Innovative Model for Promoting Interprofessional Dialogue and Action Across Healthcare Stakeholders: The ASAHP Collaborative Stakeholder Engagement Model.

BACKGROUND: The ASAHP established the Clinical Education Task Force (CETF) in 2017 to identify strategies for clinical education. Implementing the CETF recommendations requires continuous collaboration between healthcare industry and academic partners. AIM: ASAHP Regional Summits were planned and implemented to offer an active learning environment for stakeholders, strengthen translational skills, identify gaps in interprofessional collaborative practice (IPC), and create lasting networking opportunities. METHODS: The Regional Summits were organized in a standard format across three hub sites. During a virtual "Harvest" session all sites were video linked to continue the local dialogue on a national level. Outcomes were analyzed using mixed methods, including pre- and post-session surveys quantitative methods. Notes from table discussions were analyzed using a qualitative approach. RESULTS: Qualitative results offered a rich dataset from the industry and academic perspective to provide a better understanding how the CETF recommendations are being understood. Ideas for future action and partnerships were identified. Various regions contributed insights that reflect unique environments. CONCLUSIONS: The ASAHP Collaborative Stakeholder Engagement Model offers a robust and reproducible active adult learning model for IPC that can lead to change and continued engagement. These findings identify opportunities for deepening the connections made through regional hubs.

Home Care Nurses' Knowledge and Attitudes Regarding Telehealth to Promote Medication Compliance among Older Adults.

Medication noncompliance among older adults is a persistent problem resulting in morbidity, hospital readmissions, and decreased quality of life. Home care nurses are in a key position to assist older adults to employ medication compliance strategies that are tailor-made to fit their individual needs and abilities. The purpose of this study was to understand the knowledge and attitudes of home care nurses regarding telehealth practices to promote medication compliance of older adult patients and their perceived readiness to do so. We employed a qualitative research approach using semi-structured interviews. Individual interviews were conducted via Teams platform for a maximum of 60 minutes. Participants were home care nurses who use telehealth technology to advance medication compliance strategies. Ten interviews were conducted. Several themes emerged from the data which suggested home care nurses accept telehealth technology, are supportive of its continued use, and are willing to be educated on future advances in this technology to assist older adults with medication compliance strategies. Universities and home care agencies must provide opportunities to prepare nurses to utilize telehealth technologies to promote medication compliance among older adult home care patients.

Interprofessional Active Learning Environment Employing Virtual Reality Simulation to Promote Telehealth Practices and Psychosocial Well-Being.

ISSUE: As healthcare educators, we must continually evaluate innovative technologies and practices that may assist us in meeting the complex needs of individuals. In this study, we sought to address some barriers associated with using virtual reality (VR) to assess an interprofessional team of students' knowledge of and practice with telehealth and their ability to address psychosocial health. METHODS: A non-experimental, descriptive, embedded (explanatory quan/QUAL) mixed methods design of 240 students enrolled in the IPE Journey of Professional Trans-formation, Fall 2022. OUTCOMES: Several themes emerged from the students' responses; the experience prompted a recognition of the need for clear communication, both verbal and non-verbal, in coordinating person-centered care. There was a significant decrease in Interprofessional Collaborative Competency Attainment Scale (ICCAS) (z=2.54, p=0.01), suggesting that students may have overestimated their interprofessional collaboration and communication abilities. There was no significant change in Transgender Knowledge, Attitude, and Belief Scale (T-KAB) and Telehealth Confidence Survey (TCS) scores. CONCLUSION: This study demonstrates that an interprofessional active learning experience using an avatar-based simulation case can facilitate in meaningful interdisciplinary teaming and promote the quality of a transgender person's well-being by employing telehealth and person-centered care practices.

The experience of Saudi respiratory therapists dealing with COVID-19 patients: A qualitative study.

