Annette Burns | University of Ulster (original) (raw)

Papers by Annette Burns

Research paper thumbnail of Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

International journal of qualitative methods, 2021

Background: This article describes a protocol for a qualitative study to explore experiences and ... more Background: This article describes a protocol for a qualitative study to explore experiences and views and experiences of loneliness and social isolation in young adults, in Ireland. Methods: A youth Research Advisory Group will be consulted on the development of study materials. Our data collection methods will be guided by participant preferences, with potential participants choosing between virtual interviews, focus groups, and an online survey including the open-ended questions contained in the interview/focus group schedule. The data will be analyzed using framework analysis. Discussion: This protocol highlights methodological considerations relevant to a qualitative research study co-designed with young adults. Study findings will be relevant to mental health policy makers and other stakeholders involved in youth mental health.

Research paper thumbnail of Loneliness Across the Life Course; Life Story Interviews with Mental Health Services Users

Innovation in Aging, Nov 1, 2022

Research paper thumbnail of Exploring smoking, mental health and smoking-related disease in a nationally representative sample of older adults in Ireland – A retrospective secondary analysis

Journal of Psychosomatic Research, Jul 1, 2017

Objective: Smoking is the leading preventable cause of death among individuals with mental health... more Objective: Smoking is the leading preventable cause of death among individuals with mental health difficulties (MHD). The aim of the current study was to determine the impact of smoking on the physical health of older adults with MHD in Ireland and to explore the extent to which smoking mediated or moderated associations between MHD and smoking-related diseases. Methods: Cross-sectional analysis of a nationally representative sample of 8,175 communitydwelling adults aged 50 and over from The Irish Longitudinal Study on Ageing (TILDA) was undertaken. Multivariate adjusted logistic regression models were used to assess the association between MHD, smoking (current/past/never) and smoking-related diseases (respiratory disease, cardiovascular disease, smoking-related cancers). A number of variables were employed to identify individuals with MHD, including prescribed medication, self-reported diagnoses and self-report scales. Results: MHD was associated with current (RRRs ranging from 1.84 [1.50 to 2.26] to 4.31 [2.47 to 7.53]) and former (RRRs ranging from 1.26 [1.05 to 1.52] to 1.99 [1.19 to 3.33]) smoking and also associated with the presence of smoking-related disease (ORs ranging from 1.24 [1.01 to 1.51] to 1.62 [1.00 to 2.62]). Smoking did not mediate and rarely moderated associations between MHD and smoking-related disease. Conclusions: Older adults in Ireland with MHD are more likely to smoke than those without such difficulties. They also experience higher rates of smoking-related disease, although smoking had no mediating and no consistent moderating role in these analyses. Findings underscore the need for attention to the physical health of those with MHD including support in smoking cessation.

Research paper thumbnail of Irish Healthcare staff- Smoking, training and activity in treatment of tobacco dependence -an online survey

Tobacco Prevention and Cessation, 2016

INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the n... more INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the national plan of having a smoking prevalence of 5% by the year 2025 is possible. Involving all healthcare staff in this effort is regarded as important. We surveyed the present situation. METHODS An online survey was conducted of 1257 healthcare staff; 520 nurses, 440 doctors, 297 dentists in 2014. The sample was accessed with the help of the Irish Nurses and Midwifes Organisation (INMO), Irish Medical Organisation (IMO) and the Irish Dental Association (IDA). The questionnaire addressed individual smoking habits and attitudes, training and practice with regard to smoking cessation. RESULTS The prevalence in our sample was 8.5%. Nurses had the highest prevalence. Doctors had the highest never smoked rate. Smoking was related to age. Attitudes to treating smoking were positive among all HCP groups. Overall 96.4% of HCPs agreed that they should routinely ask patients about smoking and 94% agreed that they should advise all smokers to quit. 20.7 % of HCPs said they had formal training in smoking cessation and this was correlated to asking or giving advice. 42.9% with training while only 7.6% without training felt well prepared to assist smokers quit (p <001). Time, work priorities and lack of training were identified as the main barriers by all HCPs. Doctors particularly reported time problems (χ2 = 158.021, p <001). CONCLUSION Prevalence of smoking is low in HCPs, formal training in SC is low but the need for HCPs to be involved in SC is widely accepted. INTRODUCTION Research suggests that a wide variety of Healthcare Professionals can be effective in delivering brief smoking cessation interventions 1. Furthermore, smoking cessation interventions appear to be more effective when delivered by two clinician types, for instance a physician and a nurse 1. It is therefore recommended that all clinician types or Healthcare professionals should provide smoking cessation interventions and interventions involving the combined efforts of more than one clinician type should be encouraged 1. Clearly it is therefore necessary to ensure all healthcare professionals

Research paper thumbnail of Prospective study of provided smoking cessation care in an inpatient psychiatric setting

Journal of Psychosomatic Research, Dec 1, 2018

Prospective study of provided smoking cessation care in an inpatient psychiatric setting (b) Prov... more Prospective study of provided smoking cessation care in an inpatient psychiatric setting (b) Provided cessation care in inpatient psychiatry

Research paper thumbnail of Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

Frontiers in Psychiatry, Dec 21, 2018

Little is known about the experiences of people with severe mental health difficulties in smoking... more Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants' motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy.

