Psychological Care (psychological + care)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Depression in Croatian Type 2 diabetic patients: prevalence and risk factors.

A Croatian survey from the European Depression in Diabetes (EDID) Research Consortium
Abstract Aims To determine the prevalence rate of and risk factors for depression in Croatian Type 2 diabetic patients. Methods Depressive mood was examined in 384 randomly selected outpatients with Type 2 diabetes. Center for Epidemiological Studies Depression Scale (CES-D) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) were used to identify depressive disturbances. The groups with CES-D , 16 and < 16 were compared with respect to demographic, psychological and clinical characteristics. Regression analysis was used to determine risk factors for depression. Results Of the examined patients, 22% had CES-D scores , 16, and in 33% of them clinical depression was confirmed by the psychiatric interview. Depressed patients compared with the non-depressed ones reported more diabetes-related problems and poorer well-being (t = 6.71, P < 0.001 and t = 11.98, P < 0.001, respectively). Multiple regression analysis indicated female gender, experienced support and the level of emotional well-being to predict depression (R = 0.74, F = 15.3, P < 0.001). Conclusions The obtained data indicate that the prevalence rate in Croatian Type 2 diabetic patients is comparable to findings from other cultural settings. Depressive symptoms can be predicted by psychological rather than disease-related variables. Psychological care for diabetic patients may be necessary to prevent depressive symptomatology. [source]

Emotional outcome after intensive care: literature review

Janice E. Rattray
Abstract Title., Emotional outcome after intensive care: literature review. Aim., This paper is a report of a literature review to identify (a) the prevalence of emotional and psychological problems after intensive care, (b) associated factors and (c) interventions that might improve this aspect of recovery. Background., Being a patient in intensive care has been linked to both short- and long-term emotional and psychological consequences. Data sources., The literature search was conducted during 2006. Relevant journals and databases were searched, i.e. Medline and CINAHL, between the years 1995 and 2006. Review methods., The search terms were ,anxiety', ,depression', posttraumatic stress', ,posttraumatic stress disorder' and ,intensive care'. Results., Fifteen papers were reviewed representing research studies of anxiety, depression and posttraumatic stress, and seven that represented intensive care follow-up clinics and patient diaries. Being in intensive care can result in significant emotional and psychological problems for a number of patients. For the majority of patients, symptoms of distress will decrease over time but for a number these will endure for some years. Current evidence indicates that emotional problems after intensive care are related to both subjective and objective indicators of a patient's intensive care experience. Evidence suggests some benefit in an early rehabilitation programme, daily sedation withdrawal and the use of patient diaries. However, additional research is required to support such findings. Conclusion., Our understanding of the consequences of intensive care is improving. Psychological care for intensive care patients has lagged behind care for physical problems. We now need to focus on developing and evaluating appropriate interventions to improve psychological outcome in this patient group. [source]

Psychological care of children and adolescents with diabetes

Alan M Delamater
First page of article [source]

Psychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluation

H. Bergquist
SUMMARY., Cancer of the esophagus is often diagnosed at a late stage and is related to severe morbidity and a low 5-year survival rate. Previous studies have reported low health-related quality of life and high suicide rates for these patients. The occurrence of psychiatric morbidity and thus the potential need for psychological support may vary over time after diagnosis. This has not been adequately studied in patients with newly diagnosed cancer of the esophagus or gastro-esophageal junction. The present study therefore aimed to prospectively evaluate the prevalence of psychiatric morbidity in 94 consecutive patients (median age 66, range 45,88 years) with all stages of disease. Psychiatric morbidity was evaluated with the Hospital Anxiety and Depression Scale (HADS) questionnaire at inclusion and 1, 2, 3, 6 and 12 months later. At inclusion, 42% of the patients had HADS scores indicating possible or probable anxiety disorder and/or depression. At all follow-ups except at 3 months, proportions of patients with possible/probable anxiety disorder were significantly lower than at inclusion. Among patients with a duration of tumor-specific symptoms exceeding 6 months pre-diagnosis, larger proportions of patients with a possible/probable anxiety disorder were found at the 1- and 6-month follow ups. The prevalence of possible/probable depression was greater among patients treated with a palliative intent than among those with a curative intent at inclusion. Patients who died during the study period scored worse for depression compared to the survivors. Apart from this, the proportion of patients with possible/probable psychiatric morbidity (anxiety and/or depression) was relatively stable over time and was unrelated to patient characteristics or clinical background, including the treatment regime. In conclusion, psychiatric morbidity is common among esophageal cancer patients, both at inclusion and over time, regardless of the cancer therapy given. The findings stress the importance of monitoring the patients' mental health and of offering adequate psychological care when needed. [source]


Miriam Aroni Krinsky
There are more than half a million children in our nation's foster care system. While foster care is intended to provide a temporary safe harbor for abused and neglected children, too many of these youth spend years in foster care limbo,experiencing a turbulent life in motion as they move from placement to placement, community to community, and school to school. Youth in foster care commonly fail to receive basic health and psychological care, and nearly 20,000 youth age out of foster care every year to an adult path of homelessness, unemployment, and despair. Our entire community must work together to more responsibly parent these youth. This article will address how lawyers and child advocates can advocate for new approaches and enhanced support on behalf of the voiceless and most vulnerable members of our community. It will address existing hurdles and systemic challenges that have helped to create the current disheartening status quo. The article will then discuss strategies that advocates can employ to turn the corner on behalf of these youth at risk. [source]

