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Emotional Distress (emotional + distress)
Selected AbstractsAn exploratory study of anxiety in carers of stroke survivorsJOURNAL OF CLINICAL NURSING, Issue 13-14 2010Nan Greenwood Aims and objectives., To investigate anxiety in informal carers of stroke survivors in the first three months after discharge. Background., Informal carers, also called caregivers, play a vital role in supporting stroke survivors. However, caring for stroke survivors can have adverse consequences amongst carers such as burden, stress and reduced quality of life. Emotional distress is also commonly reported but anxiety has received less attention than depression. Design., Prospective, longitudinal, descriptive study. Method., Forty-five carers completed the Hospital Anxiety and Depression Scale on two occasions , within one month and at three months after discharge from stroke and rehabilitation units. Results., Carers were more likely to have scores indicating anxiety than depression. In the first month, half the carers (51·1%) scored in the cut-off for anxiety and a third were in the cut-off for depression (31·1%). At three months, the picture was very similar with nearly identical proportions in the anxious and depressed categories (48·9% and 28·9%, respectively). Changes in numbers of cases of anxiety and depression and in mean anxiety scores were non-significant but there was a significant decrease in depression scores (p = 0·048). Fourteen carers (31·1%) at one month and eleven (24·4%) at three months fell into both anxious and depressed categories. Conclusions., Anxiety is a relatively neglected emotional outcome in stroke carers. Our study suggests anxiety is an important issue very early in caring whilst other research suggests it remains prevalent for many months. Given the significant role carers play in rehabilitation of stroke survivors, greater recognition of their emotional state is required. Further, longitudinal research with larger sample sizes from a range of geographical areas and improved understanding of factors associated with anxiety is needed. Relevance to clinical practice., Nurses working in the community are ideally placed to identify and support carers suffering from anxiety. [source] Emotional distress and its correlates among parents of children with pervasive developmental disordersPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 6 2007ATSUROU YAMADA md Abstract A number of studies have reported that parents of autistic children face higher levels of stress, but few studies examined the stress associated with the home care of children with pervasive developmental disorders (PDD) other than autistic disorder. The aims of the present study were therefore to (i) evaluate the emotional stress level of parents caring for their children with PDD; and (ii) explore the correlates of their emotional stress. Participants were 147 families (147 mothers and 122 fathers) of 158 children with PDD (42 with autistic disorder, 35 with Asperger's disorder and 81 with PDD not otherwise specified). K6 was used to measure the stress level of the parents. Marital relationships and personality were assessed with the Intimate Bond Measure and the NEO Five-Factor Inventory, respectively. The parents also rated the characteristics of their children with PDD through the Pervasive Developmental Disorder,Autism Society Japan Rating Scale (PARS). The mean K6 score of the mothers was significantly higher than that of the women in the general population in Japan. Stepwise multiple regression indicated that the emotional stress of the mothers was correlated with the personality traits of Neuroticism and Agreeableness, perceived Control by the husband, and the children's PARS score. Clinicians can deliver better service by paying appropriate attention to the emotional distress of mothers of children with not only autistic disorder but also other PDD. [source] Impact of caring for a school-aged child with a disability: Understanding mothers' perspectivesAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2010Helen Bourke-Taylor Aim:,Children with a disability are reliant on a capable, healthy and well-resourced carer. Most often the child's mother provides the care that ensures the child's health, service access and community integration are attended to successfully. Through in-depth interviews with mothers and professionals, this study explores issues that challenge the mother's performance in her very important role as a caregiver. Method:,Qualitative methodology(n = 8)resulted in verbatim transcriptions that were analysed and categorised, and common themes were derived. Results:,Participants identified a multitude of challenges related to issues surrounding the child, maternal characteristics, the family, services and the community. Emotional distress and mental health issues were reported. Conclusion:,Many aspects of caregiving can be relentless and challenging. Occupational therapy clinical implications aimed at supporting mothers and their children are discussed. [source] The family impact of skin diseases: the Greater Patient conceptBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007M.K.A. Basra Summary Background, Although the impact of skin disease on patients' health-related quality of life (HRQoL) is well known, little work has been carried out to determine the secondary impact of a patient's skin disease on the patient's family or partner. Objectives, The aim of this study was to identify the different aspects of a family member's QoL that may be affected by having a family member with skin disease. Methods, Qualitative interviews were conducted with 50 family members/partners of patients attending the outpatient clinic of a university hospital, with a wide range of dermatological conditions (n = 21). Subjects were invited to discuss in detail all the ways that their lives were affected by living with a patient with skin disease. Results, The mean age of subjects (M = 19; F = 31) was 48·1 years (SD = 15·7) most were either parents (44%) or spouses/partners (44%) of the patients. Patients' ages (M = 16; F = 34) ranged from 5 months to 84 years. Fifty-nine aspects of QoL of family members were identified that were adversely affected by the patients' skin disease. These were categorized into 18 main topic areas: Emotional distress (98%), Burden of care (54%), Effect on housework (42%), Social life (48%), Holidays (46%), Financial aspect (30%), Physical well-being (22%), Job/study (40%), Leisure activities (26%), Sleep (20%), Food/drink (12%), Restriction of liked activities (14%), Need for support (12%), People's attitude (10%), Dissatisfaction with medical care (14%), Effect on sex life (8%), Role of religious faith (8%) and Miscellaneous (16%). There was no significant difference between male and female subjects regarding main QoL areas affected. The median number of main topic areas reported per family member was five (mean = 5·2, range = 1,10, SD = 2·64). Conclusions, This study has demonstrated that skin diseases can significantly impair the HRQoL of the patient's family in very diverse ways. Asking family members about this impact is greatly appreciated by them. We propose the ,Greater Patient' concept to describe the immediate close social group affected by a person having skin disease. [source] Psychiatric disorders in advanced cancerCANCER, Issue 8 2007Michael Miovic MD Abstract BACKGROUND. Emotional distress and psychiatric disorders are common among patients with advanced cancer. Oncologists play an important role in screening for these conditions, providing first-line treatment and referring patients for further evaluation and treatment when indicated. METHODS. The literature on psycho-oncology was reviewed, focusing on the epidemiology, assessment, and treatment of psychiatric disorders (adjustment disorders, major depression, anxiety and post-traumatic stress, personality disorders, substance abuse, and major mental disorders such as schizophrenia and bipolar disorder) in patients with advanced cancer. Communication skills and the role of the oncologist in dealing with end-of-life issues were also reviewed. Relevant data were summarized from the most recent systematic reviews, epidemiological studies, and intervention trials. Clinical recommendations are provided. RESULTS. About 50% of patients with advanced cancer meet criteria for a psychiatric disorder, the most common being adjustment disorders (11%,35%) and major depression (5%,26%). Both psychosocial and pharmacological treatments are effective for anxiety and depression, although existing studies have methodological limitations. Collaboration with mental health specialists is recommended for patients with personality disorders, major mental illness, and substance abuse problems. Effective communication involves active listening, exploring emotion and meaning, addressing prognosis, and discussing end-of-life issues when relevant. CONCLUSIONS. Treating psychiatric conditions improves quality of life in patients with advanced cancer. Oncologists play a key role in screening for psychiatric disorders, initiating first-line treatments for depression and anxiety, and communicating with patients and caregivers about prognosis and end-of-life issues. Cancer 2007. © 2007 American Cancer Society. [source] Emotional processing in eating disorders: specific impairment or general distress related deficiency?DEPRESSION AND ANXIETY, Issue 6 2006Eva Gilboa-Schechtman Ph.D. Abstract The literature on eating disorders emphasizes the relationship between alexithymia and anorexia nervosa on the one hand, and between bulimia nervosa and affect dysregulation on the other. In our study, two questions are addressed: (1) Are there different patterns of emotional processing deficiencies in anorexia and bulimia? and (2) Is there a unique contribution of eating disorders to emotional processing deficiencies? Participants were women with anorexia nervosa (ANs, n=20), bulimia nervosa (BNs, n=20), and normal controls (NCs, n=20). Three hypotheses were examined: (1) Women with eating disorders will exhibit lower emotional awareness and more deficient emotional regulation than will NCs (emotional deficiency); (2) ANs will be less emotionally aware than BNs, whereas BNs will be less capable of effective emotional regulation than ANs (disorder specificity); and (3) emotional distress will mediate the relationships between emotional processing and eating disorders (emotional distress mediation). Results supported the emotional deficiency and distress mediation hypotheses, and partially supported the disorder specificity hypothesis. The need to move beyond alexithymia in understanding the pattern of emotional processing deficiencies in eating disorders is discussed. Depression and Anxiety 23:331,339, 2006. © 2006 Wiley-Liss, Inc. [source] Childhood acne: evaluation and managementDERMATOLOGIC THERAPY, Issue 4 2006Julie L. Cantatore-Francis ABSTRACT:, Acne is a disease that can be seen in the first year of life, early childhood, prepubertal age, and puberty. The purpose of this article is to review the clinical presentation and pathogenesis of the various forms of prepubertal acne and to propose guidelines regarding its evaluation and treatment. The early clinical recognition of the disease and prompt initiation of therapy in these age groups will help prevent the sequelae of emotional distress and severe scarring in both the child and parents. [source] Depressive symptoms in the first year from diagnosis of Type 2 diabetes: results from the DESMOND trialDIABETIC MEDICINE, Issue 8 2010T. C. Skinner Diabet. Med. 27, 965,967 (2010) Abstract Aims, To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Methods,Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. Results, The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18,22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes; these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology. Conclusions, The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes. [source] Persistent