BACKGROUND: Healthcare professionals have fought hard to restrain the COVID-19 pandemic by providing high-quality care for their infected patients, but in doing so they have developed fears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratory therapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation. The study sought to describe the experiences and coping strategies of Saudi RT managing patients with COVID-19. MATERIALS AND METHODS: The study utilized qualitative research methods, specifically employing a phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact with COVID-19 patients were selected after they agreed to participate in this study. The study followed a one-on-one semi-structured interview process using the Zoom platform. This qualitative data collection technique focuses on the participants' lived experiences and feelings to discover shared patterns. The data were analyzed via an inductive approach. RESULTS: Six themes were found in the RT perceptions including stress while treating COVID patients, managing the fear of catching of Covid 19, feelings towards COVID-19 patients, challenges faced by female RTs, workplace experiences, and excessive workload. CONCLUSIONS: RTs feelings dramatically changed throughout the COVID-19 pandemic. All the RTs have developed a self-copying style that has helped them improve their psychosocial behavior to face the pandemic. During the outbreak, frontline RTs' positive and negative emotions intertwined and coexisted. Negative emotions predominated in the beginning, while good feelings emerged gradually. Self-coping methods and psychosocial development were significant factors in RTs mental health while caring for COVID-19 patients.

Exploring Health Science Faculty Perceptions Regarding Their Readiness to Teach Online.

Instructional technology has offered faculty new and innovative ways in which to prepare and deliver learning materials to students online. Although online learning has been a part of the higher education landscape, it has not been traditionally utilized by health science faculty to its fullest capacity. PURPOSE: The purpose of this pilot study was to examine health science faculty perceptions regarding their readiness to teach online. METHODS: This study employed a mixed method design using a sequential explanatory framework. Faculty readiness was identified by their attitude regarding competencies and ability perceptions using the Faculty Readiness to Teach Online (FRTO) instrument. RESULTS: Health science faculty have limited training in teaching online, and there is a significant difference in perceptions and attitudes towards which competencies in remote instruction are critical to focus on. OUTCOMES: Findings confirm the online instruction training needs of health science faculty that will support engagement of health science students as adult learners both meaningfully and effectively now and in the future.

Interprofessional Education Module on Professionalism, Ethics, and Teamwork: Insights from Program Review Data of Health Professions Students.

Formal interprofessional education provides health sciences students the opportunity to develop their knowledge in teamwork, communication, collaboration, and ethics. The purpose of this paper is to describe interprofessional students' perceptions of professionalism, ethics, and teamwork before and after being immersed in an interprofessional education Module on these topics. Through a program review process, pre- and post-Module survey responses from 10 interprofessional students were randomly reviewed by five faculty from different health sciences disciplines. Results from the thematic analysis of those open-ended surveys revealed students evolved in their perceptions of all three areas of professionalism, ethics, and teamwork following participation in the interprofessional Module. For professionalism, students' insights reflected a broader understanding of their roles as a professional not just individually, but on an interpersonal and societal level. Students' descriptions of ethical behavior also expanded beyond the importance of ethics within one's scope of practice to integrate cultural differences to ethically promote patient well-being. Lastly, post-survey responses indicated students' deeper understanding of the importance of teamwork to reduce errors and increase patient outcomes by working towards a common goal. The themes that emerged from this program review provided support for continued interprofessional activities to address professionalism, ethics, and teamwork.

Environmental Health Needs Among Latinas in Cleaning Occupations: A Mixed Methods Approach.

In the U.S., approximately half of maids and housekeeping cleaners are Latino or Hispanic, while the vast majority are women (88.3%). This largely immigrant, underserved workforce faces complex factors, which may contribute to adverse health outcomes. To understand relevant barriers and challenges, this mixed-methods study explored the environmental health needs of a heterogeneous group of Latinas in New Jersey (NJ) who clean occupationally, and consisted of 3 focus groups (N = 15) with a cross-sectional survey (N = 9), both conducted in Spanish. Participants were recruited from community-based English as a Second Language classes in Hackensack, NJ. Analysis of focus group audio recordings included descriptive and in vivo coding followed by inductive coding to explore thematic analysis. The survey responses were evaluated using descriptive statistics. As per the survey results, the environmental health needs of this population include sore muscles, back problems, asthma, other respiratory issues, migraine or headache, and skin issues (rash, etc.). In the group discussions, the roles of genetics, food, and chemical exposures in cancer etiology were of great interest and a variety of opinions on the topic were explored. Both the focus group discussions and survey responses suggested that this population also faces barriers including lack of training, chemical exposures and inadequate personal protective equipment (PPE). These barriers are compounded by daily environmental exposures from personal home cleaning practices. The development of culturally- and linguistically-appropriate interventions are warranted to better protect the health of essential occupational cleaners who keep homes, businesses and schools clean.

Knowledge, attitudes and behaviors of Latinas in cleaning occupations in northern New Jersey: a cross-sectional mixed methods study.

