JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 3 2003
John Kowal
The onset of chronic illness is one of the most pervasive health problems facing North Americans today. Only recently have researchers and clinicans seriously examined chronic physical conditions in the context of close relationships. This article briefly reviews the literature on chronic illness in adult couples. Initially, the focus is on the reciprocal link between close relationships and chronic physical conditions. A number of clinical approaches for working with chronic illness in couples are outlined, a particular case is made for the utility of emotionally focused therapy, and a case study is presented. [source]

NEW WAYS OF CONCEPTUALISING OCCUPATION BY DRAWING ON THE OCCUPATIONAL CHOICES OF PEOPLE WITH ENDURING MENTAL ILLNESS

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2003
M. Clare Taylor
No abstract is available for this article. [source]

ILLNESS, SUFFERING AND VOLUNTARY EUTHANASIA

BIOETHICS, Issue 2 2007
JUKKA VARELIUS
ABSTRACT It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering. [source]

The Illness/Injury Sensitivity Index: an examination of construct validity

DEPRESSION AND ANXIETY, Issue 6 2006
R. Nicholas Carleton M.A.
Abstract The 11-item Illness/Injury Sensitivity Index [ISI; Taylor, 1993: J Behav Ther Exp Psychiatry 24:289,299] measures fears of injury and illness and has the potential to delineate some mechanisms underlying anxiety-associated chronic health conditions. In a principal components analysis in 2005, Carleton et al. [2005a: J Psychopathol Behav Assess 27:235,241] indicated that a two-factor solution (Fear of Injury and Fear of Illness) best explained the structure of the ISI. The primary purpose of this study was to examine the structural and construct validity of the ISI. Results supported a two-factor solution after removal of two overinclusive items. Although the measure demonstrated good factorial validity, convergent and discriminant validity require further evaluation. In addition, a substantial correlation with fear of pain suggests a shift in our perspective on what constitutes a fundamental fear. Future research implications are discussed. Depression and Anxiety 23:340,346, 2006. © 2006 Wiley-Liss, Inc. [source]

Development and responsiveness of a scale to measure clinicians' attitudes to people with mental illness (medical student version)

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010
A. Kassam
Kassam A, Glozier N, Leese M, Henderson C, Thornicroft G. Development and responsiveness of a scale to measure clinicians' attitudes to people with mental illness (medical student version). Objective:, We report the rationale, reliability, validity and responsiveness studies of the Mental Illness: Clinicians' Attitudes (MICA) Scale, a 16-item scale designed to measure attitudes of health care professionals towards people with mental illness. Method:, Items were generated through focus groups with service users, carers, medical students and trainee psychiatrists. Psychometric testing was completed in a number of student samples. The responsiveness of the scale was tested after a 1.5 h mental illness stigma related intervention with medical students. Results:, The MICA scale showed good internal consistency, , = 0.79. The test,retest reliability (concordance) was 0.80 (95% CI: 0.68,0.91). The standardised response mean for the scale was 0.4 (95% CI 0.02,0.8) after a mental illness related stigma intervention. Conclusion:, The MICA scale is a responsive, reliable and valid tool, which can be used in medical education and mental health promotion settings and studies. [source]

Illness, power and prayer in Asser's Life of King Alfred

EARLY MEDIEVAL EUROPE, Issue 2 2001
Paul Kershaw
Asser's account of Alfred's mysterious illnesses is one of the most puzzling and most-discussed passages in his Life. This article attempts to place this account in its contemporary setting, analysing its devotional, intellectual and political contexts, in order to argue that, far from being an anomaly, it reflects the cultural interests of the Alfredian court and the influence upon it of contemporary Carolingian notions of rulership. In the process, Asser is shown to be an author with a keen sense of the prevailing notions of royal authority, but one equally aware of the potential dangers such notions could bring, particularly when one key royal attribute, humility, could be seen as indicative more of weakness than fitness to rule. Taken as a whole, the ideas, allusions and influences present in the work allow Asser's Life to be seen not merely as a descriptive but also as a thematic portrait of the king's intellectual interests. Above all, the Life emerges as a work with strong resonances with the cultural preoccupations of the late ninth century. [source]

