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Emotional Health (emotional + health)
Selected AbstractsThe Reliability, Validity and Practical Utility of Measuring Supports using the I-CAN Instrument: Part IIJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2009Vivienne C. Riches Background, There is an urgent need for developing reliable, valid and practical instruments that assess and classify the support needed by persons with disability to function in their chosen living, working and social environments. I-CAN is an instrument that addresses the frequency and level of support needed (not individual skills or deficits) for each individual with a disability. Method, Studies were conducted to assess the test,retest reliability and inter-rater reliability. Concurrent validity was investigated by exploring the relationship between the I-CAN domain scales and the Inventory for Client and Agency Planning (ICAP) (Bruininks et al. 1986) and the Quality of Life Questionnaire (QOL-Q) (Schalock & Keith 1993). Predictive validity studies were undertaken using day- and night-time support hours. Regression analyses were run using these measures with I-CAN domain scales. Two independent studies were also conducted to ascertain the practical utility of the instrument. Results, The I-CAN instrument demonstrated excellent inter-rater and test,retest reliability in the Activities and Participation domains. Low-to-moderate test,retest results in Physical Health, Mental Emotional Health and Behaviour domains were tracked to actual change in support needs in these areas. Validity proved acceptable. The relationships between I-CAN domain scales and adaptive behaviour were mixed but in the expected direction. Low-to-moderate correlation coefficients were evident between the I-CAN scales and the QOL-Q Total, but greater support needed in certain domains was associated with less empowerment and independence, and less community integration and social belonging. Attempts to explain current support hours against the I-CAN scales were disappointing and suggest that a number of other factors apart from individual support need to play a significant role. There was general satisfaction with the assessment process from stakeholders and participant groups. Conclusions, I-CAN is a reliable, valid and user-friendly instrument for assessing the support needs of people with disabilities. It uses a process that involves the persons with disability, their family and friends and staff as appropriate. It is also apparent that the current provision of paid support hours by agencies is a complex phenomenon that is not based solely on individual support needs. Further research is warranted on the influence of the environment and the perceptions of need for support based on negotiable and non-negotiable support needs. [source] Immune thrombocytopenic purpura: epidemiology and implications for patientsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2009Marc Michel Abstract The age-adjusted prevalence of immune thrombocytopenic purpura (ITP) is estimated to be 9.5 per 100 000 persons in the USA while its annual incidence is estimated to be 2.68 per 100 000 in Northern Europe (at a cut-off platelet count of <100 × 109/L). The mean age of adults at diagnosis in Europe is 50 yrs and the incidence of ITP increases with age. Both the treatments used to treat patients with ITP and the disease itself can impact on patient health-related quality of life (HRQoL). As the incidence of ITP in Europe rises, especially in the elderly, the number of patients with a decreased HRQoL is increasing. Literature searches and focus groups have aided the development of a conceptual model to assess HRQoL. In this model, low platelet counts and the associated symptoms of ITP in addition to the side effects of treatment are proposed as the main determinants of a negatively impacted HRQoL. Primary conceptual domains of HRQoL, affected in patients with ITP, include emotional health, functional health, work, social and leisure activities and reproductive health. As treatment benefits are likely to improve these domains, the conceptual model could be used for better management of patients, taking into account HRQoL. The short-form 36-item questionnaire (SF-36) and the ITP Patient Assessment Questionnaire (ITP-PAQ) are validated measures of HRQoL which can provide a comprehensive assessment of numerous factors to help evaluate decisions about patient management. Future clinical trials investigating treatment options for ITP should assess HRQoL using these validated questionnaires. [source] The interface of mental and emotional health and pregnancy in urban indigenous women: Research in progress,INFANT MENTAL HEALTH JOURNAL, Issue 3 2010Barbara A. Hayes Research among indigenous women in Australia has shown that a number of lifestyle factors are associated with poor obstetric outcomes; however, little evidence appears in the literature