BACKGROUND: In the United States, 88.3% of all 1,163,000 maids and housekeeping cleaners are female, and approximately half of them Latinas. Latinas are understudied and underrepresented in health research, particularly involving chemical exposure in cleaning practices, lack of job training, and inadequate access to personal protective equipment. The purpose of this study is twofold: 1) to examine the knowledge (via training experiences), attitudes and behaviors of a heterogeneous group of Latinas who clean occupationally and 2) to assess their cleaning practices at work and at home. METHODS: This mixed-method study consisted of two phases: 1) three focus groups to explore knowledge (via training experiences), attitudes, and behaviors regarding cleaning practices (N = 15) and 2) a 43-question cross-sectional survey. Focus group audio recordings were analyzed using descriptive and in vivo coding and then coded inductively to explore thematic analysis. Statistical analysis of the survey evaluated means, frequency and percentage for each of the responses. RESULTS: Participants (n = 9) were women (mean age = 48.78 and SD = 6.72) from South America (n = 5), Mexico (n = 1), El Salvador (n = 1) and Dominican Republic (n = 2). The mean length of time living in the US was 18.78 years and over half (55.6%) worked in the cleaning industry for 10 or more years. Findings from the three focus groups (n = 15) included that training in cleaning often occurred informally at a very young age at home. Participants reported cleaning in groups where tasks are rotated and/or shared. Most were the primary person cleaning at home, suggesting increased exposure. Gloves and masks were the most frequently used PPE, but use was not consistent. For participants who purchase their own products, driving factors included price, smell and efficacy. Some participants used products supplied or preferred by the employer. CONCLUSIONS: Latinas in cleaning occupations face a range of social and health barriers including lack of safety and health training, inadequate PPE and low literacy. To address these issues, the development of an intervention is warranted to provide training and resources for this critical population of essential workers.

Global Rehabilitation Health Worker Certification: Global Agenda, Local Imperative.

Rehabilitation, seen as a disability-specific service needed only by few of the world's population, has not been prioritized in countries and is under-resourced. A rehabilitation-ready health workforce is potentially the most important resource for improving functioning and the quality of life for the 2.41 billion people worldwide needing this care. In April 2019, CGFNS International, Inc., and the Association of Schools Advancing Health Professions (ASAHP) partnered to respond to the World Health Organization's Rehab 2030, which emphasizes the need for global action by professional organizations, development agencies, and civil society to develop and maintain a sustainable workforce for rehabilitation under different healthcare models in different economies. The global certification framework presented in this article provides a mechanism to validate rehabilitation knowledge and practice competence of individual health workers. The impact of certification on upgrading rehabilitation education and upskilling the world's rehabilitation health workforce cannot be overstated.

A Structured Immersion Approach to Approaching Interprofessional Education.

BACKGROUND: Interprofessional education (IPE) must explore the interdependency between healthcare professionals and ensure that IPE learning experiences are rooted in sound teaching and learning theories. Embedding IPE experiences into curricula using an incremental progression rather than "add-on" or "one-and-done" experience provides for continuous development of interprofessional competence by students as part of the learning process. Employing a school-wide structured immersion approach, over a 2-year period, incorporating five core IPE experiences designed to incrementally engage students in deeper, community-rich, person-centered learning experiences that are meaningful and sustainable. METHODS: An exploratory mixed-methods approach to collected data during the 2018-2019 academic year of the Core Signature IPE Experiences was employed (I-V). As part of the program review process, students were asked to voluntarily provide anonymous feedback after completion of each Core. Quantitative data was collected using Interdisciplinary Education Perception Scale (IEPS). Qualitative data were obtained from responses to open-ended questions added to the demographic component of the survey. The open-ended questions were designed to support, explain, and provide depth to the quantitative section. An elemental coding method was used to preliminarily review the corpus and generate descriptive codes and themes. Descriptive codes summarize in a word or short phrase the basic topic of a qualitative passage. RESULTS: Quantitative data of IEPS scores demonstrated students' mean scores in high range for each subscale at Core II (5.15) and slightly positive trend observed across three remaining Cores with Core V displaying highest mean score (5.44). From the qualitative survey, descriptive codes were agreed upon by two reviewers as providing the essence of response topic. Qualitative themes support and provide insight into quantitative data. CONCLUSIONS: Recognizing the interdependency which exits between professionals and developing trust and mutual respect among disciplines is paramount to ensuring evidence-based, person-centered healthcare. Infusing IPE learning experiences in the academy can play an important role in student development; however, IPE experiences must be rooted in learning theory. Program review findings from the Core Signature structured immersion experiences used across six health professions offers insight and a sound direction for health profession programs seeking to design IPE experiences that will aid in elevating the standard of healthcare and improving patient outcomes, by creating a collaborative ready workforce.