Anxiety, Remembering, and Agency: Biocultural Insights for Understanding Sasaks' Responses to Illness

ETHOS, Issue 1 2009
M. Cameron Hay
When someone is ill, people respond by seeking jampi. The more anxiety surrounds the illness, the more fervently jampi are sought. This article offers a biocultural analysis of jampi, tacking between (1) ethnographic descriptions of how jampi are transmitted, recalled, and used and (2) neuropsychological evidence regarding memory, anxiety, and agency. This biocultural approach highlights the central importance of anxiety for enabling the cultural reliance on jampi through its facilitation of memorization, recall, and social action. I conclude by suggesting that through examining the importance of anxiety ethnographically we may gain insight into the embodied experiences and social and healing practices surrounding illness. [memory, emotion, agency, anxiety, illness, Indonesia] [source]

Socio-Economic Change and Emotional Illness among the Highland Maya of Chiapas Mexico

ETHOS, Issue 1 2000
George A. Collier
This paper analyses the relation of processes of socio- economic differentiation and change to the well-being and health of families within highland Maya communities and to the lived experience of emotional suffering, as defined by local categories of mental illness. We specifically analyze how highland Maya Indians of central Chiapas, Mexico, experience the contradictions of a rapidly changing economy, social relations, politics, and culture in conjunction with chawaj (chuvaj),3 one of the major Tzeltal and Tzotzil native categories of mental illness (Castille 1996; Fabrega et al. 1970). [source]

Patients' health beliefs and coping prior to autologous peripheral stem cell transplantation

EUROPEAN JOURNAL OF CANCER CARE, Issue 2 2007
E. FRICK md
The aim of this study was to determine the associations between health locus of control (LoC), causal attributions and coping in tumour patients prior to autologous peripheral blood stem cell transplantation. Patients completed the Questionnaire of Health Related Control Expectancies, the Questionnaire of Personal Illness Causes (QPIC), and the Freiburg Questionnaire of Coping with Illness. A total of 126 patients (45% women; 54% suffering from a multiple myeloma, 29% from non-Hodgkin lymphomas, and 17% from other malignancies) participated in the study. Cluster analysis yielded four LoC clusters: ,fatalistic external', ,powerful others', ,yeah-sayer' and ,double external'. Self-blaming QPIC items were positively correlated with depressive coping, and ,fate or destiny' attributions with religious coping (P < 0.001). The highest scores were found for ,active coping' in the LoC clusters ,powerful others' and ,yeah-sayer'. External LoC and an active coping style prevail before undergoing autologous peripheral blood stem cell transplantation, whereas the depressive coping is less frequent, associated with self-blaming causal attributions. Health beliefs include causal and control attributions, which can improve or impair the patient's adjustment. A mixture between internal and external attributions seems to be most adaptive. [source]

Coherent Accounts of Coping with a Chronic Illness: Convergences and Divergences in Family Measurement Using a Narrative Analysis

FAMILY PROCESS, Issue 4 2003
BARBARA H. FIESE Ph.D.
Researchers and clinicians have shown increasing interest in family narratives as an avenue for accessing the family meaning-making process. In this study, we examine the convergences and divergences between narrative assessment, family self-report, and verbal accounts of family climate. Sixty-two families with a child with pediatric asthma were interviewed about the impact that asthma had on family life. These interviews were coded for narrative coherence, relationship expectations, and engagement with the interviewer. Primary caregivers were also interviewed using the Five Minute Speech sample (FMSS) and completed self-report assessments of family functioning (Family Assessment Device [FAD] Impact on the Family Scale [IOF]). Contrary to prediction. Narrative coherence was higher in those cases where Emotional Over-involvement (EOI) was present on the FMSS. Narrative coherence and engagement with the interviewer were positively related to self-report of family problem solving, communication, and affective responsiveness as measured on the FAD. Divergences and convergences between different types of family measurement are discussed in light of meaning-making processes associated with coping with a chronic illness. [source]

A Child's Experience of Parental Depression: Encouraging Relational Resilience in Families with Affective Illness,

