National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 71 of 71 Research Studies DisplayedRamchand R, Ayer L, Kotzias V
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
The researchers used a qualitative approach to gain insight about the concerns and nature of comments regarding suicidal ideation and intent among women veterans calling the Veterans Crisis Line (VCL). Interviewing 54 VCL call responders, the authors concluded that efforts to prevent and treat the consequences of military sexual trauma; to recognize, prevent, and treat non-suicidal self-harm; and to restrict access to lethal means most commonly reported among women veteran callers may be helpful to mitigate suicide risk in this vulnerable group of veterans.
AHRQ-funded; HS000029.
Citation: Ramchand R, Ayer L, Kotzias V .
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
Womens Health Issues 2016 Nov - Dec;26(6):667-73. doi: 10.1016/j.whi.2016.07.005.
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Keywords: Behavioral Health, Prevention, Stress, Women
Sumner JA, Khodneva Y, Muntner P
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, the authors examined associations among depressive symptoms and stress, alone and in combination, and incident cardiovascular disease (CVD) and all-cause mortality as a function of socioeconomic status. They found that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
AHRQ-funded; HS023009.
Citation: Sumner JA, Khodneva Y, Muntner P .
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
J Am Heart Assoc 2016 Oct 10;5(10). doi: 10.1161/jaha.116.003930.
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Keywords: Cardiovascular Conditions, Depression, Social Determinants of Health, Stress, Stroke
Garfield CF, Simon CD, Rutsohn J
Paternal and maternal testosterone in parents of NICU infants transitioning home.
This study examined testosterone levels for parents of very low-birth-weight infants, including links between salivary testosterone and infant factors (such as breast-feeding), psychosocial stress, and changes over time. Using multilevel modeling approaches, the researchers reported significant associations between paternal testosterone by time and psychosocial adjustment and between both paternal and maternal testosterone and infant feeding mode.
AHRQ-funded; R21 HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Paternal and maternal testosterone in parents of NICU infants transitioning home.
J Perinat Neonatal Nurs 2016 Oct/Dec;30(4):349-58. doi: 10.1097/jpn.0000000000000218.
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Keywords: Newborns/Infants, Stress, Caregiving, Hospital Discharge
Senders A, Sando K, Wahbeh H
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis.
AHRQ-funded; HS017582.
Citation: Senders A, Sando K, Wahbeh H .
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
J Health Psychol 2016 Aug;21(8):1676-87. doi: 10.1177/1359105314562084.
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Keywords: Care Management, Neurological Disorders, Ambulatory Care and Surgery, Stress
Witt WP, Mandell KC, Wisk LE
Infant birthweight in the US: the role of preconception stressful life events and substance use.
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. It concluded that PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Infant birthweight in the US: the role of preconception stressful life events and substance use.
Arch Womens Ment Health 2016 Jun;19(3):529-42. doi: 10.1007/s00737-015-0595-z.
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Keywords: Newborns/Infants, Pregnancy, Stress, Substance Abuse, Women
Kaplan RM, Milstein A
AHRQ Author: Kaplan RM
Financial strain and cancer outcomes.
This editorial discusses an article by Lathan et al. in the same issue that documents the strong associations between socioeconomic status and longevity. The editorial argues that many of the variables in that article are measured with error and, as a result, the multivariable analysis resulted in only partial adjustment. Two variables of particular importance, education and ethnicity, are discussed.
AHRQ-authored.
Citation: Kaplan RM, Milstein A .
Financial strain and cancer outcomes.
J Clin Oncol 2016 May 20;34(15):1711-2. doi: 10.1200/jco.2016.66.8079.
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Keywords: Cancer, Health Status, Healthcare Costs, Low-Income, Outcomes, Social Determinants of Health, Stress
Rhoten BA
Body image disturbance in adults treated for cancer - a concept analysis.
The author analyzed the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. Rhoten used Walker and Avant's 8-step method of concept analysis and concluded that a better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and will assist nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Body image disturbance in adults treated for cancer - a concept analysis.
J Adv Nurs 2016 May;72(5):1001-11. doi: 10.1111/jan.12892.
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Keywords: Behavioral Health, Cancer, Stress
Mathur MB, Epel E, Kind S
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
The researchers conducted a systematic review and meta-analysis to determine the association between self-reported, perceived psychological stress (PS) and telomere length (TL). They found that increased PS was associated with a very small decrease in TL and that this relationship was similar between sexes. They concluded that the association may be stronger with known major stressors and is similar in magnitude to that noted between obesity and TL. The authors recommended that futre research assess for potential confounders and use longitudinal, multidimensional models of stress.
AHRQ-funded; HS019816.
Citation: Mathur MB, Epel E, Kind S .
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
Brain Behav Immun 2016 May;54:158-69. doi: 10.1016/j.bbi.2016.02.002.