The impact of integrating environmental health into medical school curricula: a survey-based study.

BACKGROUND: Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise to address patients' environmental illnesses, nor speak to prevention. METHODS: Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine (Nutley, New Jersey), via a two-hour interactive large group learning module with follow up activities. Students completed the Environmental Health in Med School (EHMS) survey before and after the year 1 EH module. This survey evaluates medical students' attitudes, awareness and professionalism regarding environmental health. In year 2, students completed the Environmental Health Survey II, which measured students' perceptions of preparedness to discuss EH with future patients. The research team created both surveys based upon learning objectives that broadly aligned with the Institute of Medicine six competency-based environmental health learning objectives. RESULTS: 36 year 1 students completed both the pre and post EHMS surveys. McNemar's test was used for paired comparisons. Results identified no statistically significant changes from pre to post surveys, identifying a dramatic ceiling. When comparing year 2, EHS II pre-survey (n = 84) and post-survey (n = 79) responses, a statistically significant positive change in students' self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention was noted. CONCLUSIONS: Our conclusion for the EHMS in Year 1 was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Through the EHS II in Year 2, we found that the six-week environmental health module combining didactic and experiential elements significantly increased medical students' self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.

Increased pulse wave velocity in persons with spinal cord injury: the effect of the renin-angiotensin-aldosterone system.

Increased pulse wave velocity (PWV), a marker of cardiovascular disease (CVD), has been reported in otherwise healthy individuals with spinal cord injury (SCI) compared with age-matched uninjured controls. Due to decentralized descending sympathetic vascular control, individuals with injuries above T6 are prone to orthostatic hypotension and, as a result, depend on the renin-angiotensin-aldosterone system (RAAS) to maintain orthostatic blood pressure (BP). The purpose of this study was to determine resting PWV, a noninvasive surrogate of central arterial stiffness, in individuals with cervical (C4-T1; n = 11) and thoracic (T6-T12; n = 11) SCI, compared with age-matched controls (controls; n = 11). Next, our aim was to describe group differences in BP, plasma norepinephrine (NE), and renin response to head-up tilt (HUT). Finally, we sought to determine the relationship between PWV and the orthostatic change in BP, NE, and the plasma renin during HUT among the groups. PWV was significantly increased in both cervical (8.81 ± 1.91 m/s) and thoracic (7.36 ± 1.58 m/s) SCI compared with the controls (5.53 ± 0.95 m/s; P < 0.05). The change from supine to 60° HUT in BP and NE was significantly reduced and change in plasma renin was significantly increased in the cervical group compared with the thoracic and control groups. Group affiliation and change in plasma renin were significant predictors of PWV (R2 = 0.63, P = 0.001). These data suggest that dependency on the RAAS for orthostatic BP maintenance may be associated with increased PWV and risk of CVD in the SCI population.NEW & NOTEWORTHY Our novel findings suggest that increased arterial stiffness in individuals with SCI may be due to greater dependency on the RAAS to maintain hemodynamic stability during an orthostatic challenge. Asymptomatic orthostatic hypotension can occur in persons with SCI during transition from the supine to the seated position and during other upright activities of daily living; however, it is seldom addressed by clinicians.

The Effects of Mindfulness Meditation and Gentle Yoga on Spiritual Well-Being in Cancer Survivors: A Pilot Study.

