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Psychological Burden (psychological + burden)
Selected AbstractsFactors Associated With Burden of Primary Headache in a Specialty ClinicHEADACHE, Issue 6 2003Eugene M. Cassidy MRCPsych Objective.,To examine factors associated with social, occupational, and psychological burden of common primary headache (migraine and tension-type headache). Background.,The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unravelled. Methods.,One hundred eighty consecutive patients with either migraine or tension-type headache attending a specialty headache outpatient clinic for the first time were evaluated over a 9-month period. Headache subtype was operationally defined according to International Headache Society criteria. Headache frequency, duration, and severity were recorded. Occupational and social disability were quantified using the Migraine Disability Assessment questionnaire. Psychological burden was quantified using the 28-item General Health Questionnaire, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Premorbid vulnerability to life stress was quantified using the neuroticism subscale of the Eysenck Personality Inventory. Results.,Patients with frequent (chronic) headache scored higher on the Migraine Disability Assessment questionnaire and had higher Beck Depression Inventory and General Health Questionnaire depression scores than those with less frequent (episodic) headache. Frequency of headache, but not pain severity, duration, or diagnosis, predicted both Migraine Disability Assessment total disability and General Health Questionnaire/Beck Depression Inventory depression. Neuroticism was predictive of depression but not disability. Patients with chronic migraine had the highest depression and disability scores. Conclusion.,The number of days per month with headache is a key determinant of headache-related burden in those attending specialty clinics. Frequent (chronic) headache is associated with significantly higher psychopathology scores and general social impairment, but the direction of this relationship is not clear. Those with migraine and chronicity are the most impaired. [source] Psoriasis: is the impairment to a patient's life cumulative?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2010AB Kimball Abstract Psoriasis is associated with significant physical and psychological burden affecting all facets of a patient's life , relationships, social activities, work and emotional wellbeing. The cumulative effect of this disability may be self-perpetuating social disconnection and failure to achieve a ,full life potential' in some patients. Health-related quality of life studies have quantified the burden of psoriasis providing predominantly cross-sectional data and point-in-time images of patients' lives rather than assessing the possible cumulative disability over a patient's lifetime. However, social and economic outcomes indicate there are likely negative impacts that accumulate over time. To capture the cumulative effect of psoriasis and its associated co-morbidities and stigma over a patient's life course, we propose the concept of ,Cumulative Life Course Impairment' (CLCI). CLCI results from an interaction between (A) the burden of stigmatization, and physical and psychological co-morbidities and (B) coping strategies and external factors. Several key aspects of the CLCI concept are supported by data similar to that used in health-related quality of life assessments. Future research should focus on (i) establishing key components of CLCI and determining the mechanisms of impairment through longitudinal or retrospective case,control studies, and (ii) assessing factors that put patients at increased risk of developing CLCI. In the future, this concept may lead to a better understanding of the overall impact of psoriasis, help identify more vulnerable patients, and facilitate more appropriate treatment decisions or earlier referrals. To our knowledge, this is a first attempt to apply and develop concepts from ,Life Course Epidemiology' to psoriasis research. [source] Psychological well-being in rheumatoid arthritis: a review of the literatureMUSCULOSKELETAL CARE, Issue 2 2010Lynda Gettings BSc (Hons) Abstract The psychological well-being of patients with rheumatoid arthritis (RA) is an important issue, and the advent of measurement tools has led to a better understanding of the mental aspects associated with this chronic illness. Patients with RA are more likely to suffer from anxiety, depression and low self-esteem, with high levels of associated mortality and suicide. The loss of the ability to carry out daily functions owing to RA is also associated with the onset of depressive symptoms. Furthermore, the psychological effects of RA can extend to the partners, families and carers of sufferers. Conventional treatment has focused on treating the symptoms of RA and containment of disease progression, but may not necessarily address the psychological issues associated with the condition. Furthermore, patient perception of RA and of the support offered to them can cause further unnecessary psychological distress. Access to psychological support for RA patients has been shown to be inconsistent and haphazard. It is now being recognized that what is needed is a multidisciplinary team approach to treat psychological distress in RA alongside conventional treatment, involving alternative therapies tailored to the psychological needs of the patient. The benefits of treatments such as cognitive behavioural therapy, meditation and exercise are clear and these treatments should be actively encouraged, thereby enabling patients with RA to better manage the psychological burden associated with this chronic condition. Copyright © 2010 John Wiley & Sons, Ltd. [source] 2241: Principles of genetic counsellingACTA OPHTHALMOLOGICA, Issue 2010G HALL Purpose To present the genetic counselling needs of families with inherited eye disease. Methods A presentation on the counselling challenges and ethical dilemmas in genetic services for inherited eye disease using case illustrations and review of research and current literature. Results Genetic counselling for families with inherited eye disease is rapidly advancing with improvements in molecular testing leading to accurate diagnosis and information for families. With increasing patient demand and expectation, families request genetic counselling to understand the inheritance pattern and the risks to themselves and their children. However, the heterogeneity, variable penetrance and overlapping phenotypes make this particularly challenging in genetic eye disease. Genetic counselling is a communication process to provide information about the genetic condition, its inheritance and to facilitate decision-making around genetic testing and reproduction. Genetic counsellors have experience in helping individuals decide and come to terms with results from genetic testing such as pre-symptomatic testing, childhood testing and pre-natal diagnosis. In addition, families are often coping with the psychological burden of progressive blindness and the impact of vision loss and risk to other family members. Recent publications highlight the disparity in specialist service provision for families with inherited eye disease and calls for research and improvements in evidenced-based practice. Conclusion Families with inherited eye disease have complex genetic counselling needs requiring multidisciplinary co-ordination of services for accurate diagnosis, information provision, genetic testing and decision-making, and support and follow-up. [source] | ||||||||||