FAMILY PROCESS, Issue 4 2000
Lynn Focht-Birkerts LICSW
In this article, we describe an approach that parents with affective illness can use to foster the emotional resilience of their children. Building on current research that emphasizes the need to formulate concepts of risk and resilience in terms of family or relational processes, we propose that affectively ill parents can promote resilience in their children by helping them express the affect they experience as a result of parental illness-related behavior. Risk and resilience are conceptualized in terms of a family's ability to process emotion or affect: a family's need to constrict affect is a risk factor, while the family's ability to elaborate affect encourages relational resilience. An object relations model is used to discuss the ways in which encouraging this elaboration of affect, especially negative affect, contributes to resilience in children. We describe ways in which a preventive intervention helps to increase parents' emotional responsiveness to their children. Using extensive narrative data from followup interviews with families and children, constriction and expansion of emotion in children concerning affectively ill parents are documented, by multiple interviewers, over a span of more than 5 years. Where danger threatens, there also grows the saving power. ,J.C.F. Hölderlin1Patmos [source]

Mental illness, nativity, gender and labor supply

HEALTH ECONOMICS, Issue 4 2010
Victoria D. Ojeda
Abstract We analyzed the impacts of nativity and mental health (MH) on work by gender for non-elderly adults using the 2002 National Survey on Drug Use and Health. We employed two indicators of MH , the K6 scale of Mental Illness (MI) and an indicator for symptoms of Mania or Delusions (M/D). Instrumental variable (IV) models used measures of social support as instruments for MI. Unadjusted work rates were higher for immigrants (vs US-born adults). Regressions show that MI is associated with lower rates of work among US-born males but not immigrant males and females; M/D is associated lower rates of work among US-born males and females, and among immigrant males. Results did not change using IV models for MI. Most persons with MI work, yet symptom severity reduces labor supply among natives especially. Immigrants' labor supply is less affected by MI. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Obstetric Complications in Women with Diagnosed Mental Illness: The Relative Success of California's County Mental Health System

HEALTH SERVICES RESEARCH, Issue 1 2010
Dorothy Thornton
Objective. To examine disparities in serious obstetric complications and quality of obstetric care during labor and delivery for women with and without mental illness. Data Source. Linked California hospital discharge (2000,2001), birth, fetal death, and county mental health system (CMHS) records. Study Design. This population-based, cross-sectional study of 915,568 deliveries in California, calculated adjusted odds ratios (AORs) for obstetric complication rates for women with a mental illness diagnosis (treated and not treated in the CMHS) compared with women with no mental illness diagnosis, controlling for sociodemographic, delivery hospital type, and clinical factors. Results. Compared with deliveries in the general non,mentally ill population, deliveries to women with mental illness stand a higher adjusted risk of obstetric complication: AOR=1.32 (95 percent confidence interval [CI]=1.25, 1.39) for women treated in the CMHS and AOR=1.72 (95 percent CI=1.66, 1.79) for women not treated in the CMHS. Mentally ill women treated in the CMHS are at lower risk than non-CMHS mentally ill women of experiencing conditions associated with suboptimal intrapartum care (postpartum hemorrhage, major puerperal infections) and inadequate prenatal care (acute pyelonephritis). Conclusion. Since mental disorders during pregnancy adversely affect mothers and their infants, care of the mentally ill pregnant woman by mental health and primary care providers warrants special attention. [source]

Short- and Long-Term Mortality after an Acute Illness for Elderly Whites and Blacks

HEALTH SERVICES RESEARCH, Issue 4 2008
Daniel Polsky
Objective. To estimate racial differences in mortality at 30 days and up to 2 years following a hospital admission for the elderly with common medical conditions. Data Sources. The Medicare Provider Analysis and Review File and the VA Patient Treatment File from 1998 to 2002 were used to extract patients 65 or older admitted with a principal diagnosis of acute myocardial infarction, stroke, hip fracture, gastrointestinal bleeding, congestive heart failure, or pneumonia. Study Design. A retrospective analysis of risk-adjusted mortality after hospital admission for blacks and whites by medical condition and in different hospital settings. Principal Findings. Black Medicare patients had consistently lower adjusted 30-day mortality than white Medicare patients, but the initial survival advantage observed among blacks dissipated beyond 30 days and reversed by 2 years. For VA hospitalizations similar patterns were observed, but the initial survival advantage for blacks dissipated at a slower rate. Conclusions. Racial disparities in health are more likely to be generated in the posthospital phase of the process of care delivery rather than during the hospital stay. The slower rate of increase in relative mortality among black VA patients suggests an integrated health care delivery system like the VA may attenuate racial disparities in health. [source]