BACKGROUND: Cancer survivors face countless physiological and psychological challenges that affect their abilities and negatively impact their quality of life and general well-being. A biopsychosocial-spiritual approach to health management may be beneficial. PRIMARY STUDY OBJECTIVE: To assess the effect of gentle yoga and mindfulness meditation on spiritual well-being in cancer survivors. METHODS/DESIGN: This is a mixed methods, quasi-experimental pilot study providing 10 weeks of gentle yoga and mindfulness meditation twice per week to cancer survivors. SETTING: The intervention was provided at a South Florida university in the summer months. PARTICIPANTS: Ten cancer survivors self-selected to participate in the 10-week study; 2 participants did not complete the post-test data collection. INTERVENTION: Each class opened and closed with 5 to 6 minutes of nonmoving mindfulness meditation. The mindfulness meditation techniques included body scan, breath awareness, visualization, affirmation, and compassion meditations. The gentle yoga practice was a series of beginner yoga postures and stretches. The mindfulness meditation techniques of breath and body awareness during yoga created what is referred to as a "moving meditation" with yoga postures encompassing the movement portion. PRIMARY OUTCOME MEASURES: The Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being 12 Item Scale (FACIT-Sp-12) and 2 open-ended questions. RESULTS: The FACIT-Sp-12 pre- and post-test data were analyzed using a paired samples t test. There was a significant improvement in overall spiritual well-being from pretest (µ = 34.25, SD = 7.28) to post-test (µ = 39.50, SD = 7.91); t (7) = -4.02, P = 0.003. Qualitative data: the participants reported improvements in various aspects of spirituality, fitness, emotional well-being, stress management, sleep, and a sense of social connectedness. CONCLUSION: The biopsychosocial-spiritual approach to health care may play a vital role in addressing the well-being of the whole person. Gentle yoga and mindfulness meditation can result in improvement in measures of spiritual well-being among cancer survivors and may be further utilized as an accessible intervention for those who are suffering throughout all segments of society.

Mind Mapping to Enhance Critical Thinking Skills in Physician Assistant Education: A Randomized Controlled Study.

Physician assistant (PA) students need to assimilate and integrate voluminous information quickly and effectively to promote critical thinking skills required to deliver competent care. Mind mapping (MM) is an innovative strategy used to facilitate students' recognition and recall of essential information and to ensure depth in their understanding via making connections between pieces of information. The establishment of relationships between concepts expressed in mind maps enhances critical thinking skills. The purpose of this study was to determine the overall critical thinking skills of PA students using MM as a learning strategy and to determine if there was a significant difference in critical thinking skills between students who used MM versus standard note-taking in their learning environment. In this randomized control study, a convenience sample of 74 PA students was assigned to a standard note-taking group (SNTG) or mind-mapping group (MMG). After completing the Health Science Reasoning Test (pre-HSRT), MMG members were instructed on how to construct mind maps and then asked to create weekly mind maps for 9 weeks, while the SNTG followed their method of study without mind maps for 9 weeks. Differences in the mean pre- and post-overall HSRT scores between groups and within groups were analyzed using independent and dependent t-tests, respectively. There was no significant difference between pre- and post-overall critical thinking scores as measured by HSRT after 9 weeks of intervention in both groups. However, there was a significant difference in the mean overall post-HSRT scores between groups (p=0.026). Hence, mind mapping is a viable active learning strategy to promote critical thinking in PA students.

An exploration of higher-level language comprehension deficits and factors influencing them following blast TBI in US veterans.

PRIMARY OBJECTIVE: The objective of this study was to investigate the factors that might have a negative influence on auditory processing and higher-level language processing in the US veterans of the recent foreign wars (Iraq and Afghanistan). RESEARCH DESIGN: Exploratory, cross-sectional, correlational, prospective, cohort-design. METHODS AND PROCEDURES: The experimental group consisted of 12 US veterans of war (10 males and 2 females) with blast exposure. The control group consisted of six US veterans (5 males and 1 female) without the history of blast exposure. Both groups were matched in mean age. Both groups were tested on Boston Assessment of Traumatic Brain Injury, Consonant Trigrams Test, Symbol Digit Modality Test, Trail Making Test, SCAN-3, CELF-5-Metalinguistics, CASL, and an unpublished test on the processing of sentence prosody. MAIN OUTCOMES AND RESULTS: Significant group differences in attention, and time-compressed sentence processing were found. For those veterans (in the experimental group) who were not wearing their helmets at the time of blast, additional significant differences were noted with inferencing and auditory figure-ground tasks. CONCLUSIONS: Findings support the importance of including speech/language pathologists in all stages of recovery for veterans post-blast exposure.

Exploring the Relationship Between Timed Up and Go Test Times and Fall History in an Inpatient Geriatric Psychiatry Unit: A Retrospective Case-Control Study.