Research paper thumbnail of The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment

Early Intervention in Psychiatry, Jan 16, 2023

AimEvidence suggest individuals with mental disorders and psychotic experiences (PE), even transi... more AimEvidence suggest individuals with mental disorders and psychotic experiences (PE), even transient PE, show poorer psychosocial outcomes relative to those with mental disorders. The concept of “attachment” is hypothesized as the mechanism by which people seek support in times of need. This can be measured as discrete styles or as positive (low avoidance/anxiety)/negative (high avoidance/anxiety) dimensions. Adult attachment has previously been examined on PE risk factors, but not outcomes. This study aimed to examine the relationship between transient childhood PE and adult psychosocial outcomes, comparing those with and without mental disorders. Second, to examine the role of adult attachment.MethodParticipants (n = 103) attended baseline (age 11–13) and 10‐year follow‐up. PE and mental disorders were measured using the Schedule for Affective Disorders and Schizophrenia for School‐aged Children. Attachment and outcomes were measured using self‐report measures. Analysis compared those with PE (with/without mental disorders), and mental disorders without PE, to controls, using linear and Poisson regression.ResultsPE was associated with lower self‐esteem (β = −2.28, p = .03), perceived social support from friends (β = −2.80, p = .01), and higher stress in platonic relationships (IRR = 1.64). PE and mental disorders were associated with lower self‐esteem (β = −5.74, p = .002), higher stress in romantic (IRR = 1.40) and platonic (IRR = 1.59) relationships, general stress (β = 5.60, p = .006), and mental distress (β = 5.67, p = .001). Mental disorders alone was not associated with any measure. Adult attachment dimensions attenuated some results.ConclusionsThis paper illustrates the association between transient PE and adult psychosocial outcomes, with &amp; without co‐occurring mental disorders, and demonstrates the role of adult attachment.

Research paper thumbnail of Exploring Smoking, Mental Health and Smoking-Related Disease in Older Adults

Journal of Psychosomatic Research, Jun 1, 2016

Smoking is the leading preventable cause of death among individuals with mental health difficulti... more Smoking is the leading preventable cause of death among individuals with mental health difficulties (MHD). The aim of the current study was to determine the impact of smoking on the physical health of older adults with MHD in Ireland and to explore the extent to which smoking mediated or moderated associations between MHD and smoking-related diseases. Methods: Cross-sectional analysis of a nationally representative sample of 8175 community-dwelling adults aged 50 and over from The Irish Longitudinal Study on Ageing (TILDA) was undertaken. Multivariate adjusted logistic regression models were used to assess the association between MHD, smoking (current/past/never) and smoking-related diseases (respiratory disease, cardiovascular disease, smoking-related cancers). A number of variables were employed to identify individuals with MHD, including prescribed medication, self-reported diagnoses and self-report scales. Results: MHD was associated with current (RRRs ranging from 1.84 [1.50 to 2.26] to 4.31 [2.47 to 7.53]) and former (RRRs ranging from 1.26 [1.05 to 1.52] to 1.99 [1.19 to 3.33]) smoking and also associated with the presence of smoking-related disease (ORs ranging from 1.24 [1.01 to 1.51] to 1.62 [1.00 to 2.62]). Smoking did not mediate and rarely moderated associations between MHD and smoking-related disease. Conclusions: Older adults in Ireland with MHD are more likely to smoke than those without such difficulties. They also experience higher rates of smoking-related disease, although smoking had no mediating and no consistent moderating role in these analyses. Findings underscore the need for attention to the physical health of those with MHD including support in smoking cessation.

Research paper thumbnail of Smoking and Smoking Cessation in those with Mental Health Difficulties in Ireland

Exploring smoking, mental health and smoking-related disease in a nationally representative sampl... more Exploring smoking, mental health and smoking-related disease in a nationally representative sample of older adults in Ireland-A retrospective secondary analysis.