Mental Illness and Length of Inpatient Stay for Medicaid Recipients with AIDS

HEALTH SERVICES RESEARCH, Issue 5 2004
Donald R. Hoover
Objective. To examine the associations between comorbid mental illness and length of hospital stays (LOS) among Medicaid beneficiaries with AIDS. Data Source and Collection/Study Setting. Merged 1992,1998 Medicaid claims and AIDS surveillance data obtained from the State of New Jersey for adults with ,1 inpatient stay after an AIDS diagnosis from 1992 to 1996. Study Design. Observational study of 6,247 AIDS patients with 24,975 inpatient visits. Severe mental illness (SMI) and other less severe mental illness (OMI) diagnoses at visits were ascertained from ICD,9 Codes. About 4 percent of visits had an SMI diagnosis; 5 percent had an OMI diagnosis; 43 percent did not have a mental illness diagnosis, but were patients who had been identified as having an SMI or OMI history; and 48 percent were from patients with no identified history of mental illness. Principal Findings. The overall mean hospital LOS was 12.7 days. After adjusting for measures of HIV disease severity and health care access in multivariate models, patients presenting with primary and secondary severe mental illness (SMI) diagnoses had ,32 percent and ,11 percent longer LOS, respectively, than did similar patients without a mental illness history (p<0.001 for each). But in these adjusted models of length of stay: (1) diagnosis of OMI was not related to LOS, and (2) in the absence of a mental illness diagnosed at the visit, an identified history of either SMI or OMI was also not related to LOS. In adjusted models of time to readmission for a new visit, current diagnosis of SMI or OMI and in the absences of a current diagnosis, history of SMI or OMI all tended to be associated with quicker readmission. Conclusions. This study finds greater (adjusted) LOS for AIDS patients diagnosed with severe mental illness (but not for those diagnosed with less severe mental comorbidity) at a visit. The effect of acute severe mental illness on hospitalization time may be comparable to that of an acute AIDS opportunistic illness. While previous research raises concerns that mental illness increases LOS by interfering with treatment of HIV conditions, the associations here may simply indicate that extra time is needed to treat severe mental illnesses or arrange for discharge of afflicted patients. [source]

The Cost-Effectiveness of Independent Housing for the Chronically Mentally Ill: Do Housing and Neighborhood Features Matter?

HEALTH SERVICES RESEARCH, Issue 5 2004
Joseph Harkness
Objective. To determine the effects of housing and neighborhood features on residential instability and the costs of mental health services for individuals with chronic mental illness (CMI). Data Sources. Medicaid and service provider data on the mental health service utilization of 670 individuals with CMI between 1988 and 1993 were combined with primary data on housing attributes and costs, as well as census data on neighborhood characteristics. Study participants were living in independent housing units developed under the Robert Wood Johnson Foundation Program on Chronic Mental Illness in four of nine demonstration cities between 1988 and 1993. Study Design. Participants were assigned on a first-come, first-served basis to housing units as they became available for occupancy after renovation by the housing providers. Multivariate statistical models are used to examine the relationship between features of the residential environment and three outcomes that were measured during the participant's occupancy in a study property: residential instability, community-based service costs, and hospital-based service costs. To assess cost-effectiveness, the mental health care cost savings associated with some residential features are compared with the cost of providing housing with these features. Data Collection/Extraction Methods. Health service utilization data were obtained from Medicaid and from state and local departments of mental health. Non-mental-health services, substance abuse services, and pharmaceuticals were screened out. Principal Findings. Study participants living in newer and properly maintained buildings had lower mental health care costs and residential instability. Buildings with a richer set of amenity features, neighborhoods with no outward signs of physical deterioration, and neighborhoods with newer housing stock were also associated with reduced mental health care costs. Study participants were more residentially stable in buildings with fewer units and where a greater proportion of tenants were other individuals with CMI. Mental health care costs and residential instability tend to be reduced in neighborhoods with many nonresidential land uses and a higher proportion of renters. Mixed-race neighborhoods are associated with reduced probability of mental health hospitalization, but they also are associated with much higher hospitalization costs if hospitalized. The degree of income mixing in the neighborhood has no effect. Conclusions. Several of the key findings are consistent with theoretical expectations that higher-quality housing and neighborhoods lead to better mental health outcomes among individuals with CMI. The mental health care cost savings associated with these favorable features far outweigh the costs of developing and operating properties with them. Support for the hypothesis that "diverse-disorganized" neighborhoods are more accepting of individuals with CMI and, hence, associated with better mental health outcomes, is mixed. [source]