BACKGROUND AND PURPOSE: Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these 2 specific functional tasks and has been used to predict falls in other geriatric populations but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine whether the TUG time measurements of inpatient geriatric psychiatry patients were associated with falling. METHODS: The study was a retrospective chart review using a case-control design. The sample was obtained from patients admitted to 1 inpatient geriatric psychiatry unit during the 4-month study period. RESULTS: The total sample size was N = 62 and included older adults with (N = 29; "fallers") and without (N = 33; "nonfallers") a history of falls in the 6 months prior to admission. The mean age of fallers (M = 75.8, SD = 9.6) was not significantly different from the age of nonfallers (M = 74.0, SD = 7.6), P = .424. Both groups had higher proportions of female subjects; nonfallers were 75.8% (n = 25) female and fallers were 69.0% (n = 20) female. Most nonfallers (84.8%) completed the TUG testing without an assistive device, while most fallers (48.3%) used a walker. A significant difference was found between the TUG times of nonfallers and fallers, U = 737.00, z = 3.65, P < .001, r = 0.46. Fallers took longer to complete the TUG test (median = 26.5) than nonfallers (median = 13.6). The TUG time explanatory variable was statistically significant, P = .002. Increasing TUG times were associated with an increased likelihood of patient falls (odds ratio = 1.10). The optimal TUG cutoff score was 16.5 seconds, with 79.3% sensitivity and 72.7% specificity. CONCLUSIONS: The TUG time measurement was found to be associated with falling. A cutoff time of 16.5 seconds is recommended to identify nonfallers from fallers in the inpatient geriatric psychiatry setting.

An evidence-based approach to learning clinical anatomy: A guide for medical students, educators, and administrators.

The amount of information that medical students learn is voluminous and those who do not use evidence-based learning strategies may struggle. Research from cognitive and educational psychology provides a blueprint on how best to learn science subjects, including clinical anatomy. Students should aim for high-cognitive learning levels as defined in the SOLO taxonomy. Using a real-world example from a modern clinical anatomy textbook, we describe how to learn information using strategies that have been experimentally validated as effective. Students should avoid highlighting and rereading text because they do not result in robust learning as defined in the SOLO taxonomy. We recommend that students use (1) practice testing, (2) distributed practice, and (3) successive relearning. Practice testing refers to nonsummative assessments that contain questions used to facilitate retrieval (e.g., flashcards and practice questions). Practice questions can be fill-in, short-answer, and multiple-choice types, and students should receive explanatory feedback. Distributed practice, the technique of distributing learning of the same content within a single study session or across sessions, has been found to facilitate long-term retention. Finally, successive relearning combines both practice testing and distributed practice. For this strategy, students use practice questions to continue learning until they can answer all of the practice questions correctly. Students who continuously use practice testing, distributed practice, and successive relearning will become more efficient and effective learners. Our hope is that the real-world clinical anatomy example presented in this article makes it easier for students to implement these evidence-based strategies and ultimately improve their learning. Clin. Anat., 2018. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.

"To sleep, perchance to tweet": in-bed electronic social media use and its associations with insomnia, daytime sleepiness, mood, and sleep duration in adults.

OBJECTIVES: The use of mobile device-based electronic social media (ESM) in bed is rapidly becoming commonplace, with potentially adverse impacts on sleep and daytime functioning. The purpose of this study was to determine the extent to which in-bed ESM use is associated with insomnia, daytime sleepiness, mood, and sleep duration in adults. METHODS: This was a cross-sectional observational study conducted among 855 hospital employees and university students (mean age, 43.6years; 85% female) via an online questionnaire. RESULTS: Nearly 70% of participants indulged in in-bed ESM use, with nearly 15% spending an hour or more a night doing so. The degree of in-bed ESM use did not vary by gender, but higher levels of in-bed ESM use were seen in younger and middle-aged than elderly participants. Compared with participants with no in-bed ESM use and controlling for age, gender, and ethnicity, participants with high in-bed ESM use were more likely to have insomnia, anxiety, and short sleep duration on weeknights, but not depression or daytime sleepiness; low in-bed ESM use only increased the likelihood of short sleep duration on weeknights. In-bed ESM use by a bed partner did not have an adverse association with sleep or mood. CONCLUSIONS: In-bed ESM use is associated with sleep and mood dysfunction in adults. These findings are of relevance to clinicians, therapists, and the public at large, as they suggest that limitation of in-bed ESM use is a potential interventional strategy in the overall management of sleep hygiene and mental health.