Research paper thumbnail of Scoping Review of Experience of People living with Inherited Cardiac Conditions and Congenital Heart Disease. The experience of individuals with inherited cardiac conditions and congenital heart disease and their families throughout the life course: impact, difficulties and resilience

Research paper thumbnail of Dental Practitioners and Smoking Cessation in Ireland

Tobacco Prevention and Cessation, 2015

IntroductIon As the Irish government works towards their stated goal of a 'tobacco free society' ... more IntroductIon As the Irish government works towards their stated goal of a 'tobacco free society' in 2025, treatment offered to smokers must be expanded and improved. As such, it is inadequate to confine smoking cessation to a limited group of specialists and rather, it should be widely embraced by all health care professionals. In that regard, dentists could play a significant and crucial role. PurPose To examine smoking prevalence, training in smoking cessation treatment, and awareness of smoking cessation services available to smokers in Ireland among dentists practicing in Ireland. Methods We used an internet based, cross-sectional online survey to measure beliefs and behaviours among 289 dentists in Ireland in 2013. The instrument included items on personal tobacco use, training, and awareness of smoking cessation treatments and services. Descriptive statistics were generated for all variables and chi-squared tests examined potential gender differences in providing smoking cessation treatment. results Nine percent of dentists were current smokers, 7% reported receiving formal training in smoking cessation, and 5.6% refer their patients to specialist cessation services. Over 65% of dentists surveyed felt they did not have adequate training in smoking cessation. Female dentists were significantly more likely to give advice than male dentists (P < 0.005) and more likely to record the smoking status of their patients than male dentists (P < 0.001). conclusIons The prevalence of smoking among dentists at 9% is well below the national rate of 19.5%. There is a large discrepancy between the number of dentists who feel they should provide advice and those who actually do. Overall, dentists feel they lack adequate training, time and resources to provide smoking cessation services and most were not aware of existing referral pathways to specialist smoking cessation services.

Research paper thumbnail of Systematic Review and Meta-Analysis of the Impact of Carer Stress on Subsequent Institutionalisation of Community-Dwelling Older People

PLOS ONE, Jun 2, 2015

Background In the caregiving literature there is a common assertion that a higher level of carer ... more Background In the caregiving literature there is a common assertion that a higher level of carer stress is a critical determinant of premature ending of homecare. However, this contention has not been systematically assessed. We therefore systematically reviewed and meta-analysed the prospective association between various forms of carer stress and subsequent institutionalisation of community-dwelling older people. Methods Systematic literature search of prospective studies measuring carer stress at baseline and institutionalisation at follow-up. Given substantial interchangeability in the measurement of carer stress, we included a wide number of exposure measures, namely: carer stress, burden, depression, distress, anxiety, burnout, and strain. Institutionalisation included both acute and long-term care utilisation. The standardised mean difference between stressed and non-stressed carers was the primary measure of effect. We assessed study quality with the Crowe Critical Appraisal Tool (CCAT). Pre-planned sensitivity analysis included examination of estimates according to study size; decade published; study quality according to quartiles of CCAT scores; population; follow-up period; study design and impact of adjusted or unadjusted estimates. Results The search yielded 6,963 articles. After exclusions, we analysed data from 54 datasets. The meta-analysis found that while carer stress has a significant effect on subsequent institutionalisation of care recipients, the overall effect size was negligible (SMD=0Á05, 95% CI=0Á04-0Á07). Sensitivity analyses found that, the effect size was higher for measurements of stress than for other measures, though still relatively small (SMD=0Á23, 95% CI=0Á09-0Á38). Thus, whether analysing the association between carer stress, burden, distress, or

Research paper thumbnail of The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment

Early Intervention in Psychiatry

Research paper thumbnail of Loneliness Across the Life Course; Life Story Interviews with Mental Health Services Users

Innovation in Aging

Introduction The complexity of loneliness and its negative impact on our health and wellbeing is ... more Introduction The complexity of loneliness and its negative impact on our health and wellbeing is well established. However, the qualitative experience of loneliness over the life course is poorly understood. Method: This presentation, based on 18 life story interviews, with a sample of older adults, who were attending a mental health service and objectively defined as lonely, provides an insight into the personal experiences of loneliness as well as the situations and factors associated with loneliness across the life course. Results The analysis identified three distinct typologies of loneliness; those who experienced (1) chronic loneliness across their life (2) those whose loneliness became chronic after a transition e.g. bereavement (3) those whose loneliness remained situational/transitional. Conclusions The insights are important to inform both general loneliness services and policy as well as specialist mental health services and training. The presentation demonstrates the imp...

