Showing papers by "Souraya Sidani published in 2020"

Evaluating the impact of onsite diabetes education teams in primary care on clinical outcomes

Abstract: To evaluate the impact of integrating diabetes education teams in primary care on glycemic control, lipid, and blood-pressure management in type 2 diabetes patients. A historical cohort design was used to assess the integration of teams comprising nurse and dietitian educators in 11 Ontario primary-care sites, which delivered individualized self-management education. Of the 771 adult patients with A1C ≥ 7% recruited, 487 patients attended appointments with the diabetes teams, while the remaining 284 patients did not. The intervention’s primary goal was to increase the proportion of patients with A1C ≤7%. Secondary goals were to reduce mean A1C, low-density lipoprotein, total cholesterol-high density lipoprotein, and diastolic and systolic blood pressure, as recommended by clinical-practice guidelines. After 12 months, a higher proportion of intervention-group patients reached the target for A1C, compared with the control group. Mean A1C levels fell significantly among all patients, but the mean reduction was larger for the intervention group than the control group. Although more intervention-group patients reached targets for all clinical outcomes, the between-group differences were not statistically significant, except for A1C. Nurse and dietitian diabetes-education teams can have a clinically meaningful impact on patients’ ability to meet recommended A1C targets. Given the study’s historical cohort design, results are generalizable and applicable to day-to-day primary-care practice. Longer follow-up studies are needed to investigate whether the positive outcomes of the intervention are sustainable.

Menopausal transition experiences and management strategies of Chinese immigrant women: a scoping review.

Abstract: Importance and objective Chinese immigrants are among some of the fastest growing groups in many Western countries, and experience challenges such as language barriers, education gaps, and gender discrimination, which highlights the need for special attention and consideration in Western health care. The purpose of this scoping review is to summarize existing research on the menopausal experiences of Chinese immigrant women (CIW). Methods This scoping review was written in accordance with PRISMA guidelines. MEDLINE, PsycINFO, CINAHL, AgeLine, ERIC, ProQuest, Nursing and Allied Health Database, PsycARTICLES, Sociology Database, and Education Research Complete were utilized for the literature search. Articles were included if they examined CIW experiencing menopausal transition. A total of 18 studies were included for review. Discussion and conclusion Findings suggested that CIW experienced a variety of physical symptoms, including muscle and joint pain, urogenital symptoms, vasomotor symptoms, weight gain, decreased physical strength, vision changes, and skin changes. Muscle and joint pain were particularly prevalent and emphasized. CIW also experienced psycho-behavioral symptoms including emotional changes, depression, memory loss, and sexual dysfunction. However, they had a decreased concern regarding symptoms of sexual dysfunction and decreased libido when compared with women from Western cultures. CIW interpreted menopause as a natural aging process involving the next step in life. Cultural expectations of stoicism and silence may cause immigrant women to be less vocal about their menopause experiences and result in feelings of loneliness. Acculturation may be both a facilitator and a barrier to a healthy menopausal transition. CIW were resistant to Western Medicine management such as hormone therapy but were willing to incorporate traditional medicine into their health care. They believed that a healthy mentality was important and used various psychocognitive strategies to maintain a good quality of life. Healthcare providers, researchers, and policymakers need to consider the unique characteristics of CIW's menopausal transition in research, intervention innovation, and practice.

Acceptability of personal contact interventions to address loneliness for people with dementia: An exploratory mixed methods study