about the role of social stressors and mental health among indigenous women. The not-for-profit organization beyondblue established a "Depression Initiative" in Australia. As part of this they provided funding to the Townsville Aboriginal and Torres Strait Islander Health Service in the "Mums and Babies" clinic. The aim of this was to establish a project to (a) describe the mental health and level of social stressors among antenatal indigenous women and (b) assess the impact of social stressors and mental health on perinatal outcome. A purposive sample of 92 indigenous women was carried out. Culturally appropriate research instruments were developed through consultations with indigenous women's reference groups. The participants reported a range of psychosocial stressors during the pregnancy or within the last 12 months. Significant, positive correlations emerged between the participants' Edinburgh Postnatal Depression Scale (EPDS; J. Cox, J. Holden, & R. Sagovsky, 1987) score and the mothers' history of child abuse and a history of exposure to domestic violence. A more conservative cutoff point for the EPDS (>9 vs. >12) led to 28 versus 17% of women being identified as "at risk" for depression. Maternal depression and stress during pregnancy and early parenthood are now recognized as having multiple negative sequelae for the fetus and infant, especially in early brain development and self-regulation of stress and emotions. Because of the cumulative cultural losses experienced by Australian indigenous women, there is a reduced buffer to psychosocial stressors during pregnancy; thus, it is important for health professionals to monitor the women's emotional and mental well-being. [source] Health-related quality of life of children with acute lymphoblastic leukaemia: Comparisons and correlations between parent and clinician reportsINTERNATIONAL JOURNAL OF CANCER, Issue 4 2003Elizabeth B. Waters Abstract The improving prognosis for children with cancer refocusses attention to long-term outcomes with an emphasis on quality of life. Few studies have examined relationships and differences in reported results between the parent, child and clinician. We examined parent-proxy and clinician-reported functional status and health-related quality of life for children and adolescents with acute lymphoblastic leukemia (ALL). Children and adolescents, 5,18 years, in the maintenance phase of treatment for ALL attending the Haematology/Oncology outpatient clinic at the Royal Children's Hospital, Melbourne, were eligible. Measures included: 1) parent-reported functional health and well-being (Child Health Questionnaire [CHQ]); 2) parent-reported condition specific quality of life (Pediatric Cancer Quality of Life inventory [PCQL]); 3) clinician ratings of physical and psychosocial health; and 4) clinical indicators. Insufficient numbers of older patients prohibited collection of adolescent self-reports. We had a 94% response and 31 participants. Mean time since diagnosis: 1.5 (SD 0.4) years. Parents reported significantly lower functioning and well-being than population norms for all CHQ scales, whereas cancer-specific quality of life was comparable to PCQL norms. Clinician reports of the child's global physical and psychosocial health were moderately associated with each other (rs = 0.56, p < 0.001), and with the parent-reported physical (rs = 0.47, p < 0.01) and psychosocial (rs = 0.56, p < 0.001) CHQ summary scores. Clinician reports of the child's psychosocial health were not associated with any clinical indicators reported regularly. The results demonstrate that the social, physical and emotional health and well-being of children with ALL is significantly poorer than the health of their community-based peers. Routinely collected indicators of clinical progress conceal the psychosocial burden of ALL. Data on health, well-being and quality of life can easily be incorporated into clinical care. © 2002 Wiley-Liss, Inc. [source] Maternal distress: a concept analysisJOURNAL OF ADVANCED NURSING, Issue 9 2010Elizabeth Emmanuel emmanuel e. & st john w. (2010) Maternal distress: concept analysis. Journal of Advanced Nursing,66(9), 2104,2115. Abstract Aim., This paper is a report of an analysis of the concept of maternal distress. Background., Although not well-developed, the concept of maternal distress has offered an important viewpoint in nursing and midwifery practice since the mid-1990s. Traditionally, understanding of maternal distress has been based on the medical model and dysfunction. The concept of maternal distress needs development so that it describes responses ranging from normal stress responses to those indicating mental health problem/s. Data sources., The SCOPUS, CINAHL and Medline databases were searched for the period from 1995 to 2009 using the keywords ,psychological distress', ,emotional distress' and ,maternal distress'. Review methods., Steps from Rodgers' evolutionary