Research paper thumbnail of Irish Healthcare staff- Smoking, training and activity in treatment of tobacco dependence -an online survey

Tobacco Prevention & Cessation, 2016

INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the n... more INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the national plan of having a smoking prevalence of 5% by the year 2025 is possible. Involving all healthcare staff in this effort is regarded as important. We surveyed the present situation. METHODS An online survey was conducted of 1257 healthcare staff; 520 nurses, 440 doctors, 297 dentists in 2014. The sample was accessed with the help of the Irish Nurses and Midwifes Organisation (INMO), Irish Medical Organisation (IMO) and the Irish Dental Association (IDA). The questionnaire addressed individual smoking habits and attitudes, training and practice with regard to smoking cessation. RESULTS The prevalence in our sample was 8.5%. Nurses had the highest prevalence. Doctors had the highest never smoked rate. Smoking was related to age. Attitudes to treating smoking were positive among all HCP groups. Overall 96.4% of HCPs agreed that they should routinely ask patients about smoking and 94% agreed that they should advise all smokers to quit. 20.7 % of HCPs said they had formal training in smoking cessation and this was correlated to asking or giving advice. 42.9% with training while only 7.6% without training felt well prepared to assist smokers quit (p <001). Time, work priorities and lack of training were identified as the main barriers by all HCPs. Doctors particularly reported time problems (χ2 = 158.021, p <001). CONCLUSION Prevalence of smoking is low in HCPs, formal training in SC is low but the need for HCPs to be involved in SC is widely accepted. INTRODUCTION Research suggests that a wide variety of Healthcare Professionals can be effective in delivering brief smoking cessation interventions 1. Furthermore, smoking cessation interventions appear to be more effective when delivered by two clinician types, for instance a physician and a nurse 1. It is therefore recommended that all clinician types or Healthcare professionals should provide smoking cessation interventions and interventions involving the combined efforts of more than one clinician type should be encouraged 1. Clearly it is therefore necessary to ensure all healthcare professionals

Research paper thumbnail of Associations between parental bonding, social isolation and loneliness: do associations persist in later life and is isolation a mediator between parental bonding and loneliness?

BMC Psychology

Background Poor parental bonding in childhood has been associated with loneliness in younger popu... more Background Poor parental bonding in childhood has been associated with loneliness in younger populations. Whether these associations persists into middle and older adulthood is unclear. Additionally, given the overlapping relationship between loneliness and social isolation we sought to explore the role of social isolation in any associations present i.e. are those reporting worse parental bonding lonely due to less connections or are they more likely to be lonely regardless of isolation. Methods Analysis of a nationally representative longitudinal sample of adults aged 50 and over from the English Longitudinal Study of Ageing was undertaken. The current analysis was based on data for core participants across waves 3[2006/7] to 8[2016/17] with missing data across waves leading to analytical samples ranging from 4384 to 5173. Multivariate adjusted multinomial regression models were used to assess associations between parental bonding [PBI], isolation [score derived from data on livin...

Research paper thumbnail of Is Physical Activity Associated With Loneliness or Social Isolation in Older Adults? Results of a Longitudinal Analysis Using the Irish Longitudinal Study on Ageing

Journal of aging and physical activity, 2020

Social relationships are central to the health and well-being of older adults. Evidence exploring... more Social relationships are central to the health and well-being of older adults. Evidence exploring the association of physical activity (PA) with social isolation and loneliness is limited. This study uses a path analysis to investigate the longitudinal association between loneliness and social isolation with PA using the Irish Longitudinal Study on Ageing. Higher levels of social isolation measured using the Berkman-Syme Social Network Index were directly and indirectly associated with lower levels of walking, moderate PA, and vigorous PA over 6 years. Additionally, higher levels of walking were associated with lower levels of loneliness measured using a modified version of the University of California, Los Angeles loneliness scale over a 3-year period. Future interventions should target individuals who are more socially isolated and explore the effects of different types of PA on loneliness over time.

Research paper thumbnail of Supplemental Material, sj-pdf-1-ijq-10.1177_16094069211028682 - Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

Supplemental Material, sj-pdf-1-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Stud... more Supplemental Material, sj-pdf-1-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE) by Ann-Marie Creaven, Emma Kirwan, Annette Burns and Páraic S. O'Súilleabháin in International Journal of Qualitative Methods

Research paper thumbnail of Supplemental Material, sj-pdf-3-ijq-10.1177_16094069211028682 - Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

Supplemental Material, sj-pdf-3-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Stud... more Supplemental Material, sj-pdf-3-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE) by Ann-Marie Creaven, Emma Kirwan, Annette Burns and Páraic S. O'Súilleabháin in International Journal of Qualitative Methods

Research paper thumbnail of Supplemental Material, sj-pdf-2-ijq-10.1177_16094069211028682 - Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

Supplemental Material, sj-pdf-2-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Stud... more Supplemental Material, sj-pdf-2-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE) by Ann-Marie Creaven, Emma Kirwan, Annette Burns and Páraic S. O'Súilleabháin in International Journal of Qualitative Methods

Research paper thumbnail of Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

International journal of qualitative methods, 2021

Background: This article describes a protocol for a qualitative study to explore experiences and ... more Background: This article describes a protocol for a qualitative study to explore experiences and views and experiences of loneliness and social isolation in young adults, in Ireland. Methods: A youth Research Advisory Group will be consulted on the development of study materials. Our data collection methods will be guided by participant preferences, with potential participants choosing between virtual interviews, focus groups, and an online survey including the open-ended questions contained in the interview/focus group schedule. The data will be analyzed using framework analysis. Discussion: This protocol highlights methodological considerations relevant to a qualitative research study co-designed with young adults. Study findings will be relevant to mental health policy makers and other stakeholders involved in youth mental health.