poor glycaemic control in adult Type 1 diabetes.DIABETIC MEDICINE, Issue 12 2004A closer look at the problem Abstract Around 25% of the adult Type 1 diabetes population is in persistent poor glycaemic control and thus at increased risk of developing microvascular complications. We here discuss correlates of long-standing poor glycaemic control and review the efficacy of clinical strategies designed to overcome persistent poor control. Only a few studies have identified determinants and correlates of long-standing poor glycaemic control in Type 1 diabetes. There is some evidence implicating genetic factors, as well as lower economic status, and psychological factors, including lack of motivation, emotional distress, depression and eating disorders. Ways of improving glycaemic control include strategies to enable self-management, e.g. motivational strategies, coping-orientated education, psychosocial therapies, and/or intensifying insulin injection therapy plus continuous subcutaneous insulin infusion. Long-standing poor glycaemic control appears to be a heterogeneous and complex phenomenon, for which there is no simple, single solution. Comprehensive psycho-medical assessment in diabetes care may prove useful in tailoring interventions. Further research is warranted, to increase our understanding how psychosocial and biomedical factors, separately and in interaction, determine poor outcomes in Type 1 diabetes. [source] Phobia of self-injecting and self-testing in insulin-treated diabetes patients: opportunities for screeningDIABETIC MEDICINE, Issue 8 2001E. D. Mollema Abstract Aims To define clinically relevant cut-off points for severe fear of self-injecting (FSI) and self-testing (FST) (phobia) in insulin-treated patients with diabetes, and to estimate the magnitude of these phobias in our research population. Methods, FSI and FST were assessed in a cross-sectional survey using the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ). A sample of 24 insulin-treated adult diabetic patients was selected from the high-scorers on FSI and/or FST (, 95th percentile). FSI and FST were re-assessed, after which patients participated in a behavioural avoidance test (BAT), thereby determining the current level of avoidance of either self-injecting or self-testing. FSI and FST scores were linked to the outcome of the BATs. Cut-off scores for severe FSI/FST were determined and extrapolated to the total study population (n = 1275). Results, Seven patients participated in the self-injecting BAT: two patients refused to perform an extra injection. In the self-testing BAT (n = 17) four patients declined to perform the extra blood glucose self-test. Extrapolation of FSI and FST cut-off scores to the total research population showed that 0.2,1.3% of the population scored in the severe FSI range. In FST, 0.6,0.8% of the total study population obtained scores in the cut-off range. Conclusions, Severe FSI and FST, characterized by emotional distress and avoidance behaviour, seems to occur in a small group of insulin-treated patients with diabetes. The D-FISQ can be of use to health care professionals (physicians, nurse specialists) in quickly providing valuable information on levels of FSI and FST in diabetes patients. Diabet. Med. 18, 671,674 (2001) [source] Does Neuroticism Influence Cognitive Self-Assessment After Epilepsy Surgery?EPILEPSIA, Issue 10 2000S. Cañizares Summary Purpose: To examine how cognitive, personality, and seizure outcome variables influence the subjective cognitive functioning of patients with refractory temporal lobe seizures after epilepsy surgery. Methods: Thirty-three consecutive patients with drug-resistant partial epilepsy who underwent surgical treatment at a tertiary referral university epilepsy center were tested before surgery and 1 year after surgery. Objective cognitive and subjective cognitive functioning tests were used, and personality was assessed. Seizure control was operationalized as a dichoto-mous variable. Results: A significant inverse relationship was found between neuroticism and subjective cognitive functioning. None of the other pre- and postoperative cognitive and surgery outcome variables were significant predictors of subjective cognitive functioning, even after controlling for the effect of neuroticism. Conclusions: Subjective and objective memory functioning are independent in patients with epilepsy after surgical treatment. Subjective memory functioning appears to be related not to seizure relief but to neuroticism. These data suggest that psychological factors such as personality traits predisposing to emotional distress should be taken into consideration in the clinical management and counseling of patients undergoing epilepsy surgery. [source] Cognitive,Emotional,Behavioural Therapy for the eating disorders: working with beliefs about emotionsEUROPEAN EATING DISORDERS REVIEW, Issue 6 2006Emma Corstorphine Abstract A subgroup of eating-disordered patients have particular difficulty in tolerating negative mood states and existing interventions seem to be less effective when working with such cases. This clinical practice paper outlines a Cognitive,Emotional,Behavioural Therapy (CEBT). This intervention is aimed at enabling patients to challenge the basis of their emotional distress, and thus to reduce the need for the function of the associated eating behaviours. The intervention draws on range of models and techniques, including cognitive behavioural therapy, dialectical behavioural therapy, mindfulness training and experiential exercises. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Religious Involvement and the Use of Mental Health CareHEALTH SERVICES RESEARCH, Issue 2 2006Katherine M. Harris Objectives. To examine the association between religious involvement and mental health care use by adults age 18 or older with mental health problems. Methods. We used data from the 2001,2003 National Surveys on Drug Use and Health. We defined two subgroups with moderate (n=49,902) and serious mental or emotional distress (n=14,548). For each subgroup, we estimated a series of bivariate probit models of past year use of outpatient care and prescription medications using indicators of the frequency of religious service attendance and two measures of the strength and influence of religious beliefs as independent variables. Covariates included common Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, disorders symptoms, substance use and related disorders, self-rated health status, and sociodemographic characteristics. Results. Among those with moderate distress, we found some evidence of a positive relationship between religious service attendance and outpatient mental health care use and of a negative relationship between the importance of religious beliefs and outpatient use. Among those with serious distress, use of outpatient care and medication was more strongly associated with service attendance and with the importance of religious beliefs. By contrast, we found a negative association between outpatient use and the influence of religious beliefs on decisions. Conclusion. The positive relationship between religious service participation and service use for those with serious distress suggests that policy initiatives aimed at increasing the timely and appropriate use of mental health care may be able to build upon structures and referral processes that currently exist in many religious organizations. [source] Brain dopamine is associated with eating behaviors in humansINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2003Nora D. Volkow Abstract Objective Eating behavior in humans is influenced by variables other than just hunger-satiety including cognitive restraint, emotional distress, and sensitivity to food stimuli. We investigate the role of dopamine (DA), a neurotransmitter involved with food motivation, in these variables. Methods We used the Dutch Eating Behavior Questionnaire (DEBQ) to measure Restraint, Emotionality, and Externality in 10 subjects. We correlated DEBQ scores with brain DA levels. Positron emission tomography and {11C}raclopride uptake were used to measure baseline D2 receptors (neutral stimulation) and to assess changes in extracellular DA to food stimulation (display of food). Results Restraint was correlated with DA changes with food stimulation (higher restraint, greater responsivity), emotionality was negatively correlated with baseline D2 receptors (higher emotionality, lower D2 receptors), whereas externality was not. These correlations were significant in the dorsal but not in the ventral striatum. Discussion These results provide evidence that DA in the dorsal striatum is involved with the restraint and emotionality components regulating eating behavior and that these two dimensions reflect different neurobiologic processes. © 2003 by Wiley Periodicals, Inc.Int J Eat Disord 33: 136,142, 2003. [source] Depressive symptoms and suicidal ideation among older adults receiving home delivered mealsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2008Jo Anne Sirey Abstract Objective Homebound older adults may be vulnerable to the deleterious impact of untreated depression. Yet because these elders are difficult to reach, there is little data on the rates of depressive symptoms and suicidal ideation among this group. The objective of this study is to document the rates of depression and correlates among a population of homebound elders. Methods Using a community based participatory research partnership, we implemented a routine screening for depressive symptoms and suicidal ideation among older recipients of Westchester County's home meal program. Older adults enrolled in the home delivered meal program were administered the Physician Health Questionnaire,9 (PHQ-9), and questions to assess pain, falls, alcohol abuse and perceived emotional distress. Results In our sample of 403 meal recipients, 12.2% of older adults reported clinically significant depression (PHQ-9,>,9) and 13.4% reported suicidal thoughts. One-third of recipients with significant depressive symptoms were currently taking an antidepressant. Almost one-third of older adults who endorsed suicide ideation did not report clinically significant depressive symptoms. Among men, suicidal thoughts were associated with chronic pain and greater depression severity, whereas pain was not a predictor of suicidal thoughts among women. Conclusion More than one in nine elders suffer from depression; most are untreated with one-third undertreated. Through partnerships between public agencies that provide age related services and academic investigators there is an opportunity for improved detection of unmet mental health needs. Future research should explore innovative models to improve access to mental health services once unmet need is detected. Copyright © 2008 John Wiley & Sons, Ltd. [source] Mental health nurses: De facto policeINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2007Jacklin E. Fisher ABSTRACT:, This paper examines the consequences for nursing staff and patients when police bring to hospital a person they assess to have a mental illness who exhibits violent or criminal behaviour. In particular, the impact on the nurse,patient relationship and the occupational health and safety of patients and staff is explored. Tensions between the conflicting roles for nurses of controlling the behaviour of this small minority of patients, while providing care and therapy, are examined within the context of health policy, bed shortages, and staffing problems. Recent Australian government and non-government reports are examined to assess the capacity of current health services in the State of New South Wales, to adequately and safely control behaviour while also provide therapeutic care for patients who are seeking help for their mental illness and emotional distress. [source] Fatigue after