazzo, Nicola Scichilone
INTRODUCTION: Asthma and COPD are under-diagnosed and undertreated in adult populations, mainly due to the discrepancy between guideline recommendations and clinicians' practices. One of the reasons of this discrepancy is the difficulty encountered in real life in sharing the management of chronic respiratory diseases between general practitioners (GPs) and respiratory physicians. METHODS: An explorative, population-based investigation was performed to test whether, and to what extent, an active collaboration between GPs and pulmonologists increases the diagnosis and proper treatment of chronic obstructive airway diseases...
March 28, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28361730/safeguarding-confidentiality-in-electronic-health-records
#14
Akhil Shenoy, Jacob M Appel
Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health...
April 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28358755/patients-knowledge-and-attitudes-towards-regular-alcohol-urine-screening-a-survey-study
#15
Pablo Barrio, Lídia Teixidor, Lluisa Ortega, Mercè Balcells, Eduard Vieta, Antoni Gual
BACKGROUND: Despite its wide implementation, there is a paucity of data supporting the effectiveness of regular alcohol urine screening (RAUS) in maintaining abstinence. This study aims at investigating if RAUS serves other purposes, what attitudes patients display towards it, and patients' technical knowledge about basic screening notions. METHOD: We conducted a cross-sectional survey among adults with alcohol dependence, attending outpatient alcohol-dependence treatment...
March 29, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28345940/early-development-of-mechanisms-of-change-as-a-predictor-of-subsequent-change-and-treatment-outcome-the-case-of-working-alliance
#16
Sigal Zilcha-Mano, Paula Errázuriz
OBJECTIVE: Advanced statistical tools have created the opportunity to systematically examine the effect of early trajectories in predictors of therapeutic change, such as early alliance development patterns, on outcome. To date, however, these methods have been used almost exclusively to examine the effect of the development of early symptoms on later ones. Development patterns of alliance early in treatment, and their association with treatment outcome, have received much theoretical attention, but few systematic examinations have been conducted so far...
May 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/28339847/telephone-delivered-exercise-advice-and-behavior-change-support-by-physical-therapists-for-people-with-knee-osteoarthritis-protocol-for-the-telecare-randomized-controlled-trial
#17
Rana S Hinman, Belinda J Lawford, Penny K Campbell, Andrew M Briggs, Janette Gale, Caroline Bills, Simon D French, Jessica Kasza, Andrew Forbes, Anthony Harris, Stephen J Bunker, Clare M Delany, Kim L Bennell
Background.: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. Objective.: Determine the effectiveness of incorporating exercise advice and behaviour change support by physical therapists into an existing Australian nurse-led musculoskeletal telephone service for adults with knee OA. Design.: Randomized controlled trial with nested qualitative studies...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339563/trauma-informed-social-work-practice
#18
Jill Levenson
Social workers frequently encounter clients with a history of trauma. Trauma-informed care is a way of providing services by which social workers recognize the prevalence of early adversity in the lives of clients, view presenting problems as symptoms of maladaptive coping, and understand how early trauma shapes a client's fundamental beliefs about the world and affects his or her psychosocial functioning across the life span. Trauma-informed social work incorporates core principles of safety, trust, collaboration, choice, and empowerment and delivers services in a manner that avoids inadvertently repeating unhealthy interpersonal dynamics in the helping relationship...
April 1, 2017: Social Work
https://www.readbyqxmd.com/read/28338498/challenge-of-progressive-multiple-sclerosis-therapy
#19
Alan J Thompson
PURPOSE OF REVIEW: Understanding the mechanisms underlying progression in multiple sclerosis (MS) and identifying appropriate therapeutic targets is a key challenge facing the MS community. This challenge has been championed internationally by organizations such as the Progressive MS Alliance, which has raised the profile of progressive MS and identified the key obstacles to treatment. This review will outline the considerable progress against these challenges. RECENT FINDINGS: New insights into mechanisms underlying progression have opened up potential therapeutic opportunities...
June 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28330702/-exploratory-population-study-of-overweight-and-obese-subjects-perceptions-searching-for-improved-management-practices
#20
C Crutze, B Pétré, N Dardenne, A-F Donneau, S Streel, A Albert, A Scheen, E Husson, M Guillaume
BACKGROUND: Overweight and obesity are major public health problems of growing concern. Few studies have investigated the representations and perceptions of subjects with overweight and obesity, especially in the general population, as compared to people in a medical weight loss process. The objective of this study was to fill this gap by enabling participants to express their feelings and experience about their overweight, and to assess the extent of the body mass index (BMI) as a determinant of these perceptions...
March 19, 2017: Revue D'épidémiologie et de Santé Publique
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