Research paper thumbnail of Loneliness Across the Life Course; Life Story Interviews with Mental Health Services Users

Innovation in Aging, Nov 1, 2022

Research paper thumbnail of Exploring smoking, mental health and smoking-related disease in a nationally representative sample of older adults in Ireland – A retrospective secondary analysis

Journal of Psychosomatic Research, Jul 1, 2017

Objective: Smoking is the leading preventable cause of death among individuals with mental health... more Objective: Smoking is the leading preventable cause of death among individuals with mental health difficulties (MHD). The aim of the current study was to determine the impact of smoking on the physical health of older adults with MHD in Ireland and to explore the extent to which smoking mediated or moderated associations between MHD and smoking-related diseases. Methods: Cross-sectional analysis of a nationally representative sample of 8,175 communitydwelling adults aged 50 and over from The Irish Longitudinal Study on Ageing (TILDA) was undertaken. Multivariate adjusted logistic regression models were used to assess the association between MHD, smoking (current/past/never) and smoking-related diseases (respiratory disease, cardiovascular disease, smoking-related cancers). A number of variables were employed to identify individuals with MHD, including prescribed medication, self-reported diagnoses and self-report scales. Results: MHD was associated with current (RRRs ranging from 1.84 [1.50 to 2.26] to 4.31 [2.47 to 7.53]) and former (RRRs ranging from 1.26 [1.05 to 1.52] to 1.99 [1.19 to 3.33]) smoking and also associated with the presence of smoking-related disease (ORs ranging from 1.24 [1.01 to 1.51] to 1.62 [1.00 to 2.62]). Smoking did not mediate and rarely moderated associations between MHD and smoking-related disease. Conclusions: Older adults in Ireland with MHD are more likely to smoke than those without such difficulties. They also experience higher rates of smoking-related disease, although smoking had no mediating and no consistent moderating role in these analyses. Findings underscore the need for attention to the physical health of those with MHD including support in smoking cessation.

Research paper thumbnail of Irish Healthcare staff- Smoking, training and activity in treatment of tobacco dependence -an online survey

Tobacco Prevention and Cessation, 2016

INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the n... more INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the national plan of having a smoking prevalence of 5% by the year 2025 is possible. Involving all healthcare staff in this effort is regarded as important. We surveyed the present situation. METHODS An online survey was conducted of 1257 healthcare staff; 520 nurses, 440 doctors, 297 dentists in 2014. The sample was accessed with the help of the Irish Nurses and Midwifes Organisation (INMO), Irish Medical Organisation (IMO) and the Irish Dental Association (IDA). The questionnaire addressed individual smoking habits and attitudes, training and practice with regard to smoking cessation. RESULTS The prevalence in our sample was 8.5%. Nurses had the highest prevalence. Doctors had the highest never smoked rate. Smoking was related to age. Attitudes to treating smoking were positive among all HCP groups. Overall 96.4% of HCPs agreed that they should routinely ask patients about smoking and 94% agreed that they should advise all smokers to quit. 20.7 % of HCPs said they had formal training in smoking cessation and this was correlated to asking or giving advice. 42.9% with training while only 7.6% without training felt well prepared to assist smokers quit (p <001). Time, work priorities and lack of training were identified as the main barriers by all HCPs. Doctors particularly reported time problems (χ2 = 158.021, p <001). CONCLUSION Prevalence of smoking is low in HCPs, formal training in SC is low but the need for HCPs to be involved in SC is widely accepted. INTRODUCTION Research suggests that a wide variety of Healthcare Professionals can be effective in delivering brief smoking cessation interventions 1. Furthermore, smoking cessation interventions appear to be more effective when delivered by two clinician types, for instance a physician and a nurse 1. It is therefore recommended that all clinician types or Healthcare professionals should provide smoking cessation interventions and interventions involving the combined efforts of more than one clinician type should be encouraged 1. Clearly it is therefore necessary to ensure all healthcare professionals

Research paper thumbnail of Prospective study of provided smoking cessation care in an inpatient psychiatric setting

Journal of Psychosomatic Research, Dec 1, 2018

Prospective study of provided smoking cessation care in an inpatient psychiatric setting (b) Prov... more Prospective study of provided smoking cessation care in an inpatient psychiatric setting (b) Provided cessation care in inpatient psychiatry

Research paper thumbnail of Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

Frontiers in Psychiatry, Dec 21, 2018

Little is known about the experiences of people with severe mental health difficulties in smoking... more Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants' motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy.