concept analysis guided the conduct of this concept analysis. Results., Four attributes of maternal distress were identified as responses to the transition to motherhood, with the level of each response occurring along a continuum: stress, adapting, functioning and control, and connecting. Antecedents to maternal distress include becoming a mother, role changes, body changes and functioning, increased demands and challenges, losses and gains, birth experiences, and changes to relationships and social context. The consequences of maternal distress are compromised mental health status, maternal role development, quality of life, ability to function, quality of relationships and social engagement. The extent of the impact depends on the level of maternal distress. Conclusion., Clearer interpretation of maternal distress offers a comprehensive approach to understanding maternal emotional health during the transition to motherhood. Acknowledging women's experiences and providing more appropriate support could alleviate some of the struggles and hardships experienced by mothers. [source] A review of the information and support needs of family carers of patients with chronic obstructive pulmonary diseaseJOURNAL OF CLINICAL NURSING, Issue 4 2009Ann-Louise Caress Aims and objectives., The objectives of this narrative review were to identify: (1) The information and support needs of carers of family members with chronic obstructive pulmonary disease; (2) appropriate interventions to support carers in their caregiving role; (3) information on carers' needs as reported in studies of patients living with COPD in the community. Background., Chronic obstructive pulmonary disease is a major health problem in the UK resulting in significant burden for patients, families and the health service. Current National Health Service policies emphasise, where medically appropriate, early discharge for acute exacerbations, hospital-at-home care and other models of community care to prevent or reduce re-hospitalisations of people with chronic conditions. Understanding carers' needs is important if health care professionals are to support carers in their caregiving role. Design., A narrative literature review. Methods., Thirty five papers were reviewed after searching electronic databases. Results., Few studies were identified which addressed, even peripherally, carers' needs for information and support, and no studies were found which described and evaluated interventions designed to enhance caregiving capacity. Several studies of hospital-at-home/early discharge, self care and home management programmes were identified which included some information on patients' living arrangements or marital status. However, there was little or no detail reported on the needs of, and in many cases, even the presence of a family carer. Conclusions., This review highlights the dearth of information on the needs of carers of chronic obstructive pulmonary disease patients and the need for future research. Relevance to clinical practice., There is little research based knowledge of the needs of carers of chronic obstructive pulmonary disease patients and interventions to assist them in providing care. This knowledge is critical to ensure that carers receive the information they need to carry out this role while maintaining their own physical and emotional health. [source] Physiotherapy rehabilitation in patients with massive, irreparable rotator cuff tearsMUSCULOSKELETAL CARE, Issue 3 2006Roberta Ainsworth FSCP SRP MSc BA (Hons) Abstract Background:,Massive rotator cuff tears provide a challenge for effective rehabilitation. Work has been ongoing at Torbay Hospital, Devon since 2000 to develop an exercise programme for the management of this patient group. This programme has been evaluated in a pilot study and a further randomised controlled trial is currently taking place which will enable us to estimate the treatment effect. This paper discusses the background to the development of the rehabilitation programme, the programme itself and the results of the pilot study. The pilot study was an evaluation of the rehabilitation programme. Objectives:,This study examined the effectiveness of a physiotherapy regime for the treatment of patients with massive rotator cuff tears. Methods: Patients identified through primary and secondary care referrals to physiotherapy with a clinical diagnosis of a massive rotator cuff tear underwent an ultrasound scan to confirm the diagnosis. A massive cuff tear was one where the leading edge of the tear had retracted past the glenoid margin. The clinical diagnosis was based on the presence of some or all of the following signs: positive humeral thrust on elevation, gross weakness and wasting of supraspinatus and infraspinatus, infraspinatus lag and rupture of the long head of biceps. Eligible patients were invited to take part in the study and informed consent was obtained. The baseline