Parents and infants in changing cultural context: Immigration, trauma, and risk

Marie Rose Moro
"Entre les bibliothèques et les bébés en détresse, il y a un grand fossé" (S. Fraiberg). "Between library and at-risk infants themselves lies a great gulf" (Fraiberg, 1999, p. 416). Whether they are African or Asian, children of immigrant families live in at-risk situations where they may be exposed to serious trauma. Immigrant families often live in extreme conditions. Although research describes these conditions, the field of intervention remains weak. How many times have I heard that work among these families does not address treatment, but only basic needs, noting that the families are preoccupied with survival,where to find food, where to sleep, where to bury their dead. Yet, the psychological care of immigrant children and families has much to teach us. In this article I will describe work that attempts to bridge the gulf that Fraiberg referred to by sharing what I have learned regarding immigrant families with infants. ©2003 Michigan Association for Infant Mental Health. [source]

Orthopaedic patients' experience of motor vehicle accident in Singapore

K.L. Tan mn (ortho nrsg)
Aim:, The purpose of this paper is to present a study that explored the experiences of orthopaedic patients injured in motor vehicle accidents (MVAs), from the time of the accident until 6 months after being discharged from hospital. Background:, Trauma injuries from MVAs are increasing, with the number of deaths from such injuries continuing to rise. Victims often sustain open fractures to more than one part of their body and need rehabilitation and support to adjust to long-term chronic or permanent disability. In the last decade, research pertaining to trauma nursing has concentrated on neurologically injured patients. Although there is a paucity of research on the nursing perspective of psychological care for non-neurologically injured patients, the majority of studies located were mainly quantitative in nature and did not analyse the personal experiences of orthopaedic patients. Method:, A qualitative naturalistic inquiry approach was used, which provided a first-hand account of the traumatic MVA event experienced by six orthopaedic participants in Singapore. Data were collected from face-to-face in-depth interviews. Participants were voluntarily recruited through purposeful sampling and ,snowballing'. Interviews were audiotaped and transcribed verbatim in preparation for analysis. Findings:, The analysis of information explicated four main themes: the experience of the event, the effect of hospitalization, surviving the event and self-transformation. Conclusion:, The study provided an understanding of orthopaedic patients' experience of MVA in Singapore. The findings of the study have the potential to contribute to the limited qualitative research available concerning victims' experiences of MVAs and nurses caring for MVA victims. [source]

Rival research programmes and their influence on nursing practice

David Newbold BSc
In most forms of industry, there is an explicit link between research and development and subsequent technological processes. New discoveries can alter the direction or trajectory of technological progress. In this respect, health care is no different to any other form of industry. There are several theories of science which attempt to explain this link and predict its behaviour. According to Lakatos (1978), rival research programmes may co-exist, whilst Brouwer (1990) suggests they may vie with each other to alter the direction of technological progress. Presently, there are at least two research programmes which are competing to capture the activities of nurses. These are: the Health Care as Industrial Process programme, generating guideline driven nursing, and use of care pathways to maximize throughput plus labour substitution to minimize costs; and the Health Care as Therapeutic Interaction programme, focused on the management and delivery of the fundamental aspects of nursing care, and the use of emotional labour and psychological care to enable patients to cope and make sense of their situation. Ideally, the direction of practice should reflect both of these valid research programmes, with nurses as the staff best placed to integrate medical technology with humanity. Arguably, it is the Industrial Process programme which is currently dominant, at the price of decreased quality of care, and loss of the health benefits of therapeutic interaction. Greater effort is needed, in terms of research to reduce the apparent ,invisibility' of emotional labour, and education of nurses to boost therapeutic interaction skills. In order to re-direct the trajectory, managers should acknowledge and accommodate aspects of therapeutic interaction in service re-engineering, and use quality assurance tools which may accurately detect and monitor therapeutic interaction by nurses. [source]

Compliance in Pain Rehabilitation: Patient and Provider Perspectives

PAIN MEDICINE, Issue 1 2004
Michael E. Robinson PhD
ABSTRACT Objective. To identify potential predictors and correlates of compliance and to examine differences between patient and provider perspectives on compliance. Patients. One hundred eighty-four patients (84 men and 96 women) were recruited from a chronic pain treatment program for this telephone follow-up study. Results. Health care providers (HCPs) reported making more recommendations than patients reported hearing. Patients rated themselves as more compliant than did HCPs. Overall compliance rates at a >6-month follow-up were 89% from the patients' perspective and 70% from the HCPs' perspective. HCPs rated compliance specific to psychological care as more related to positive outcomes than did patients. Participants' pain and anxiety ratings at a >6-month follow-up and satisfaction with treatment were significantly associated with patients' compliance ratings. For HCP-rated compliance, only HCPs' perceived benefit and interference from compliance were associated. Conclusion. Results suggest important disparities between HCPs and patients on remembered recommendations, levels of compliance, and health-related importance of complying with recommendations. [source]