Research paper thumbnail of The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment

Early Intervention in Psychiatry, Jan 16, 2023

AimEvidence suggest individuals with mental disorders and psychotic experiences (PE), even transi... more AimEvidence suggest individuals with mental disorders and psychotic experiences (PE), even transient PE, show poorer psychosocial outcomes relative to those with mental disorders. The concept of “attachment” is hypothesized as the mechanism by which people seek support in times of need. This can be measured as discrete styles or as positive (low avoidance/anxiety)/negative (high avoidance/anxiety) dimensions. Adult attachment has previously been examined on PE risk factors, but not outcomes. This study aimed to examine the relationship between transient childhood PE and adult psychosocial outcomes, comparing those with and without mental disorders. Second, to examine the role of adult attachment.MethodParticipants (n = 103) attended baseline (age 11–13) and 10‐year follow‐up. PE and mental disorders were measured using the Schedule for Affective Disorders and Schizophrenia for School‐aged Children. Attachment and outcomes were measured using self‐report measures. Analysis compared those with PE (with/without mental disorders), and mental disorders without PE, to controls, using linear and Poisson regression.ResultsPE was associated with lower self‐esteem (β = −2.28, p = .03), perceived social support from friends (β = −2.80, p = .01), and higher stress in platonic relationships (IRR = 1.64). PE and mental disorders were associated with lower self‐esteem (β = −5.74, p = .002), higher stress in romantic (IRR = 1.40) and platonic (IRR = 1.59) relationships, general stress (β = 5.60, p = .006), and mental distress (β = 5.67, p = .001). Mental disorders alone was not associated with any measure. Adult attachment dimensions attenuated some results.ConclusionsThis paper illustrates the association between transient PE and adult psychosocial outcomes, with &amp; without co‐occurring mental disorders, and demonstrates the role of adult attachment.

Research paper thumbnail of Exploring Smoking, Mental Health and Smoking-Related Disease in Older Adults

Journal of Psychosomatic Research, Jun 1, 2016

Smoking is the leading preventable cause of death among individuals with mental health difficulti... more Smoking is the leading preventable cause of death among individuals with mental health difficulties (MHD). The aim of the current study was to determine the impact of smoking on the physical health of older adults with MHD in Ireland and to explore the extent to which smoking mediated or moderated associations between MHD and smoking-related diseases. Methods: Cross-sectional analysis of a nationally representative sample of 8175 community-dwelling adults aged 50 and over from The Irish Longitudinal Study on Ageing (TILDA) was undertaken. Multivariate adjusted logistic regression models were used to assess the association between MHD, smoking (current/past/never) and smoking-related diseases (respiratory disease, cardiovascular disease, smoking-related cancers). A number of variables were employed to identify individuals with MHD, including prescribed medication, self-reported diagnoses and self-report scales. Results: MHD was associated with current (RRRs ranging from 1.84 [1.50 to 2.26] to 4.31 [2.47 to 7.53]) and former (RRRs ranging from 1.26 [1.05 to 1.52] to 1.99 [1.19 to 3.33]) smoking and also associated with the presence of smoking-related disease (ORs ranging from 1.24 [1.01 to 1.51] to 1.62 [1.00 to 2.62]). Smoking did not mediate and rarely moderated associations between MHD and smoking-related disease. Conclusions: Older adults in Ireland with MHD are more likely to smoke than those without such difficulties. They also experience higher rates of smoking-related disease, although smoking had no mediating and no consistent moderating role in these analyses. Findings underscore the need for attention to the physical health of those with MHD including support in smoking cessation.

Research paper thumbnail of Smoking and Smoking Cessation in those with Mental Health Difficulties in Ireland

Exploring smoking, mental health and smoking-related disease in a nationally representative sampl... more Exploring smoking, mental health and smoking-related disease in a nationally representative sample of older adults in Ireland-A retrospective secondary analysis.