myocardial infarction: Relationships with indices of emotional distress, and sociodemographic and clinical variablesINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2010Pia Alsén RN PhD Alsén P, Brink E, Brändström Y, Karlson BW, Persson L-O. International Journal of Nursing Practice 2010; 16: 326,334 Fatigue after myocardial infarction: Relationships with indices of emotional distress, and sociodemographic and clinical variables Fatigue and depressive symptoms are relatively common among patients recovering from myocardial infarction (MI). The symptoms of depression and fatigue overlap. The present study aimed at identifying patient fatigue and at examining the incidence of fatigue, particularly without coexisting depression, after MI. The sample comprised 204 consecutive patients who had completed the questionnaires Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory,20 after MI (1 week and 4 months). The results showed that fatigue had decreased after 4 months compared with the time of MI onset. Compared with the general population, patients reported significantly higher levels of fatigue. Furthermore, fatigue was associated with depression, but 33% of the sample reported fatigue without coexisting depression after 4 months. In order to prevent or treat patients' symptoms of fatigue after MI, the concepts of fatigue and depression should be assessed separately so as to exclude overlapping effects. [source] Is nurse,patient agreement of importance to cancer nurses' satisfaction with care?JOURNAL OF ADVANCED NURSING, Issue 3 2010Gunilla Mårtensson mårtensson g., carlsson m. & lampic c. (2010) Is nurse,patient agreement of importance to cancer nurses' satisfaction with care? Journal of Advanced Nursing66(3), 573,582. Abstract Aim., This paper is a report of a study of situational (nurse,patient agreement), personal and occupational factors of potential importance to oncology nurses' satisfaction with care provided and general work satisfaction. Background., Nurses have a general tendency to attribute to patients with cancer more problems and suffering than patients themselves report. However, little is known about whether dis/agreement between oncology nurses and patients with cancer concerning perceptions of patients' situation is of importance to nurses' satisfaction with their work. Methods., The study had a comparative and prospective design. Data were collected in 2005 using self-administrated questionnaires with 81 consecutively recruited nurse,patient pairs. Data were analysed with non-parametric tests (for comparison between subgroups) and with multiple regression analyses (for identifying predictors). Results., Initial nurse,patient agreement concerning patients' emotional distress, coping resources and quality of life did not appear to be important to nurses' subsequent satisfaction with the care directed at a specific patient. However, higher satisfaction with care provided as well as general work satisfaction was reported by nurses with more experience of cancer care and with a lower workload. Conclusion., To improve oncology nurses' opportunities to provide high quality cancer care, novice nurses and advanced beginners in particular should receive support and nurses' working conditions must be improved. Further research is needed to examine whether there are other aspects of the nurse,patient relationship that contribute to oncology nurses' satisfaction with the care provided to specific patients. [source] Measuring Pricing Inefficiencies Under Stressful Market ConditionsJOURNAL OF BUSINESS FINANCE & ACCOUNTING, Issue 3-4 2003Louis Cheng This study examines the mispricing and time between arbitrage trades of the Hong Kong Hang Seng index futures and index options contracts under various stressed market conditions. Ex-ante trading profits and differences in time between trades across up and down as well as stressed and non-stressed markets are used to measure how well the derivative markets perform under emotional distress. We find evidence of illiquidity in stressed and down markets. In stressful markets and down markets, liquidity suppliers are less likely to trade against the informed traders. This, in turn, leads to longer time between trades and higher arbitrage profits. [source] A review of psychosocial needs of breast-cancer patients and their relativesJOURNAL OF CLINICAL NURSING, Issue 21 2008Silvia Schmid-Büchi Aim., To identify the psychosocial needs of breast-cancer patients and their relatives along with factors affecting these needs and to develop a tentative model to guide further research and need assessments in clinical practice. Background., Women experiencing breast cancer must deal with the diagnosis of a life-threatening illness. Treatment and the recovery process can be demanding for patients and their relatives. Need assessment may help clinicians focus on providing appropriate help. Design., Literature review. Method., Undertaken using electronic databases and specific research terms; 20 articles were identified and analysed. Results., The needs identified by patients involve (1) treatment-related physical and social impairment like fatigue, menopausal symptoms and a changed body image and (2) emotional distress like fear of recurrence, anxiety and depression. Partners need help to protect themselves and the patient from different threats. Women need information to maintain control and manage their illness. Partners want information concerning the patient's condition and both of them about the prognosis and perspectives. There is a lack of knowledge of relatives' needs. Mutual familial support, women's and partners' health and emotional distress may affect the interaction between the patients and their partners. Conclusions., A tentative family-based model to guide further research and clinical support is proposed. Further research is needed to determine precisely which psychosocial factors may influence fulfilment of the patients' and relatives' needs. Relevance to clinical