Analysis of the circumstances at the end of life in children with cancer: Symptoms, suffering and acceptance

AbstractBackground: In an effort to improve the quality of life of children with cancer, this study analyzes the signs and symptoms at the end of life in such children. It is hoped that these data will contribute to the development of appropriate programs to address the challenges faced by these children. Procedure: Between 1994 and 2000, 28 children died after treatment for cancer at Hamamatsu University Hospital, Japan. The circumstances, signs and symptoms at the end of life of these children were analyzed through their medical records. Results: Of the 28 children, the underlying diseases were leukemia/lymphoma (LL group; n=11), brain tumors (BT group; n=7), and other solid tumors (OST group; n=10). Records showed poor appetite (100%), dyspnea (82.1%), pain (75.0%), fatigue (71.4%), nausea/vomiting (57.1%), constipation (46.4%) and diarrhea (21.4%) among these children. Anxiety was reported in 53.6% of the entire group of 28 children; however, no child in the BT group manifested anxiety. However, disturbance of consciousness was reported in all children in the BT group, which was significantly greater than in the other groups. Awareness, fear or acceptance of the imminence of his/her own death as indicated by verbal expression was reported in nine children (32.1%). Conclusions: Using the data obtained in the present study, we describe situations faced in the terminal care of children. It is important to address the problems revealed by this analysis in order to achieve improvements in both the physical and psychological care of children with terminal cancer. [source]

Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: a cross-sectional nationwide survey in Japan

Mariko Asai
Abstract Purpose: To determine the prevalence of burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients in Japan and to explore associated factors related to end-of-life care. Methods: Questionnaires were mailed to 1436 Japanese clinical oncologists and palliative care physicians with a request to complete the Maslach Burnout Inventory (MBI), the General Health Questionnaire (GHQ-12), and to report on individual factors, including confidence in patient care. High levels of burnout and psychiatric morbidity were identified using cut-off scores of the MBI and GHQ-12. Results: A total of 697 physicians returned the questionnaires (response rate, 49.6%). Twenty-two percent of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization, 62% had a low level of personal accomplishment, and 20% had psychiatric morbidity. Clinical oncologists showed a significantly higher psychiatric morbidity than palliative care physicians. Confidence in having sufficient time to communicate with patients was significantly associated with all the burnout subscales. Conclusions: A low level of personal accomplishment was relatively high among Japanese physicians compared with previous studies. Insufficient confidence in the psychological care of patients was associated with physician burnout rather than involvement in end-of-life care. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Prostate cancer patients' support and psychological care needs: Survey from a non-surgical oncology clinic

Kathleen Lintz
While there are numerous uncertainties surrounding prostate cancer's detection and treatment, more research focusing on the psychological needs of prostate patients is required. This study investigated the support and psychological care needs of men with prostate cancer. Patients were approached during urological oncology clinics and asked to complete the: Support Care Needs Survey (SCNS), Support Care Preferences Questionnaire, EORTC QLQ-C30 (Version 3) Measure plus Prostate Module, and the Hospital Anxiety and Depression Scale (HADS). Of the 249 patients meeting study entry criteria, there was an 89% response rate resulting in a cohort of 210 patients. The data showed that significant unmet need exists across a number of domains in the areas of psychological and health system/information. The more commonly reported needs were ,fears about cancer spreading (44%),' ,concerns about the worries of those close to you (43%),' and ,changes in sexual feelings (41%).' Half of all patients reported some need in the domain of sexuality, especially men younger than 65 years. Needs were being well met in the domain of patient care and support. A significant number of patients reported having used or desiring support services, such as information about their illness, brochures about services and benefits for patients with cancer (55%), a series of talks by staff members about aspects of prostate cancer (44%), and one-on-one counselling (48%). Quality of life (QoL) was most negatively impacted in those who: were ,65 years old, had been diagnosed within one year, or had metastatic disease. Men ,65 had decreased social functioning, greater pain, increased sleep disturbance, and were more likely to be uncomfortable about being sexually intimate. Patients recently diagnosed had increased fatigue, more frequent urination, greater disturbance of sleep, and were more likely to have hot flushes. Those with advanced disease scored lower on 12 out of 15 QoL categories. PSA level had no effect on QoL or anxiety/depression scores. Men with advanced disease had greater levels of depression and those ,65 years old were more likely to be anxious. Although most men with prostate cancer seem to function quite well, a substantial minority report areas of unmet need that may be targets for improving care. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Implantable cardioverter defibrillator implant-explant-implant case study: Addressing the psychological adjustment to multiple shocks

Adrienne H. Kovacs PH.D
Abstract This case study details the multidisciplinary approach to a patient who underwent implantable cardioverter defibrillator (ICD) explantation for psychological reasons. The patient was unable to manage the stress associated with multiple shocks. He had a class I indicationfor an ICD but initially refused to undergo reimplantation. Treatment included the provision of comprehensive medical, nursing, and psychological care, with emphasis on patient autonomy and respect forthe patient's experience. [source]