Research paper thumbnail of Scoping Review of Experience of People living with Inherited Cardiac Conditions and Congenital Heart Disease. The experience of individuals with inherited cardiac conditions and congenital heart disease and their families throughout the life course: impact, difficulties and resilience

Research paper thumbnail of Dental Practitioners and Smoking Cessation in Ireland

Tobacco Prevention and Cessation, 2015

IntroductIon As the Irish government works towards their stated goal of a 'tobacco free society' ... more IntroductIon As the Irish government works towards their stated goal of a 'tobacco free society' in 2025, treatment offered to smokers must be expanded and improved. As such, it is inadequate to confine smoking cessation to a limited group of specialists and rather, it should be widely embraced by all health care professionals. In that regard, dentists could play a significant and crucial role. PurPose To examine smoking prevalence, training in smoking cessation treatment, and awareness of smoking cessation services available to smokers in Ireland among dentists practicing in Ireland. Methods We used an internet based, cross-sectional online survey to measure beliefs and behaviours among 289 dentists in Ireland in 2013. The instrument included items on personal tobacco use, training, and awareness of smoking cessation treatments and services. Descriptive statistics were generated for all variables and chi-squared tests examined potential gender differences in providing smoking cessation treatment. results Nine percent of dentists were current smokers, 7% reported receiving formal training in smoking cessation, and 5.6% refer their patients to specialist cessation services. Over 65% of dentists surveyed felt they did not have adequate training in smoking cessation. Female dentists were significantly more likely to give advice than male dentists (P < 0.005) and more likely to record the smoking status of their patients than male dentists (P < 0.001). conclusIons The prevalence of smoking among dentists at 9% is well below the national rate of 19.5%. There is a large discrepancy between the number of dentists who feel they should provide advice and those who actually do. Overall, dentists feel they lack adequate training, time and resources to provide smoking cessation services and most were not aware of existing referral pathways to specialist smoking cessation services.

Research paper thumbnail of Systematic Review and Meta-Analysis of the Impact of Carer Stress on Subsequent Institutionalisation of Community-Dwelling Older People

PLOS ONE, Jun 2, 2015

Background In the caregiving literature there is a common assertion that a higher level of carer ... more Background In the caregiving literature there is a common assertion that a higher level of carer stress is a critical determinant of premature ending of homecare. However, this contention has not been systematically assessed. We therefore systematically reviewed and meta-analysed the prospective association between various forms of carer stress and subsequent institutionalisation of community-dwelling older people. Methods Systematic literature search of prospective studies measuring carer stress at baseline and institutionalisation at follow-up. Given substantial interchangeability in the measurement of carer stress, we included a wide number of exposure measures, namely: carer stress, burden, depression, distress, anxiety, burnout, and strain. Institutionalisation included both acute and long-term care utilisation. The standardised mean difference between stressed and non-stressed carers was the primary measure of effect. We assessed study quality with the Crowe Critical Appraisal Tool (CCAT). Pre-planned sensitivity analysis included examination of estimates according to study size; decade published; study quality according to quartiles of CCAT scores; population; follow-up period; study design and impact of adjusted or unadjusted estimates. Results The search yielded 6,963 articles. After exclusions, we analysed data from 54 datasets. The meta-analysis found that while carer stress has a significant effect on subsequent institutionalisation of care recipients, the overall effect size was negligible (SMD=0Á05, 95% CI=0Á04-0Á07). Sensitivity analyses found that, the effect size was higher for measurements of stress than for other measures, though still relatively small (SMD=0Á23, 95% CI=0Á09-0Á38). Thus, whether analysing the association between carer stress, burden, distress, or

Research paper thumbnail of The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment

Early Intervention in Psychiatry

Research paper thumbnail of Loneliness Across the Life Course; Life Story Interviews with Mental Health Services Users

Innovation in Aging

Introduction The complexity of loneliness and its negative impact on our health and wellbeing is ... more Introduction The complexity of loneliness and its negative impact on our health and wellbeing is well established. However, the qualitative experience of loneliness over the life course is poorly understood. Method: This presentation, based on 18 life story interviews, with a sample of older adults, who were attending a mental health service and objectively defined as lonely, provides an insight into the personal experiences of loneliness as well as the situations and factors associated with loneliness across the life course. Results The analysis identified three distinct typologies of loneliness; those who experienced (1) chronic loneliness across their life (2) those whose loneliness became chronic after a transition e.g. bereavement (3) those whose loneliness remained situational/transitional. Conclusions The insights are important to inform both general loneliness services and policy as well as specialist mental health services and training. The presentation demonstrates the imp...