practice., The proposed model may provide a framework for healthcare professionals to evaluate the patients' and relatives' met and unmet needs and the real demand for help, to guide care planning, counselling and education. [source] Why Bystanders Decline Telephone Cardiac Resuscitation AdviceACADEMIC EMERGENCY MEDICINE, Issue 9 2010Fabrice Dami MD Abstract Objectives:, The aim of this study was to evaluate the rate and reason for refusal of telephone-based cardiopulmonary resuscitation (CPR) instruction by bystanders after the implementation of the dispatch center's systematic telephone CPR protocol. Methods:, Over a 15-month period the authors prospectively collected all case records from the emergency medical services (EMS) dispatch center when CPR had been proposed to the bystander calling in and recorded the reason for declining or not performing that the bystander spontaneously mentioned. All pediatric and adult traumatic and nontraumatic cases were included. Situations when resuscitation had been spontaneously initiated by bystanders were excluded. Results:, During the study period, dispatchers proposed CPR on 264 occasions: 232 adult nontraumatic cases, 17 adult traumatic cases, and 15 pediatric (traumatic and nontraumatic) cases. The proposal was accepted in 163 cases (61.7%, 95% confidence interval [CI] = 54.6% to 66.5%), and CPR was eventually performed in 134 cases (51%, 95% CI = 43.2% to 55.3%). In 35 of the cases where resuscitation was not carried out, the condition of the patient or conditions at the scene made this decision medically appropriate. Of the remaining 95 cases, 55 were due to physical limitations of the caller, and 33 were due to emotional distress. Conclusions:, The telephone CPR acceptance rate of 62% in this study is comparable to those of other similar studies. Because bystanders' physical condition is one of the keys to success, the rate may not improve as the population ages. ACADEMIC EMERGENCY MEDICINE 2010; 17:1012,1015 © 2010 by the Society for Academic Emergency Medicine [source] Psychological issues and treatments for people with diabetesJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2001Richard R. Rubin This article examines psychological issues and their treatment among people with diabetes. The paper contains two main sections, one dealing with diagnosable clinical disorders, and the other with more mundane but nevertheless important subclinical problems in living with diabetes. We review the published literature on prevalence, manifestation, consequences, and treatment of psychological disorders in persons with diabetes, primarily depression, anxiety, and eating disorders. In describing everyday problems in living with diabetes we expand our sources beyond the published literature to include our own clinical and consulting experiences as well as our unpublished qualitative research. These problems include dietary restrictions, self-monitoring of blood glucose, taking insulin injections, and lack of support from family and health care professionals. We describe methods for dealing with such problems and discuss the tension between focusing on emotional distress versus practical issues of disease management. Finally, we briefly present some potentially positive consequences of living with diabetes so that readers can be aware of the inspirational aspects of personal experience with this disease. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 457,478, 2001 [source] Preventive interventions among children exposed to trauma of armed conflict: a literature reviewAGGRESSIVE BEHAVIOR, Issue 2 2010Kirsi Peltonen Abstract Increasing research is available on the preconditions for child mental health and optimal development in traumatic conditions, whereas less is known how to translate the findings into effective interventions to help traumatized children. This literature review analyses the effectiveness of psychosocial preventive interventions and treatments and their theoretical bases among children traumatized in the context of armed conflicts (war, military violence, terrorism and refugee). The first aim is to evaluate the effectiveness of preventive interventions in preventing emotional distress and impairment and promoting optimal emotional-cognitive and social development. The second task is to analyze the nature of the underlying mechanisms for the success of preventive interventions, and the theoretical premises of the choice of intervention techniques, procedures and tools. We found 16 relevant published studies, but an examination of them revealed that only four of them had experimental designs strong enough that they could be included in the meta-analysis. While the subjective reports of the researchers suggested that systematic preventive interventions were effective in decreasing PTSD and depressive symptoms among children traumatized due to armed conflict, the more objective results of the meta-analysis and the weaknesses in designs uncovered during the meta-analysis undermine such a conclusion. Additionally, a majority of the reported preventive interventions focused only on children's biased cognitive processes and negative emotions, while only a few aimed at influencing multiple domains of child development and improving developmental functioning on emotional, social and psychophysiological levels. It is concluded that substantial additional work needs to be done in developing effective preventive interventions and treatments for children traumatized by exposure to war and violence. Aggr. Behav. 