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Psychological Support (psychological + support)
Selected AbstractsPsychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluationDISEASES OF THE ESOPHAGUS, Issue 6 2007H. 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] Diabetes mellitus and geriatric syndromesGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2009Atsushi Araki Diabetes mellitus is associated with an increased prevalence and incidence of geriatric syndrome: functional disabilities, depression, fall, urinary incontinence, malnutrition and cognitive impairment. Geriatric syndrome not only leads to frailty, loss of independence and low quality of life, but also becomes a major obstacle in the treatment and care of diabetic people. The risk factors or contributing factors of geriatric symptoms are micro- and macrovascular complications, age-rated comorbid disease and aging per se. Comprehensive geriatric assessment of geriatric syndrome, including basic activities of daily living, instrumental activities of daily living, gait and balance, visual acuity, the Mini-Mental State Examination, depression scores, history and risk of fall, urination and nutrition, should be performed as part of the care of elderly diabetic patients, in particular old-old patients. Because geriatric syndromes are multifactorial and share risk factors, diabetic people with any geriatric symptoms should be treated with a common concentric strategy, such as supervised exercise therapy including muscle-strengthening training, psychological support, social support for adherence, and good glycemic control with avoidance of hypoglycemia. [source] Huntington's disease with onset ages greater than 60 yearsGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2007Kunihiro Yoshida We examined five patients with late-onset Huntington's disease (HD), who developed chorea as an initial symptom at age 60 or later. The mean disease duration from the onset of chorea was approximately 8 years (range, 2,16 years). All carried expanded HD alleles with 39 or 40 CAG repeats. Cognitive or psychiatric decline was observed in four patients, the mean duration of the disease being approximately 10 years. One of them had been institutionalized in a nursing home undiagnosed for a long time. Late-onset HD patients with shorter repeat expansions may be overlooked in Japan. Non-disabling chorea, mild cognitive or psychiatric decline in such patients are sometimes unrecognized or misunderstood as aging-related phenomena, and do not come to medical attention. Considering the potential genetic risk to younger generations, however, genetic testing on such late-onset HD patients should be conducted with careful genetic counseling and psychological support for their family members. [source] Psychological aspects and coping styles of parents with Haemophilic child undergoing a programme of counselling and psychological supportHAEMOPHILIA, Issue 3 2007A. M. BOTTOS Summary., Parents of children affected by haemophilia must face, often without prior knowledge, the difficult challenge imposed by such a pathology. To satisfy the need of information, guideline and psychological support for a better quality of life, 30 parents with haemophiliac children have participated in a programme of counselling and psychological support. Such a programme has the aim of guiding the group trough a process of discovery, comparison and personal growth and stimulating adaptive processes of problem,solving and decision,making. The aim of this paper was to verify how the programme influenced coping strategies and other psychological constructs such as depression and anxiety. Subjects of this study were administered the following psychological tests: COPE (coping, orientation to problems experienced), BDI (beck depression inventory), STAI-Y form (state,trait anxiety inventory) at the beginning and at the end of the programme. The results show that by the end of the programme subjects are characterized by a greater use of problem,focused coping strategies, typical of individuals who think that the situation is susceptible to change, and a minor use of emotion,focused coping strategies, related to individuals who regard the situation as immutable. The use of avoidance ,focused coping strategies seems to remain at the same level even if it was low. Also the other psychological aspects investigated, namely depression and anxiety, did receive a positive influence. The results show how significant such programme has been for parents. [source] Disclosing the Diagnosis of Pediatric HIV Infection: Mothers' ViewsJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2000Wendy M. Nehring ISSUES AND PURPOSE. The stigma of HIV infection creates barriers to disclosure. The purpose of this study was to identify to whom biological and foster mothers disclose the diagnosis of HIV infection, discuss their rationale, and describe the recipient's reactions. DESIGN AND METHODS. A descriptive, qualitative study included biological (n = 9) and foster (n = 11) mothers of children with HIV infection. RESULTS. Three themes emerged from the data: Telling for support, determining who should know, and telling children. These themes were present for both biological and foster mothers. PRACTICE IMPLICATIONS. It is important for nurses to realize that parental disclosure of the diagnosis of HIV infection is a long-term, age-appropriate process that will take place over many discussions and time, and should have the support of the interdisciplinary team. Additional psychological support also should be available. [source] What people with multiple sclerosis perceive to be important to meeting their needsJOURNAL OF ADVANCED NURSING, Issue 1 2007Angus Forbes Abstract Title. What people with multiple sclerosis perceive to be important to meeting their needs Aim., This paper is a report of the findings of a survey in which people with multiple sclerosis identified what they believed would be helpful in meeting their current needs. Background., People with multiple sclerosis have low levels of satisfaction with the health and social care that they receive, but previous studies suggest that they have a broad range of physical, psychological and social needs. Method., A total of 714 people with different levels of disease impact who were participating in a prospective study evaluating multiple sclerosis specialist nurses were asked, ,What one thing would be most helpful in meeting your current needs?' The question was included in the postal questionnaire used for the study (mailed in 2001 and 2002). The overall response rate for usable returns (at both time points) was 42%. Descriptive statistics on the frequency of codes and categories generated by content analysis were compiled and compared in relation to demographic and disease characteristics. Findings., A total of 445 people responded to the question. Seven categories were identified: medical treatment (29%, n = 126); socio-environmental support and adaptation (19%, n = 81); enhanced care provision (18%, n = 79); information provision (9%, n = 38); rehabilitation therapies (7%, n = 29); non-professional care (6%, n = 28); and psychological support (3%, n = 15). Nine