2 results
Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis
- Shane O'Donnell, Etain Quigley, John Hayden, Dimitrios Adamis, Blánaid Gavin, Fiona McNicholas
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- Journal:
- BJPsych Open / Volume 9 / Issue 2 / March 2023
- Published online by Cambridge University Press:
- 06 March 2023, e49
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- Article
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Background
Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists.
AimsTo examine the work-related experiences and psychosocial needs of consultant psychiatrists situated in the Republic of Ireland arising from the COVID-19 response.
MethodWe interviewed 18 consultant psychiatrists and analysed data using inductive thematic analysis.
ResultsWork-related experience of participants was characterised by increased workload associated with assumption of guardianship of physical and mental health of vulnerable patients. Unintended consequences of public health restrictions increased case complexity, limited availability of alternative supports and hindered the practice of psychiatry, including inhibiting peer support systems for psychiatrists. Participants perceived available psychological supports as generally unsuitable for their needs given their specialty. Long-standing under-resourcing, mistrust in management and high levels of burnout exacerbated the psychological burden of the COVID-19 response.
ConclusionsThe challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists – as well as the pandemic preparedness of healthcare systems – is contingent on implementation of policies addressing long-standing under-investment in the services vulnerable populations rely on, not least community mental health services.
Mobile health (mHealth) applications with children in treatment for obesity: A randomised feasibility study
- Sarah Browne, Gerardine Doyle, Tahar Kechadi, Shane O'Donnell, James O'Connor, Louise Tully, Mckenzie Dow, Grace O'Malley
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E394
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Introduction
Smartphone mHealth apps can help children with obesity modify their rate of eating(1) and monitor physical activity(2). However, owing to issues with adherence, mHealth interventions require rigorous feasibility testing(3).
AimTo evaluate, using a randomised design, the feasibility and acceptability of a mHealth intervention to reduce rate of eating and track physical activity among children in treatment for obesity.
MethodsChildren (9–16 years) with obesity (BMI ≥ 98th centile) were recruited at a tertiary healthcare centre. The Research Ethics Committee at Temple St. Children's University Hospital granted ethical approval. Upon completing informed consent and assent, participants completed 2-week baseline testing including anthropometry, rate of eating by Mandometer® and physical activity using myBigO app. Thereafter participants were randomised to:(1)Treatment: Usual clinical care + Mandometer® training or (2)Control: Usual clinical care. Gender and age (9.0–12.9 years and 13.0–16.9 years) stratifications were applied. After a 4-week treatment period, participants repeated the 2-week testing period. Feasibility measures included fidelity with planned recruitment, randomisation, and intervention delivery and attrition. Acceptability measures included objective clinical portal engagement data and feedback from participants.
ResultsOf 20 recruited, eight were randomised to intervention and 12 to control, with no significant age, gender or BMI SDS differences between groups. At baseline, 7 intervention (87.5%) and 8 control (66.7%) participants recorded rate of eating. Eighteen participants (90%) registered with myBigO app, with 16 recording data successfully. Two had smartphones incompatible with myBigO (n = 1 intervention;n = 1 control) and two did not engage with myBigO app (n = 1 intervention;n = 1 control). Among 4 participants who completed Mandometer® intervention, dose received ranged from 7%-92% of planned meals. 37.5% intervention and 58.3% control participants completed post-intervention measures. Attrition was higher in the intervention (n = 5;62.5%) than control (n = 3;25%) group. Reasons cited for withdrawing included loss of interest (n = 3 intervention), child felt overwhelmed or self-conscious (n = 2 control), lack of time (n = 1 intervention), behavioural issue with child (n = 1 control), and family illness (n = 1 intervention). No significant age, gender or BMI SDS differences were observed between non-completers and completers. Participant engagement and feedback indicated mixed acceptability among this cohort.
ConclusionBased on results, the current protocol for study design and intervention should be improved, if engagement is to be maximised.
The study is part of EU H2020 BigO Study (Big Data Against Childhood Obesity, Grant No. 727688.https://bigoprogram.eu/).