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Keywords: Evidence-Based Practice, Genetics, Stress
Rocque GB, Taylor RA, Acemgil A
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
This study assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. It concluded that lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
AHRQ-funded; HS013852.
Citation: Rocque GB, Taylor RA, Acemgil A .
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
J Natl Compr Canc Netw 2016 Apr;14(4):407-14.
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Keywords: Elderly, Cancer, Tools & Toolkits, Stress, Behavioral Health
Heberlein EC, Picklesimer AH, Billings DL
The comparative effects of group prenatal care on psychosocial outcomes.
This study compared the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care. It used a prospective cohort study of women who chose CP group or individual prenatal care. Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 percent greater increase in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 percent greater decrease in postpartum depressive symptom scores.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Picklesimer AH, Billings DL .
The comparative effects of group prenatal care on psychosocial outcomes.
Arch Womens Ment Health 2016 Apr;19(2):259-69. doi: 10.1007/s00737-015-0564-6.
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Keywords: Pregnancy, Stress, Depression, Outcomes
Edrees H, Brock DM, Wu AW
The experiences of risk managers in providing emotional support for health care workers after adverse events.
The authors surveyed members of the American Society for Health Care Risk Management (ASHRM) about their training, experience, competence, and comfort with providing emotional support to health care workers. Risk managers who were comfortable listening to and supporting health care workers were more likely to report prior training. Most respondents expressed a preference to receive additional training.
AHRQ-funded; HS019531.
Citation: Edrees H, Brock DM, Wu AW .
The experiences of risk managers in providing emotional support for health care workers after adverse events.
J Healthc Risk Manag 2016 Apr;35(4):14-21. doi: 10.1002/jhrm.21219.
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Keywords: Adverse Events, Medical Errors, Stress, Patient Safety
Abdelrahman AM, Bingener J, Yu D
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
The goal of this study was to compare surgeon stress and workload between single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC). It concluded that surgeon heart rate, salivary cortisol level, instrument usability, and Surg-TLX ratings indicate that SILC is significantly more stressful and physically demanding than the CLC.
AHRQ-funded; HS023146.
Citation: Abdelrahman AM, Bingener J, Yu D .
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
Surg Endosc 2016 Mar;30(3):1205-11. doi: 10.1007/s00464-015-4332-5.
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Keywords: Provider, Provider: Physician, Stress, Surgery
Sawchuk CN, Roy-Byrne P, Noonan C
The association of panic disorder, posttraumatic stress disorder, and major depression with smoking in American Indians.
This survey asked whether lifetime panic disorder, posttraumatic stress disorder, and major depression were related to lifetime cigarette smoking in two geographically distinct American Indian tribes. It found that the odds of smoking were two times higher in Southwest participants with panic disorder and major depression, and 1.7 times higher in those with posttraumatic stress disorder, after controlling for sociodemographic variables.
AHRQ-funded; HS010854.
Citation: Sawchuk CN, Roy-Byrne P, Noonan C .
The association of panic disorder, posttraumatic stress disorder, and major depression with smoking in American Indians.
Nicotine Tob Res 2016 Mar;18(3):259-66. doi: 10.1093/ntr/ntv071.
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Keywords: Depression, Tobacco Use, Racial and Ethnic Minorities, Stress
Johnson TJ, Hickey RW, Switzer GE
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
The researchers sought to determine if physicians have different levels of implicit racial bias post-ED shift versus preshift and to examine associations between demographics and cognitive stressors (e.g., fatigue, stress, time pressure, and complex decision-making) with bias. They concluded that resident implicit bias remained stable overall preshift to postshift, cognitive stressors (overcrowding and patient load) were associated with increased implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Hickey RW, Switzer GE .
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
Acad Emerg Med 2016 Mar;23(3):297-305. doi: 10.1111/acem.12901.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Stress, Provider: Health Personnel
Cummings DM, Kirian K, Howard G
Consequences of comorbidity of elevated stress and/or depressive symptoms and incident cardiovascular outcomes in diabetes: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
The authors evaluated the impact of comorbid depressive symptoms and/or stress on adverse cardiovascular (CV) outcomes in individuals with diabetes compared with those without diabetes. They concluded that comorbid stress and/or depressive symptoms are common in individuals with diabetes and together are associated with progressively increased risks for adverse CV outcomes.
AHRQ-funded; HS023009.
Citation: Cummings DM, Kirian K, Howard G .
Consequences of comorbidity of elevated stress and/or depressive symptoms and incident cardiovascular outcomes in diabetes: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
Diabetes Care 2016 Jan;39(1):101-9. doi: 10.2337/dc15-1174.
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Keywords: Cardiovascular Conditions, Depression, Diabetes, Patient-Centered Outcomes Research, Stress
Linzer M, Poplau S, Grossman E
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
This study aimed to assess if improvements in work conditions reduce clinician stress and burnout. It found that burnout was more likely to improve with workflow interventions and with targeted QI projects than in controls. Also, interventions in communication or workflow led to greater improvements in clinician satisfaction.
