30^th International Conference on Psychiatry and Mental Health August 14-15, 2019 Tokyo, Japan

Biography:

Lynnette Lyzwinski is pursuing her PhD in Medicine at the School of Medicine at University of Queensland in the Department of Psychiatry and the Centre for Online Health. Her research interests include clinical trials and health promotions behaviors for promoting mental well-being and reducing lifestyle behavioral risk factors. She has special interests in mHealth, mindfulness and lifestyle medicine.

Abstract:

Background: University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight related behaviors due to stress. Mindfulness holds promise for weight management. However, there has not been a previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight related behavior’s and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based mindfulness-based stress reduction and mindful eating techniques that were tailored to university students, with student relevant themes for targeting weight behavior’s, weigh and stress.

Method: A two arm Randomized Controlled Trial (RCT) of 11 weeks duration was undertaken at the University of Queensland. Students were randomized to the mindfulness app (N=45) or to a behavioral self-monitoring electronic diary (e-diary) (N=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, mindful eating, physical activity and eating behaviors between both groups.

Results: Neither the mindfulness app group nor the e-diary group lost weight nor there were no differences between groups at follow-up. The mindfulness app group had significantly lower stress levels (adherers only), lower emotional eating and uncontrolled eating as well as higher mindfulness and mindful eating levels overall (p-values<0.05). The e-diary group had Higher Metabolic Equivalents (MET) of moderate activity levels (p-value<0.05). However, the effect sizes were small. Regular adherence to the mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. The most helpful reported meditation was the short breathing exercise observing the breath (39.5% preferred it) compared with other exercises.

Conclusion: A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness as well as mindful eating but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance.

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Erika Berggren is currently working as a Health Care Development Leader at the Academic Primary Health Care Centre, Stockholm County Council and affiliated with Karolinska Institute's Department of Neurobiology, Care Sciences and Society.

Abstract:

Primary health care professionals can find it difficult to participate in continuing education despite their need for up-to-date knowledge. Suitable models for addressing this problem are rare. Th is study aimed to evaluate a continuing educational model tailored for primary health care circumstances (ConPrim). Th e model considers the need for inter-professional education to facilitate teamwork; pedagogical theory and methods to achieve a deeper level of understanding; and content adapted to the circumstances of primary health care to help fi ll knowledge gaps and make attendance more attractive. ConPrim consists of three steps that build on each other: a web-based program, a practical exercise, and a case seminar. Th is study tested ConPrim by using it to develop and evaluate an intervention in the subject “Nutritional care of patients cared for at home.” District nurses/registered nurses and general practitioners/physicians (n=87) working with home care at 10 primary health care centers in Stockholm, Sweden, completed a post-intervention questionnaire about the model. Th e professionals found the design attractive and user-friendly and the pedagogical methods to promote inter-professional and interactive learning. They rated the time spent as acceptable for all parts except the practical exercise; found the design suitable to primary health care; and thought the intervention increased their knowledge about a subject they viewed as useful and relevant to their work. ConPrim seems well-suited for continuing inter-professional education in primary health care. Future studies could test the model in other subject areas where there is a gap between evidence-based knowledge and practice.

Biography:

Young-Cho Koh is a Neurosurgeon at Konkuk University Hospital, South Korea

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Lena Lund has completed PhD in Medical Science from Karolinska Institute in 2015. She is currently working as a Head of the Lifestyle Unit at the Academic Primary Health Care Centre in Stockholm.

Abstract:

Chronic Obstructive Pulmonary Disease (COPD) is mostly caused by smoking and patients’ prognoses are related to whether or not they continue to smoke aft er diagnosis. Quitting is therefore crucial to COPD treatment, but many patients find it difficult to stop smoking. To investigate which factors infl uence quit attempts among patients with COPD, our research group interviewed smokers with COPD to identify factors associated with success in quitting. Th ese factors were used to develop the Trying to quit smoking Questionnaire (TTQ), which measures pressure-fi lled mental states, use of destructive pressure-relief strategies and ambivalent thoughts about quitting. Th is study evaluated whether the TTQ could predict smoking cessation outcomes in smokers with COPD. One hundred and nine smokers completed the TTQ at baseline and three months later. Logistic regression was used to measure the association between TTQ scores and making at least one quit attempt, reducing the intensity of smoking, and achieving abstinence. Higher total TTQ scores were signifi cantly associated with a lower probability of at least one quit attempt. In a secondary analysis, we found that patients who were ready to make a quit attempt but also experienced pressure-fi lled mental states had a lower probability of attempting to quit. However, patients who did not feel ready to quit and who simultaneously experienced pressure-fi lled mental states halved the number of cigarettes they smoked. The TTQ can identify specifi c mental processes related to success in quitting and can be useful when counselling patients with COPD who need to quit smoking.

Biography:

Liisa Samuelsson has completed her MSc in Medical Science at Karolinska Institute in 2017. She works as a Health Care Development Leader in the field of nutritional care, developing and providing continuing professional education for primary health care personnel in Stockholm County.

Abstract:

In 2011, the Stockholm County Council gave District Nurses (DNs) the right to prescribe Oral Nutritional Supplements (ONS). DNs are registered nurses who have completed an additional year of specialist education in primary care. Th e council charged the academic primary health care center with developing a course that would give DNs the knowledge they needed and the right to prescribe ONS. A group at the center used the Structure of the Observed Learning Outcome (SOLO) taxonomy to design a two-and-a-half-day course that covers identifying and analyzing older patients’ nutritional problems, planning and carrying out nursing care measures, prescribing ONS and following up and evaluating the measures. Th is questionnaire study evaluated participants’ perceived nutritional care and actual level of knowledge about nutritional care before and after the course. A total of 493 district nurses in Stockholm County participated in the course, which was given over a period of two to three months. Before and aft er the intervention, participants completed a study-specifi c questionnaire that covered their perceived nutritional care and actual level of knowledge. Th ere were signifi cant improvements in participants work with nutrition care and in their knowledge of all subject areas covered aft er the course (p=0.000-0.014). However, all participants did not fully achieve all learning objectives. DNs’ improvements as a result of the intervention lay the foundation for good nutritional care for older patients in primary care. Th e results have been used to improve the course, and an assessment of the revised course is ongoing.