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Chronic Health Problems (chronic + health_problem)
Selected AbstractsOne-year stability of the Measure of Processes of CareCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2007R. C. Siebes Abstract Background, The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. Methods, Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1,18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. Results, All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443,0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. Conclusions, The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted. [source] Prevalence of recurrent complaints of pain among Greek schoolchildren and associated factors: A population-based studyACTA PAEDIATRICA, Issue 8 2006Chryssa Bakoula Abstract Aim: To determine the prevalence of recurrent complaints of pain (RCP) in Greek children, and to examine associations with socio-demographic characteristics and psychosocial factors. Methods: Cross-sectional study comprising a nationally representative population of 8130 7-y-old Greek schoolchildren. Data were collected by mailed questionnaires (response rate 89%). RCP was defined as present if at least one of the complaints of headache, abdominal pain or limb pain occurred at least once a week. Results: The RCP prevalence rate was 7.2%, with significant gender differences (8.8% of girls, 5.7% of boys; p<0.001). RCP was significantly positively associated with a chronic health problem among the children, frequent change of residence, poor school performance, often watching TV and rarely playing with other children. There were no statistically significant associations of RCP with family structure and socio-economic status. Conclusion: The results are indicative of the prevalence of RCP in Greek schoolchildren. This study enlightens the psychosocial component of RCP and emphasizes the importance of gathering information on children's social background in medical settings. [source] Reduction of quantity smoked predicts future cessation among older smokersADDICTION, Issue 1 2004Tracy Falba ABSTRACT Aim To examine whether smokers who reduce their quantity of cigarettes smoked between two periods are more or less likely to quit subsequently. Study design Data come from the Health and Retirement Study, a nationally representative survey of older Americans aged 51,61 in 1991 followed every 2 years from 1992 to 1998. The 2064 participants smoking at baseline and the first follow-up comprise the main sample. Measurements Smoking cessation by 1996 is examined as the primary outcome. A secondary outcome is relapse by 1998. Spontaneous changes in smoking quantity between the first two waves make up the key predictor variables. Control variables include gender, age, education, race, marital status, alcohol use, psychiatric problems, acute or chronic health problems and smoking quantity. Findings Large (over 50%) and even moderate (25,50%) reductions in quantity smoked between 1992 and 1994 predict prospectively increased likelihood of cessation in 1996 compared to no change in quantity (OR 2.96, P < 0.001 and OR 1.61, P < 0.01, respectively). Additionally, those who reduced and then quit were somewhat less likely to relapse by 1998 than those who did not reduce in the 2 years prior to quitting. Conclusions Reducing successfully the quantity of cigarettes smoked appears to have a beneficial effect on future cessation likelihood, even after controlling for initial smoking level and other variables known to impact smoking cessation. These results indicate that the harm reduction strategy of reduced smoking warrants further study. [source] Vulvar Pain: A Phenomenological Study of Couples in Search of Effective Diagnosis and TreatmentFAMILY PROCESS, Issue 2 2008JENNIFER J. CONNOR PH.D. Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of, the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships. RESUMEN Dolor vulvar: estudio fenomenológico de parejas que buscan un diagnóstico y tratamiento efectivos El síndrome de vestibulitis vulvar (svv), un trastono de dolor vulvar, continúa dejando perplejos a los profesionales de la salud física y mental debido a su etiología desconocida y a la inexistencia de un tratamiento efectivo. Este estudio utilizó metodología fenomenológica experimental para explorar las experiencias de parejas en que a la mujer se le ha diagnosticado el svv. Se llevaron a cabo dieciséis entrevistas (en profundidad y semiestructuradas) con 13 parejas heterosexuales y 3 mujeres, de las que se obtuvieron cuatro conclusiones esenciales: (1) En busca de , la investigación médica requería una búsqueda más exhaustiva de médicos eruditos y respetuosos que aportasen un tratamiento. (2) El proceso de desarrollar una comprensión personal del trastorno condujo a varias parejas a plantearse su papel en la causa y la prolongación del svv. (3) Desarrollar estrategias para afrontar un coito doloroso condujo a tres estrategias: prescindir del sexo, optar por alternativas al sexo vaginal y modificar o soportar el coito doloroso. (4) Se experimentaron sensaciones de aislamiento, pues el proceso de adaptación a este síndrome de dolor crónico resultó, a menudo, un proceso solitario. Entre los consejos clínicos se incluyen tratar a la pareja, y no sólo a la mujer con svv; animar a las parejas a ampliar las definiciones de la importancia y preferencia por el coito vaginal, así como sugerir actividades sexuales con menor riesgo de causar dolor vulvar; desarrollar un significado común como pareja; y ayudar a las parejas a encontrar médicos y recursos. Palabras clave: síndrome de vestibulitis vulvar; dolor vulvar; terapia de pareja. [source] Chronic illness as a family process: A social-developmental approach to promoting resilienceJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2002Ester R. Shapiro This paper describes a social-developmental approach to interventions in chronic illness using naturally occurring processes of change during family life-cycle transitions to promote more positive developmental outcomes. Clinical interventions can help build resilience by creating a therapeutic collaboration designed to help patients improve their use of existing and new resources in multiple systems. They can then better meet demands of the illness as it impacts on shared development. A case example of a 13-year-old daughter with complex, chronic health problems and developmental disabilities illustrates clinical interventions designed to promote family resilience during the entry into adolescence and a transition in schooling. This approach involves focusing on the family's own definition of the current problem and relevant history, constructing a multidimensional, coherent story of the illness and its impact that recognizes stressors yet highlights strengths, and normalizing their strategies for stability under circumstances of developmental stress. These interventions with mother, daughter, and family helped improve health efficacy, communication toward mutual understanding and shared problem solving, and better use of existing and new resources to enhance current and future developmental adaptation. