Social media allows users to explore self-identity and express emotions or thoughts. Research looking into the association between social media use (SMU) and mental health outcomes, such as anxiety or depressive symptoms, have produced mixed findings. These contradictions may best be addressed by examining different patterns of SMU as they relate to depressive symptomatology. We sought to assess the independent associations between active versus passive SMU and depressive symptoms. For this, we conducted an online survey of adults 18-49 of age. Depressive symptoms were measured using the Patient-Reported Outcomes Measurement Information System brief depression scale. We measured active and passive SMU with previously developed items. Factor analysis was used to explore the underlying factor structure. Then, we used ordered logistic regression to assess associations between both passive and active SMU and depressive symptoms while controlling for sociodemographic covariates. Complete data were received from 702 participants. Active and passive SMU items loaded on separate factors. In multivariable analyses that controlled for all covariates, each one-point increase in passive SMU was associated with a 33 percent increase in depressive symptoms (adjusted odds ratio [AOR] = 1.33, 95 percent confidence interval [CI] = 1.17-1.51). However, in the same multivariable model, each one-point increase in active SMU was associated with a 15 percent decrease in depressive symptoms (AOR = 0.85, 95 percent CI = 0.75-0.96). To inform interventions, future research should determine directionality of these associations and investigate related factors.
OBJECTIVES
To determine the effect of integrating informal caregivers into discharge planning on post-discharge cost and resource utilization in the older adult population.
DESIGN
A systematic review and meta-analysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun prior to patient discharge on healthcare cost and resource utilization outcomes. MEDLINE, EMBASE and the Cochrane Library databases were searched for all English language articles published between 1990 and April 2016.
SETTING
Hospital or skilled nursing facility.
PARTICIPANTS
Older adults with informal caregivers discharged to a community setting.
MEASUREMENTS
Readmission rates, length of and time to post-discharge rehospitalizations, costs of post-discharge care.
RESULTS
Of 10,715 abstracts identified, fifteen studies met the inclusion criteria. Eleven studies provided sufficient detail to calculate readmission rates for treatment and control. Compared to usual care, discharge planning interventions with caregiver integration were associated with a 25 percent reduction in readmissions at 90 days (Relative Risk [RR], .75 [95% CI, .62-.91]) and a 24 percent reduction in readmissions at 180 days (Relative Risk [RR], .76 [95% CI, .64–.90]). The majority of studies reported statistically significant reductions in time to readmission, length of rehospitalization, and costs of post-discharge care.
CONCLUSION
For older adult patients discharged to a community setting, the integration of caregivers into the discharge planning process, compared to non-systematic inclusion of caregivers, reduces the risk of hospital readmission.
Adjusted prevalences derived from multivariable negative binomial regression model controlling for: year of delivery, age, race, ethnicity, Medicaid region, medical co-morbidities including psychiatric disorder, HCV and HIV infection and substance use history including tobacco, alcohol and polysubstance use.Krans EE, Kim JY, James AE, Kelley D, Jarlenski MP. Medication-assisted treatment utilization among pregnant women with opioid use disorder. Obstet Gynecol 2019; 133. The authors provided this information as a supplement to their article.
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