AHRQ-funded; HS018160.
Citation: Linzer M, Poplau S, Grossman E .
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
J Gen Intern Med 2015 Aug;30(8):1105-11. doi: 10.1007/s11606-015-3235-4..
Keywords: Burnout, Stress, Primary Care, Workflow, Quality Improvement, Quality of Care, Communication
Macapagal K, Greene GJ, Rivera Z
"The best is always yet to come": relationship stages and processes among young LGBT couples.
This study sought to determine the stages and processes during young LGBT couples’ relationship development. Its qualitative analyses showed that relationship stages and processes were similar to past research on heterosexuals, but participants’ subjective experiences reflected their LGBT identities and emerging adulthood, which exerted additional stress on the relationship.
AHRQ-funded; HS000078.
Citation: Macapagal K, Greene GJ, Rivera Z .
"The best is always yet to come": relationship stages and processes among young LGBT couples.
J Fam Psychol 2015 Jun;29(3):309-20. doi: 10.1037/fam0000094..
Keywords: Lifestyle Changes, Quality of Life, Stress
Mayberry LS, Egede LE, Wagner JA
Stress, depression and medication nonadherence in diabetes: test of the exacerbating and buffering effects of family support.
The researchers tested the moderation hypotheses that the associations between stressors/depressive symptoms and nonadherence would be stronger in the context of more obstructive family behaviors (exacerbating hypothesis) and weaker in the context of more supportive family behaviors (buffering hypothesis). They found that stressors and nonadherence were only associated at higher levels of obstructive family behaviors. Similarly, depressive symptoms and nonadherence were only associated at higher levels of obstructive family behaviors.
AHRQ-funded; HS022990.
Citation: Mayberry LS, Egede LE, Wagner JA .
Stress, depression and medication nonadherence in diabetes: test of the exacerbating and buffering effects of family support.
J Behav Med 2015 Apr;38(2):363-71. doi: 10.1007/s10865-014-9611-4..
Keywords: Diabetes, Medication, Patient Adherence/Compliance, Depression, Stress
Alcantara C, Muntner P, Edmondson D
Perfect storm: concurrent stress and depressive symptoms increase risk of myocardial infarction or death.
A recently offered psychosocial perfect storm conceptual model hypothesizes amplified risk will occur in those with concurrent stress and depressive symptoms. The authors tested this hypothesis in a large sample of US adults with coronary heart disease. They found that those with low stress and high depressive symptoms or high stress and low depressive symptoms were not at increased risk, while participants with concurrent high stress and high depressive symptoms had increased risk for myocardial infarction or death relative to those with low stress and low depressive symptoms. They concluded that their results provide initial support for a psychosocial perfect storm conceptual model.
AHRQ-funded; HS023009.
Citation: Alcantara C, Muntner P, Edmondson D .
Perfect storm: concurrent stress and depressive symptoms increase risk of myocardial infarction or death.
Circ Cardiovasc Qual Outcomes 2015 Mar;8(2):146-54. doi: 10.1161/circoutcomes.114.001180.
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Keywords: Depression, Heart Disease and Health, Mortality, Risk, Stress
Ojard C, Donnelly JP, Safford MM
Psychosocial stress as a risk factor for sepsis: a population-based cohort study.
This study characterized the relationship between stress and future risk of sepsis and evaluated the role of depression in this relationship. It found that increased stress was associated with higher 1-year adjusted incidence of sepsis, even after accounting for depressive symptoms.
AHRQ-funded; HS013852.
Citation: Ojard C, Donnelly JP, Safford MM .
Psychosocial stress as a risk factor for sepsis: a population-based cohort study.
Psychosom Med 2015 Jan;77(1):93-100. doi: 10.1097/psy.0000000000000120..
Keywords: Risk, Depression, Stress
Austrom MG, Lu YY, Perkins AJ
Impact of noncaregiving-related stressors on informal caregiver outcomes.
The researchers studied the most stressful events experienced by spouse caregivers of older adults with Alzheimer s disease during a 6-month period. They found that caregivers reported no stressors 21.5% of the time, 1-2 stressors 25% of the time, and 3 stressors 53% of the time with 318 stressors reported in total. They concluded that their results can be used to develop targeted intervention and support strategies for spouse caregivers experiencing non-caregiving related stressors as well as the traditional challenges with caregiving-related issues.
AHRQ-funded; HS010884.
Citation: Austrom MG, Lu YY, Perkins AJ .
Impact of noncaregiving-related stressors on informal caregiver outcomes.
Am J Alzheimers Dis Other Demen 2014 Aug;29(5):426-32. doi: 10.1177/1533317513518652.
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Keywords: Caregiving, Dementia, Elderly, Stress