468 I can relate! Design and implementation of a clinic-based caregiver mentorship program
Bibliographic record
Abstract
Background: The St. Paul's Hospital (SPH) Adult Cystic Fibrosis Clinic (Vancouver, Canada) has been conducting annual anxiety and depression screenings using the Generalized Anxiety Disorder seven-item scale and Patient Health Questionnaire-9 since January 2019.The purpose of this quality improvement audit was to identify, from a patient perspective, supportive components of our adult CF anxiety and depression screening program (and mental health services in general) and areas that may be lacking.Methods: An anonymous online survey link with consent was emailed to patients aged 19 and older at the SPH Adult CF Clinic using the Qualtrics survey tool whether they had been screened for anxiety and depression or not.The survey included 55 quantitative and qualitative questions on whether the screening process provided appropriate space, time and support to discuss mental health issues; whether they were able to act on recommendations and referrals and if not why; whether there were challenges accessing recommended counseling and what were these; how useful the educational package provided was; if patients declined to be screened, what were the reasons; and overall how well they felt the CF clinic supported their mental health and emotional wellness.Results: At the time of the survey, there were approximately 300 patients registered at the SPH Adult CF Clinic, most of whom were aged 19 and older.We received 48 survey responses (16% of the clinic population), 43 of whom completed screenings; 41 (95%) agreed that there was a safe, private space created for the screening process and that they were treated with respect, and 29 (68%) were satisfied with the screening program.When assessing the general mental health supports in the CF clinic, 43 (90%) felt that their mental health and emotional well-being were valued by the CF team as part of their overall health and CF care, and 29 (60%) accessed mental health and emotional well-being support from a CF clinic team member: 28 (97%) from a social worker, 20 (69%) from a psychiatrist, and seven (24%) from a nurse.Although 20 (69%) indicated that there were no barriers to accessing support, some faced barriers; nine (31%) reported long wait times to get an appointment, six (21%) could not see the provider as often as needed, and four (14%) felt that it was difficult to connect with a care provider.When asked to indicate which mental health supports are missing in the clinic, 20 of 48 (44%) selected in-clinic counselor services, 16 (33%) selected virtual workshops, 16 (33%) selected access to mental health and emotional wellness resources, and 15 (31%) selected additional psychiatry time.Qualitative responses indicated the need for moreconsistent mental health follow-up and check-ins.Conclusions: Patients were positive about the screening program and focus on mental health.They requested additional psychiatry time; a counselor with knowledge of CF attached to the clinic; and affordable, timely access to community counselors with CF knowledge.They desire more mental health check-ins and follow-ups between visits, virtual group workshops on CF and mental health, and better access to mental health and emotional wellness resources.With this data and insight into the patient experience, we aim to improve and strengthen the screening program and overall mental health support at our CF clinic and inform other Canadian CF clinics.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.004 | 0.007 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.028 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".