36:95,116, 2010. © 2009 Wiley-Liss, Inc. [source] The connections between childhood sexual abuse and human immunodeficiency virus infection: Implications for interventionsJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2005Nalini Tarakeshwar A qualitative study was conducted with 28 women who are human immunodeficiency virus (HIV),positive and have experienced childhood sexual abuse (CSA) in order to examine (1) the challenges generated by the experience of sexual abuse and related coping strategies, (2) the impact of the HIV diagnosis on their coping strategies, and (3) the links perceived by the women between their CSA and HIV infection. The interviews revealed that CSA raised challenges in four areas: disclosure of the abuse, sexual problems, relationship difficulties, and psychological distress. The women used two strategies to cope with their CSA: illicit substances to numb their emotional distress and sexual activity, and alienation to gain control in relationships. When diagnosed with HIV, the women initially coped with their illness by using these two strategies. The women reported that, over time, they were able to accept their HIV illness, seek social support, find alternative sources of significance, and use spirituality to sustain their growth. However, they continued to suffer psychological distress related to their sexual trauma. Further, most of the women did not perceive any connection between the two traumas. Implications of these findings for secondary prevention interventions with women who have HIV and experience of CSA are discussed. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 655,672, 2005. [source] Emotional response to the ano-genital examination of suspected sexual abuseJOURNAL OF FORENSIC NURSING, Issue 3 2009Gail Hornor RNC Abstract Introduction: Concerns have arisen among professionals working with children regarding potential emotional distress as a result of the ano-genital examination for suspected child sexual abuse. The purpose of this study was to describe and compare children's anxiety immediately preceding and immediately following the medical assessment of suspected child sexual abuse, including the ano-genital exam, and to examine demographic characteristics of those children reporting clinically significant anxiety. Method: In this descriptive study, children between the ages of 8 to 18 years of age requiring an ano-genital examination for concerns of suspected sexual abuse presenting to the Child Assessment Center of the Center for Child and Family Advocacy at Nationwide Children's Hospital were asked to participate. The Multidimensional Anxiety Scale for Children (MASC-10) was utilized in the study. The MASC-10 was completed by the child before and after the physical exam for suspected sexual abuse. Results: Although most (86%) children gave history of sexual abuse during their forensic interview, the majority (83%) of children in this study did not report clinically significant anxiety before or after the child sexual abuse examination. Children reporting clinically significant anxiety were more likely to have a significant cognitive disability, give history of more invasive forms of sexual abuse, have a chronic medical diagnosis, have a prior mental health diagnosis, have an ano-genital exam requiring anal or genital cultures, and lack private/public medical insurance. Discussion: A brief assessment of child demographics should be solicited prior to exam. Children sharing demographic characteristics listed above may benefit from interventions to decrease anxiety regardless of provider ability to detect anxiety. [source] Attachment behaviour towards support staff in young people with intellectual disabilities: associations with challenging behaviourJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2010J. C. De Schipper Abstract Background Attachment research has shown the importance of attachment behaviour for the prevention of dysregulated behaviour due to emotional distress. The support of an attachment figure may be especially important for people with intellectual disability (ID), because they are less adept in dealing with stressful situations on their own. Our purpose was to examine the role of support staff as targets of attachment behaviour for young people with ID by testing the hypothesis that young people who more often engage in attachment interactions with group care staff are less at risk for challenging behaviours. The study design included professional caregivers' report of young persons' attachment behaviour across different relationships to address the relationship-specific nature of attachment behaviour in a group care context. Methods Support staff rated attachment behaviour of 156 young participants with moderate to severe ID who were attending a group care setting. For each participant, we asked two members of the classroom support staff to fill out the Secure Base Safe Haven Observation list. One of them also rated challenging behaviour (Abberant Behavior Checklist). Results Young people who showed more secure attachment behaviour towards professional caregivers were less irritable, less lethargic and less stereotypic in their behaviour, even if we controlled for developmental age and Autism Spectrum Disorders. Two results point in the direction of relationship-specific attachment behaviour: the absence of high consistency in a person's attachment behaviour towards two different caregivers and the independent contribution of each of these relationships to explaining differences in lethargy and stereotypies. A certain preference in attachment behaviour towards specific caregivers was not associated with challenging behaviour. Conclusions Findings suggest that attachment behaviour may be part of young persons' adaptation to the stresses and challenges of group care. Furthermore, adaptation may be determined by the integration of relationships with support staff, because each relationship with a care staff member bears uniquely on challenging behaviour. [source] Offender and crime characteristics of female serial arsonists in JapanJOURNAL OF INVESTIGATIVE PSYCHOLOGY AND OFFENDER PROFILING, Issue 1 2007Taeko Wachi Abstract This study of Japanese female serial arsonists examined their crimes and background characteristics. The data were a sample from the national police register containing arson cases resulting in charges in Japan between 1982 and 2005. Serial arsonists were 6% of the