I'm not Alone: A Teen's Guide to Living with a Parent Who Has a Mental Illness

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2008
Article first published online: 28 FEB 200
No abstract is available for this article. [source]

Recovery of Activities of Daily Living in Older Adults After Hospitalization for Acute Medical Illness

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2008
Cynthia M. Boyd MD
OBJECTIVES: To compare functional outcomes in the year after discharge for older adults discharged from the hospital after an acute medical illness with a new or additional disability in their basic self-care activities of daily living (ADL) (compared with preadmission baseline 2 weeks before admission) with those of older adults discharged with baseline ADL function and identify predictors of failure to recover to baseline function 1 year after discharge. DESIGN: Observational. SETTING: Tertiary care hospital, community teaching hospital. PARTICIPANTS: Older (aged ,70) patients nonelectively admitted to general medical services (1993,1998). MEASUREMENTS: Number of ADL disabilities at preadmission baseline and 1, 3, 6, and 12 months after discharge. Outcomes were death, sustained decline in ADL function, and recovery to baseline ADL function at each time point. RESULTS: By 12 months after discharge, of those discharged with new or additional ADL disability, 41.3% died, 28.6% were alive but had not recovered to baseline function, and 30.1% were at baseline function. Of those discharged at baseline function, 17.8% died, 15.2% were alive but with worse than baseline function, and 67% were at their baseline function (P<.001). Of those discharged with new or additional ADL disability, the presence or absence of recovery by 1 month was associated with long-term outcomes. Age, cardiovascular disease, dementia, cancer, low albumin, and greater number of dependencies in instrumental ADLs independently predicted failure to recover. CONCLUSION: For older adults discharged with new or additional disability in ADL after hospitalization for medical illness, prognosis for functional recovery is poor. Rehabilitation interventions of longer duration and timing than current reimbursement allows, caregiver support, and palliative care should be evaluated. [source]

Are Patient Preferences for Life-Sustaining Treatment Really a Barrier to Hospice Enrollment for Older Adults with Serious Illness?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006
David Casarett MD
OBJECTIVES: To determine whether patient preferences are a barrier to hospice enrollment. DESIGN: Prospective cohort study. SETTING: Fifteen ambulatory primary care and specialty clinics and three general medicine inpatient units. PARTICIPANTS: Two hundred three seriously ill patients with cancer (n=65, 32%), congestive heart failure (n=77, 38%), and chronic obstructive pulmonary disease (n=61, 30%) completed multiple interviews over a period of up to 24 months. MEASUREMENTS: Preferences for high- and low-burden life-sustaining treatment and site of death and concern about being kept alive by machines. RESULTS: Patients were more likely to enroll in hospice after interviews at which they said that they did not want low-burden treatment (3 patients enrolled/16 interviews at which patients did not want low-burden treatment vs 47 patients enrolled/841 interviews at which patients wanted low-burden treatment; relative risk (RR)=3.36, 95% confidence interval (CI)=1.17,9.66), as were interviews at which patients said they would not want high-burden treatment (5/28 vs 45/826; RR=3.28, 95% CI=1.14,7.62), although most patients whose preferences were consistent with hospice did not enroll before the next interview. In multivariable Cox regression models, patients with noncancer diagnoses who desired low-burden treatment (hazard ratio (HR)=0.46, 95% CI=0.33,0.68) were less likely to enroll in hospice, and those who were concerned that they would be kept alive by machines were more likely to enroll (HR=5.46, 95% CI=1.86,15.88), although in patients with cancer, neither preferences nor concerns about receiving excessive treatment were associated with hospice enrollment. Preference for site of death was not associated with hospice enrollment. CONCLUSION: Overall, few patients had treatment preferences that would make them eligible for hospice, although even in patients whose preferences were consistent with hospice, few enrolled. Efforts to improve end-of-life care should offer alternatives to hospice that do not require patients to give up life-sustaining treatment, as well as interventions to improve communication about patients' preferences. [source]