Research paper thumbnail of Irish Healthcare staff- Smoking, training and activity in treatment of tobacco dependence -an online survey

Tobacco Prevention & Cessation, 2016

INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the n... more INTRODUCTION Ireland has strong tobacco control legislation but must get smokers to stop if the national plan of having a smoking prevalence of 5% by the year 2025 is possible. Involving all healthcare staff in this effort is regarded as important. We surveyed the present situation. METHODS An online survey was conducted of 1257 healthcare staff; 520 nurses, 440 doctors, 297 dentists in 2014. The sample was accessed with the help of the Irish Nurses and Midwifes Organisation (INMO), Irish Medical Organisation (IMO) and the Irish Dental Association (IDA). The questionnaire addressed individual smoking habits and attitudes, training and practice with regard to smoking cessation. RESULTS The prevalence in our sample was 8.5%. Nurses had the highest prevalence. Doctors had the highest never smoked rate. Smoking was related to age. Attitudes to treating smoking were positive among all HCP groups. Overall 96.4% of HCPs agreed that they should routinely ask patients about smoking and 94% agreed that they should advise all smokers to quit. 20.7 % of HCPs said they had formal training in smoking cessation and this was correlated to asking or giving advice. 42.9% with training while only 7.6% without training felt well prepared to assist smokers quit (p <001). Time, work priorities and lack of training were identified as the main barriers by all HCPs. Doctors particularly reported time problems (χ2 = 158.021, p <001). CONCLUSION Prevalence of smoking is low in HCPs, formal training in SC is low but the need for HCPs to be involved in SC is widely accepted. INTRODUCTION Research suggests that a wide variety of Healthcare Professionals can be effective in delivering brief smoking cessation interventions 1. Furthermore, smoking cessation interventions appear to be more effective when delivered by two clinician types, for instance a physician and a nurse 1. It is therefore recommended that all clinician types or Healthcare professionals should provide smoking cessation interventions and interventions involving the combined efforts of more than one clinician type should be encouraged 1. Clearly it is therefore necessary to ensure all healthcare professionals

Research paper thumbnail of Associations between parental bonding, social isolation and loneliness: do associations persist in later life and is isolation a mediator between parental bonding and loneliness?

BMC Psychology

Background Poor parental bonding in childhood has been associated with loneliness in younger popu... more Background Poor parental bonding in childhood has been associated with loneliness in younger populations. Whether these associations persists into middle and older adulthood is unclear. Additionally, given the overlapping relationship between loneliness and social isolation we sought to explore the role of social isolation in any associations present i.e. are those reporting worse parental bonding lonely due to less connections or are they more likely to be lonely regardless of isolation. Methods Analysis of a nationally representative longitudinal sample of adults aged 50 and over from the English Longitudinal Study of Ageing was undertaken. The current analysis was based on data for core participants across waves 3[2006/7] to 8[2016/17] with missing data across waves leading to analytical samples ranging from 4384 to 5173. Multivariate adjusted multinomial regression models were used to assess associations between parental bonding [PBI], isolation [score derived from data on livin...

Research paper thumbnail of Is Physical Activity Associated With Loneliness or Social Isolation in Older Adults? Results of a Longitudinal Analysis Using the Irish Longitudinal Study on Ageing

Journal of aging and physical activity, 2020

Social relationships are central to the health and well-being of older adults. Evidence exploring... more Social relationships are central to the health and well-being of older adults. Evidence exploring the association of physical activity (PA) with social isolation and loneliness is limited. This study uses a path analysis to investigate the longitudinal association between loneliness and social isolation with PA using the Irish Longitudinal Study on Ageing. Higher levels of social isolation measured using the Berkman-Syme Social Network Index were directly and indirectly associated with lower levels of walking, moderate PA, and vigorous PA over 6 years. Additionally, higher levels of walking were associated with lower levels of loneliness measured using a modified version of the University of California, Los Angeles loneliness scale over a 3-year period. Future interventions should target individuals who are more socially isolated and explore the effects of different types of PA on loneliness over time.

Research paper thumbnail of Supplemental Material, sj-pdf-1-ijq-10.1177_16094069211028682 - Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

Supplemental Material, sj-pdf-1-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Stud... more Supplemental Material, sj-pdf-1-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE) by Ann-Marie Creaven, Emma Kirwan, Annette Burns and Páraic S. O'Súilleabháin in International Journal of Qualitative Methods

Research paper thumbnail of Supplemental Material, sj-pdf-3-ijq-10.1177_16094069211028682 - Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

Supplemental Material, sj-pdf-3-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Stud... more Supplemental Material, sj-pdf-3-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE) by Ann-Marie Creaven, Emma Kirwan, Annette Burns and Páraic S. O'Súilleabháin in International Journal of Qualitative Methods

Research paper thumbnail of Supplemental Material, sj-pdf-2-ijq-10.1177_16094069211028682 - Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE)

Supplemental Material, sj-pdf-2-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Stud... more Supplemental Material, sj-pdf-2-ijq-10.1177_16094069211028682 for Protocol for a Qualitative Study: Exploring Loneliness and Social Isolation in Emerging Adulthood (ELSIE) by Ann-Marie Creaven, Emma Kirwan, Annette Burns and Páraic S. O'Súilleabháin in International Journal of Qualitative Methods