arson offenders and 12% of these were female, resulting in 83 female serial arsonist data sets. The mean age was 37.6 years and 43% were unemployed. Nearly half were married. Only 28% had a documented history of mental problems and 22% had a prior arrest, usually for theft (19%). Female serial arsonists are characterised by going to a place near their home with a lighter and setting fire directly to combustible materials. Non-metric multidimensional scaling was used to analyse 33 variables related to the offences. The arsons could be differentiated in terms of either expressive or instrumental sources of action. Expressive arsons were opportunistic and impulsive acts, motivated by emotional distress. The fires were mostly set close to home. Expressive arsons were characteristic of 66% of the females. Instrumental arsons were often motivated by revenge and involved planned and goal-directed behaviours. They were committed by 13% of the females. Instrumental arsonists tended to travel further from home. Copyright © 2007 John Wiley & Sons, Ltd. [source] Economic Crisis and Marital Problems in Turkey: Testing the Family Stress ModelJOURNAL OF MARRIAGE AND FAMILY, Issue 3 2009ik A. Aytaç This paper applied the family stress model to the case of Turkey in the wake of the 2001 economic crisis. Using structural equation modeling and a nationally representative urban sample of 711 married women and 490 married men, we tested whether economic hardship and the associated family economic strain on families resulted in greater marital problems. Our results showed a modified family stress model applies to Turkey. In contrast to most previous research, economic strain had a direct effect on marital problems, and the indirect effect of strain, via emotional distress, was only significant for women. The results were interpreted in light of social and cultural factors that condition how economic distress affects marital relations. [source] Pituitary disease , perspectives of patients and partnersJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 2 2009FRCNA, Trisha Dunning AM Aim. To explore experiences of pituitary disease of people with pituitary disease (PD) and their partners (PT). Background. Pituitary disease encompasses a range of hormonal abnormalities that produce a variety of signs and symptoms depending on the underlying cause. Design. A triangulated exploratory study. Methods. The study was conducted in three phases: (a) non-participant monitoring of an Internet pituitary chat room over four months; (b) in-depth structured interviews with PD attending a pituitary outpatient clinic (n = 8) and PT (n = 6), (c) focus groups (n = 12). Data were collected in 2005. Results. Four themes emerged from the discussion in each phase: ,need to be normal', ,emotional merry-go-round', ,damage to the self', and ,doctor ignorance'. Symptoms of pituitary disease were often mistaken for sinusitis, ,getting old before my time', hypochondria, stress, and ,something sinister changing the way I look'. Time to diagnosis varied from four weeks to 15 years. PD felt included in decision-making but partners relied on PD for information. Body image changes were significant making PD feel like a ,freak show for medical students' and the emotional distress persisted after treatment and ,cure'. The word ,tumour' caused significant stress and anxiety and depression was common. PD and PT felt general practitioners (GP) lacked information about pituitary disease. Conclusions. Pituitary disease has a major impact on psychological well-being. PD but not PT felt involved in decisions about their management. GPs may need more education about pituitary disease. The study adds important information about the emotional effects of pituitary disease and its treatment. Relevance to clinical practice. Pituitary disease is a generic term encompassing a range of underlying disease processes that often produce vague symptoms, often attributed to other causes, which delays diagnosis and treatment. Pituitary disease has a significant under recognised impact on people's mental and physical wellbeing and self-concept. Although the underlying hormonal imbalances associated with pituitary disease are largely reversible (cured), emotional distress persists. Regular monitoring of emotional wellbeing as well as medical and hormone status is warranted. [source] Restraint and seclusion: a distressing treatment option?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 7 2009A. MORAN phd bns (hons) rgn The effectiveness of restraint and seclusion interventions in the nursing management of disturbed and aggressive clients remains questionable. Considerable debate continues regarding the use of these treatment options in psychiatric hospitals. The existing literature suggests that the controversial nature of restraint and seclusion creates a complex dilemma for nurses, which initiates emotional distress. This study specifically explored the emotions and feelings experienced by a group of psychiatric nurses working in Ireland in relation to incidents of restraint and seclusion. A qualitative research approach was employed incorporating focus group discussions. A total of 23 nurses participated in three focus group interviews. The data were analysed using qualitative interpretive analysis. Three themes were created consisting of: (1) the last resort , restraint and seclusion; (2) emotional distress; and (3) suppressing unpleasant emotions. It is suggested that the nurses' experience of restraint and seclusion created a dynamic movement between the release and suppression of distressing emotions. The oscillatory characteristics embedded within the nurses' emotional responses were reminiscent of a model of suffering developed by Morse in 2001. Consequently, this model is incorporated throughout the discussion of the findings to provide a more in-depth description of the emotional distress experienced by the nurses in the study. [source] | ||||||||||||||||||||||||||||||||||||||||