Abstract: Background Personal contact interventions involve routine visits with a person or animal to address loneliness. Research supports the promise of these interventions to address loneliness among cognitively intact older adults, but little is known about their use with people with dementia. Objective To assess the acceptability of personal contact interventions for use to address loneliness with older people with dementia, according to formal and informal care providers. Design Cross-sectional, mixed methods complementarity design. Setting Ontario, Canada Participants A purposive sample of 25 family members, friends, and health care providers of people with dementia. Methods Participants attended a face-to-face interview to discuss the acceptability of personal contact interventions. Participants completed questionnaires to rate acceptability (adapted Treatment Perception and Preference measure). A semi-structured interview followed to discuss the ratings and features of personal contact (with another person or animal) in more detail. The analysis involved descriptive statistics (quantitative data) and conventional content analysis (qualitative data). During the interpretation of the results, the qualitative findings were compared to the quantitative results to provide context and understand participants’ perceptions of intervention acceptability in more depth; these are presented together in the results to demonstrate their distinct and complementary contributions to the findings. Results Personal contact with a person or animal was rated as effective, logical, suitable, and low risk to address loneliness by over 80% of participants. Participants’ willingness to engage in this type of contact, for example as a visitor or as a facilitator of animal contact, was 72%. Participants emphasized the benefits of personal contact. The findings highlight that individualized, flexible interventions that include appropriate facilitation are needed. Conclusions Future studies to develop and test personal contact interventions should involve flexible delivery, assess the feasibility and acceptability of these interventions (as in a Phase 2 trial of a complex intervention), and focus on the experiences of people with dementia. Tweetable Abstract: Tailored, routine, and facilitated contact with a person or animal shows promise to address loneliness for people with dementia. What is already known about this topic: • Loneliness is emotionally painful and harms the health and quality of life of those that experience it. • Personal contact interventions refer to routine visits with another person or animal and have been found effective in addressing loneliness among cognitively intact older adults. What this paper adds: • Friends, family members and health care providers of people with dementia view personal contact interventions as logical, suitable and effective to address loneliness of older adults with dementia. • Personal contact interventions are not always easy to implement and do not automatically promote meaningful connection and prevent loneliness for people with dementia. • Strategies to tailor and facilitate personal contact interventions are needed to promote their effectiveness when used with people with dementia.

Identifying evidence informed psychological interventions during the COVID-19 pandemic: Rapid review of the literature

Abstract: •Less than a quarter of psychological interventions are developed based on evidence.•Evaluation of the effectiveness of existing online mental health resources is required.•Front-line healthcare providers experienced severe mental distress during COVID-19.

The Role of Treatment Perceptions in Intervention Evaluation: A Review

Abstract: Introduction: With the emphasis on patient-centeredness, the interest in examining people’s perceptions of health interventions has resurged. Mounting evidence suggests that people’s perceptions play an important role in their pursuit and use of interventions in the practice and research contexts. In research, participants’ perceptions of the treatments under evaluation affect their behaviors reflected in enrollment, attrition, and treatment implementation (i.e., engagement and enactment by participants), all of which contribute to outcomes. Objectives: The objectives of this review are to generate a common understanding of treatment perceptions and to increase awareness of their role in intervention evaluation trials. Method: A literature review was conducted of conceptual and empirical articles that examined the contribution of participants’ perceptions of treatment to enrollment, attrition, as well as treatment implementation and outcome achievement in intervention evaluation studies. Results: In this paper, we clarify the conceptualization and operationalization of four types of perceptions: acceptability, preferences, credibility and expectancy. We also describe the way in which these perceptions influence participants’ behaviors (i.e., mechanism of action), and we summarize relevant empirical evidence. Implications and conclusion: Researchers are encouraged to account for participants’ perceptions in making inferences about interventions’ effectiveness or lack thereof.

Recreational Cannabis Usage Among Young Adults Living with Diabetes: Protocol for a Mixed Methods Study

Abstract: Canada is the second country in the world to legalize recreational cannabis (marijuana). Young adults are the highest users of cannabis. Recreational cannabis use may increase anxiety, depression, breathing problems, and weight in young adults in general and further result in poor control of sugar levels, increased consumption of carbohydrates, and poor self-management in young adults living with diabetes. There is limited research on the influence of recreational cannabis usage on young adults living with diabetes. To explore the frequency of recreational cannabis usage, self-management behaviors and experiences of cannabis-related adverse events, to identify the factors encouraging recreational cannabis usage, and to determine the influence of recreational cannabis usage on self-reported health among young adults living with diabetes. A sequential explanatory mixed method design will be used. The first phase will be a cross-sectional online survey in which quantitative data will be collected on the demographic and health/clinical characteristics, cannabis use patterns, and diabetes self-management of young adults living with diabetes who use cannabis. The second phase will involve the collection of qualitative data through telephone, semi-structured, one-on-one interviews. Potential participants will be recruited through study flyers, posters, and clinicians from two outpatient diabetes clinics in the province of Ontario, Canada. The findings from this study may provide useful information regarding the effects of recreational cannabis consumption on young adults living with diabetes. This, in turn, may provide guidance to healthcare providers on how to counsel, assist, educate, and support diabetes-related management through strategies and interventions for this patient population, contributing to patient health and safety.