Caring for the Whole Person: Integrated Health Care for Older Adults with Severe Mental Illness and Medical Comorbidity

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2004
Stephen J. Bartels MD
First page of article [source]

Predictive Value of Nonspecific Symptoms for Acute Illness in Nursing Home Residents

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003
Kenneth S. Boockvar MD
OBJECTIVES: To examine the predictive value of nonspecific symptoms for acute illness in nursing home residents. DESIGN: Prospective, observational study. SETTING: Academic nursing home located in an urban setting. PARTICIPANTS: Two hundred two newly admitted residents. MEASUREMENTS: Eleven nonspecific symptoms were ascertained by review of observations documented by nursing home staff in the medical record. Research staff independently identified acute illness according to previously established criteria from nurse report and medical record review. Follow-up was divided into 10-day intervals, and concordance between nonspecific symptoms and acute illness within these intervals was determined. Predictive values were calculated according to standard formulae. RESULTS: Nonspecific symptoms and acute illnesses occurred in 21.7% and 12.5% of 10-day intervals, respectively. Positive predictive values (PPVs) were highest for lethargy, weakness, and decreased appetite, each of which correctly predicted the presence of an acute illness one out of two times the symptoms were reported. Agitation and disorientation predicted an acute illness one out of three times, and falls predicted an acute illness one out of four times. Overall, the PPV of the occurrence of any nonspecific symptom was 0.24, and the negative predictive value of the absence of nonspecific symptoms was 0.91. CONCLUSION: Hypoactive nonspecific symptoms are more likely than other nonspecific symptoms to be signs of incipient acute illness. Studies are needed to determine whether an intervention in residents with these nonspecific symptoms can enable earlier detection and treatment of acute illness. [source]

Malingering, Perceptions of Illness, and Compensation Seeking in Whiplash Injury: A Comparison of Illness Beliefs Between Individuals in Simulated Compensation Scenarios and Litigation Claimants,

JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 11 2006
Maggie Linnell
This paper compares beliefs about whiplash injury between individuals in simulated compensation/no compensation scenarios and actual litigant claimants. Comparisons between simulators and the clinical sample revealed that chronic patients reported significantly more symptoms than all simulator groups. The beliefs of the real compensation claimants in the acute phase of the condition were similar to those in the ,injury only' simulator group. The analyses identified a trend towards beliefs in the expected timeline of the illness becoming more negative with time, whilst feelings of control over the symptoms improve. The paper discusses indicators of malingering behavior and the possible involvement of litigation and treatment processes in the transition to a chronic state of ill health. [source]

Depressive Illness in Teens and Preteens and Effectiveness of the RADS-2 as a First-Stage Assessment.

JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 3 2009
Part 1: Descriptive Paper
PROBLEM:, Measurement of the characteristics and severity of depression in adolescence is an emerging science. During patient assessment, or if using first-stage screening measures in practice, nurses must be confident that these instruments demonstrate high levels of accuracy in capturing the specific features of depressive symptoms expressed in diverse individuals. METHODS:, A review of the scientific literature of depressive illness and its assessment in teens and preteens is presented. The Reynolds Adolescent Depression Scale,Revised (RADS-2) measure is introduced and evaluated from a nursing practice standpoint. FINDINGS:, The RADS-2 is easy to use and demonstrates good reliability, validity, and construct features, providing evidence for nurses that the measure can be used with confidence in assessment of depressive symptoms in adolescents. CONCLUSIONS:, The RADS-2 is an effective first-stage assessment of depressive mood in teens and preteens. [source]