assessment was carried out and then the patient undertook the treatment programme. Outcome measures were reassessed 12 weeks from the baseline assessment. Design:,A cohort study of 10 patients evaluating the change from baseline to twelve weeks in the shoulder function of patients undergoing a programme of anterior deltoid strengthening and functional rehabilitation. The outcome measures used were the Oxford Shoulder Disability Questionnaire (OSDQ) and SF36. The OSDQ is validated for use with the UK population and has 12 questions with 5 point responses. The lowest (best) score is 12 and the highest (worse) score is 60. Results: Scores on the OSDQ improved with all patients. The mean improvement was 9 (range 3 to 16, standard deviation 10.3). The SF36 showed an improvement in the pain scores for all patients (mean 22 points) and an overall improvement of 10 points for the sections on role limitation due to physical health. There was an overall decline in perceived general health (9 points) and in role limitation due to emotional health (23 points). Conclusions:,As all 10 patients showed improved scores on the OSDQ, in spite of the long-standing nature of many of their shoulder problems, this rehabilitation programme was shown to improve shoulder function in this group of patients. The variation shown in the quality of life scores reflects the age group of this cohort who had a mean age of 75.5 years. All patients deemed their pain and function to have improved over the three-month period. [source] Study of the Factors Affecting Health-Related Quality of Life in Adolescents After Liver TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2009R. M. Taylor The aim of the study was to identify factors affecting health-related quality of life (HRQL) in adolescents after liver transplantation. HRQL was measured using the CHQ-CF87 in 55 adolescents, aged 12,18 years. Factors associated with HRQL included allograft morbidity, psychological and family-related variables measured through standardized questionnaires. The domains of the CHQ-CF87 were reduced using factor analysis to give physical, psychological and social domains. Impacting factors were identified through stepwise, multiple regression analysis. Adolescents had significantly lower HRQL in every domain except for role/social-behavior and family cohesion compared to the general population. Adolescents experienced median 18 (range 4,31) symptoms related to immunosuppression, 40(75%) had one or more chronic illnesses related to immunosuppression and 12(22%) had a history of emotional difficulties. Self-esteem and emotional health were similar to the general population but behavior and aspects of family function were lower. Following regression analysis, the factors associated with HRQL were: age at transplant, secondary chronic illness, symptom distress, headaches, history of emotional difficulties, self-esteem and family conflict. These explained 57% of the variance in physical function, 61% of psychological function and 39% of social function. HRQL is significantly reduced in adolescents after transplantation, which could be related to immunosuppression and psychosocial factors. [source] An exploration into the wellbeing of the families living in the ,suburbs in the bush',AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Sanjay Sharma Abstract Objective: To examine the wellbeing of families of male mine-workers living in remote mining towns in Australia. Methods: Through an extensive review of available (but limited) social science literature on mining towns this paper explores and identifies the key social issues and problems of mining towns. Social science and health-related research are used to argue that there are several factors that may negatively affect the relationship and psychological wellbeing of family members. Results: Atypical work schedules of the mining jobs could negatively affect the long-term health of the workers, and could constrain their qualitative participation in domestic roles. Limited availability of resources, services and flexi-time jobs in mining towns marginalise female partners to domestic chores. Higher level of alcohol consumption by workers and their preferred spending of leisure time with workmates symbolise patriarchal culture in mining towns that further marginalises women and could strain marital relationships. These factors could affect the social and emotional health of the children. Conclusion: Interdisciplinary studies are needed to gain realistic understanding of the dynamics of long-term impacts of long work hours/compressed work weeks, socio-cultural, motivational and environmental factors on the wellbeing of the workers and their families living in mining towns. Family counsellors and mental health professionals working in remote mining towns must take into consideration the likely negative impacts of work and community on individuals and families. [source] | ||||||||||