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 1375,1384, 2002. [source] Expanding self-help group participation in culturally diverse urban areas: Media approaches to leveraging referent powerJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2004Keith Humphreys Accumulating research attests to the benefits of self-help groups for people who have various chronic health problems. Expansion of self-help group participation may enable a broader portion of society to experience these health benefits. The Media and Education for Self-Help (MESH) Project was an effort to increase interest in health-related self-help groups among middle- and lower-income people in two California urban areas with minority,majority populations. A diverse coalition of self-help group leaders designed English- and Spanish-language radio public service announcements and posters that were disseminated in Oakland and Los Angeles. The outcome measures in each urban area were self-help-group-related telephone inquiries to local information and referral agencies (English and Spanish language) and the number of individuals attending self-help groups at agencies hosting many groups. Telephone caller data were also gathered in a nonintervention control urban area (Sacramento). Los Angeles experienced an overall increase in telephone calls about self-help groups during the MESH intervention, whereas the control urban area had no change in the number of telephone calls over the same period. The initial sharp increase in self-help-group-related telephone calls was not sustained in Oakland, however. The number of Spanish-language calls about self-help groups increased 821% in Los Angeles and 149% in Oakland in the period from the 6 months that preceded the project through the first 6 months of the MESH Project. In the MESH Project urban areas, the number of visits to self-help groups was significantly higher in intervention months than in the same calendar months of the preceding year, particularly in Oakland, where the increase exceeded 300 visits to self-help groups per month. These intriguing findings are discussed in terms of their health policy and program evaluation implications. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 413,424, 2004. [source] Analysis of fatty acids in early mid-life in fertile women: Implications for reproductive decline and other chronic health problemsAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2010Judith H. Ford The relationship between adipose fatty acid levels and age is examined in 635 Scottish fertile women aged 25,48. Fatty acids levels are highly significantly correlated with age. Factor analysis identifies four factors that account for 79.6% of variance in the data. Three Factors show significant regressions with age and patterns of involvement of specific fatty acids suggest that these Factors represent the activity of fatty acid delta-desaturase enzymes as follows: Factor 1,delta-9-desaturase, Factor 2,delta-5-desaturase, and Factor 4,delta-6-desaturase. Key changes, apparently reductions in enzyme activity, occur through the 30 and 40-year-old age groups. Such changes in enzyme function could account for decline in female fertility and increases in body fat and chronic disease common in early mid-life. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Developmental outcomes of infants with bronchopulmonary dysplasia: Comparison with other medically fragile infantsRESEARCH IN NURSING & HEALTH, Issue 3 2001Diane Holditch-Davis Abstract The purpose of this study was to compare the developmental outcomes and mother,infant interactions of infants with bronchopulmonary dysplasia (BPD) and those of other medically fragile infants. One-hour behavioral observations were made of the interactions of mothers with two groups of infants (23 with BPD, 39 medically fragile without BPD or neurological problems) at enrollment, every 2 months during hospitalization, 1 month after discharge, and at 6 months' and 12 months' corrected age. Assessment of the home environment also was done at 6 and 12 months. Multiple regressions were calculated separately for child mental, adaptive, language, and motor outcomes. Predictors were: home environment assessment, measures of maternal interactive behaviors (positive attention, expression of negative affect, medicalized caregiving), infant group membership, and presence of intraventricular hemorrhage (IVH) in the infant. There were no significant differences between the two groups in any of the developmental outcomes or interactive variables, and the presence of IVH had no effect on these variables. Maternal positive attention and the home environment were correlated with mental development, and mother negative affect was related to adaptive behavior for both groups. Differences in developmental and interactive behaviors between infants with BPD and other prematurely born infants found in other studies appear to be a result of chronic health problems and, thus, are not unique to infants with BPD. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24: 181,193, 2001 [source] Follow-up of 5- to 11-year-old children treated for persistent pulmonary hypertension of the newbornACTA PAEDIATRICA, Issue 2 2009Vibeke Eriksen Abstract Aim: Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn (PPHN). Methods: The index group consisted of 85 children and a reference group was matched for age, sex and municipality of current residence. Questionnaires were sent to the families. The families in the index group were asked to participate in an examination of their child's hearing. Results: Seven children (11%) had SNHL. SNHL was not associated with hypoxia, hypocapnia or hypotension during treatment for PPHN. In the index group chronic health problems were reported in 42% compared with 17% in the reference group (chi-square test, p = 0.001). Twenty-one percent in the index group were treated with bronchodilator therapy compared with 8% in the reference group (chi-square test, p = 0.028). In the index group five children had cerebral palsy and two had developmental delay. Nineteen percent in the index group and 5% in the reference group had remedial education (chi-square test, p = 0.008). Conclusion: Children treated for PPHN are at high risk for SNHL. Exposure to hypoxia, hypocapnia or hypotension did not predict SNHL. The incidence of chronic health problems and use of remedial education was high. [source] | ||||||||||||||||