Living with a Long-Term Illness: The Facts

JOURNAL OF CLINICAL NURSING, Issue 10 2006
Janice Brown
[source]

Chronic and Terminal Illness: New Perspectives on Caring and Carers

JOURNAL OF CLINICAL NURSING, Issue 6 2002
Brenda Roe
[source]

The epidemiologic, health-related quality of life, and economic burden of gastrointestinal stromal tumours

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 6 2007
P. Reddy PharmD
Summary Background and objectives:, Gastrointestinal stromal tumours (GIST) are uncommon tumours believed to arise from interstitial cells of Cajal or their precursors in the gastrointestinal (GI) tract, accounting for a small percentage of GI neoplasms and sarcomas. Given the recent recognition of GIST as a distinct cancer, as well as new treatment options available today, a review of the epidemiologic, health-related quality of life (HRQL), and economic burden of GIST is timely from a payer, provider and patient perspective and may provide guidance for treatment decision making and reimbursement. Methods:, A systematic literature review of PubMed and five scientific meeting databases, was conducted to identify published studies and abstracts describing the epidemiologic, HRQL and economic impact of GIST. Publications deemed worthy of further review, based on the information available in the abstract, were retrieved in full text. Results and discussion:, Thirty-four publications met the review criteria: 29 provided data on GIST epidemiology, one provided cost data, three reported HRQL outcomes, and one reported cost and HRQL outcomes. The annual incidence of GIST (cases per million) ranged from 6·8 in the USA to 14·5 in Sweden, with an estimated 5-year survival rate of 45,64%. On the Functional Illness of Chronic Therapy-fatigue instrument, GIST patients scored 40·0 compared with 37·6 in anaemic cancer patients (0 = worst; 52 = least fatigue). Total costs over 10 years for managing GIST patients with molecularly targeted treatment was estimated at £47 521,£56 146 per patient compared with £4047,£4230 per patient with best supportive care. Conclusions:, The incidence of GIST appears to be similar by country; the lower estimate in one country could be explained by differences in method of case ascertainment. Data suggest that the HRQL burden of GIST is similar to that with other cancers although this requires further exploration. The value of new therapies in GIST needs to consider not only cost but also anticipated benefits and the unmet medical need in this condition. [source]

Behavioral treatment of substance abuse in schizophrenia

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2009
Wendy N. Tenhula
Abstract Co-occurring substance use disorders are highly prevalent among individuals with schizophrenia and other serious and persistent mental illnesses (SPMI) and are associated with clinically significant consequences. A multifaceted behavioral treatment called Behavioral Treatment for Substance Abuse in Serious and Persistent Mental Illness (BTSAS) can reduce substance abuse in persons with SPMI. The key treatment strategies in BTSAS include a urinalysis contingency, short-term goal setting, training in drug refusal skills, psychoeducation about the impact of drug use, and relapse prevention training. A case example illustrating the application of BTSAS is presented and relevant clinical issues are discussed. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,11, 2009. [source]

Vietnamese Americans' attitudes toward seeking mental health services: Relation to cultural variables

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2005
Quang Charles X. Nguyen
This study examined the relation between culturally based variables and attitudes toward seeking mental health services among a community sample of Vietnamese Americans ( N = 148) with at least 8 years' residence in the United States (U.S.). Variables included Stigma, Traditional Beliefs about Mental Illness, Help-Seeking Preferences, Problem Prioritizing, and Disclosure. The results indicated that Disclosure, Help-Seeking Preferences, and Problem Prioritizing were significant predictors of attitudes. Greater willingness to disclose, greater preference for professional resources over family/community resources, and higher priority placed on mental/emotional health concerns over other concerns were each associated with more favorable attitudes toward seeking mental health services. Stigma and Traditional Beliefs about Mental Illness did not appear to be significant predictors. Implications of the findings are discussed. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 213,231, 2005. [source]