per cent of responses (n = 39) were not coded as their meanings were unclear. Socio-environmental support, rehabilitation and non-professional care were more frequently identified by those with greater disease impact. Information was identified as a stronger need for those in lower disease impact groups. Conclusion., The findings could provide the basis for developing a multiple sclerosis-specific service satisfaction tool. This could be helpful in assessing the quality of provision, given current variations in the coverage and quality of care provided. Nurses could use such a tool to assess the quality of care in a given population, thereby highlighting gaps in service provision. [source] Interaction between caregivers and families expecting a malformed childJOURNAL OF ADVANCED NURSING, Issue 1 2003Hanna Maijala MNSc RN Background. Earlier research has shown that the care of families expecting a malformed child should be intensified and that the topic is understudied. Aim. This study aimed at generating a practical nursing theory of interaction between caregivers and families expecting a malformed child, as experienced by families. Methods. A grounded theory study was undertaken at a university hospital, Finland. Data consisted of semi-structured interviews with 29 mothers and fathers, analysed using the constant comparative method. Findings. The interaction process starts with the confirmation of the diagnosis. It usually comes as a shock to the parents, and gives rise to questions about the nature of the malformation, family members' relationship with themselves, family relationships and relationships with people outside the family. These questions are crucial to the family's coping and form the core of interaction. Families' own coping strategies are either reinforced or undermined by caregivers' actions and are reflected in parents' expectations about caregivers, which in part account for their actions and experiences of interaction. The care system as an interactive environment is part of a process which results in the experiences of being helped or being left without help. The core of the interaction process comprises two dimensions: gaining strength and losing strength in relation to malformation issues. Conclusions. The findings of the study are consistent with earlier research and complement it by providing a detailed delineation of the interaction from the perspective of the family. They can be used to formulate recommendations for improving caregivers' interactive skills and awareness of the topic through training. The care system should be developed to ensure that families receive psychological support and that the family as a whole receives proper care. Consideration of the viewpoint of siblings is a challenge for further research. [source] Patients' perceptions of information and support received from the nurse specialist during HCV treatmentJOURNAL OF CLINICAL NURSING, Issue 19-20 2010Anne Grogan Aim., To identify patients' perceptions of support received from the nurse specialist during Hepatitis C virus (HCV) treatment. Background., HCV is a worldwide health problem. However, it is a treatable disease and treatment success rates are high. Unfortunately, treatment comes with a multitude of adverse side effects and patients require informational and psychological support from specialist nurses while on treatment. To date, there is little nursing research on support received from this specialist nursing care. Design., This study used a quantitative descriptive design. Method., A 59-item questionnaire collected data from 106 patients with a diagnosis of HCV attending a HCV outpatient clinic. Results., Overall, patients were very satisfied with support received. Advice on contraception was well received. However, many patients did not feel supported with regard to advice on sleep management. There were no statistically significant differences between overall satisfaction and gender, age, genotype and risk factor. However, there were significant correlations found between support received and reported genotype. Those patients presenting with genotype 1, who are mostly infected through blood or blood products, indicated that they require more support in relation to information on side effects of treatment, quality of life and support groups. Specific approaches to support and advice for this cohort may need to be incorporated into current services. Conclusion., Results of this study reinforce the need for the ongoing use of specialist nurse services and development of this service where no such facilities exist. In addition, the service may need to further recognise and support the information and psychological needs of patients with differing modes of HCV infection. Relevance to clinical practice., Findings provide information to practising nurse specialists about patient's views of information and support received from nurse specialists in HCV treatment centres and identify where deficits exist. [source] Rapid assessment of a helpdesk service supporting severe acute respiratory syndrome patients and their relativesJOURNAL OF CLINICAL NURSING, Issue 6 2004Joanne WY Chung PhD Background., To contain severe acute respiratory syndrome, the Hong Kong Hospital Authority set a policy that stipulated there should be no visitors to hospital wards. A helpdesk service was established with the goal of providing immediate emotional and communication support to relatives while severe acute respiratory syndrome patients were isolated during the acute phase of the illness. Aim., This study describes the results of a rapid assessment of the effectiveness of a helpdesk service designed to meet the immediate needs of relatives of severe acute respiratory syndrome patients in Hong Kong. Design., Survey. Method., Eighty-three respondents, representing about 46.3% of relatives (179), attending the helpdesk on the day of the study were recruited. Service evaluation data was collected using a self-administered questionnaire completed by respondents. Results., Nearly 100% of respondents who used the service found the delivery service with on-site counselling useful for alleviating their anxiety. However, about half of these relatives complained of insufficient information regarding the patient's condition and progress. The majority of respondents were satisfied with the service. In describing the most important traits of the service providers, caring and enthusiasm were mentioned most frequently by respondents who stated that they were very satisfied with the service. Conclusion., The results support the value of the service, and demonstrate that the service is effective in meeting relatives' immediate needs. These needs include information, aid in fulfilling their role as caretaker for the patient (delivering prepared soup) and psychological support. The results suggest that facilitation of visitation of patients by relatives via video conferencing and education of the public on the nature and course of severe acute respiratory syndrome to reduce the social stigma of having a potentially life-threatening disease should be introduced in Hong Kong. Relevance to clinical practice., The results highlight important attributes that helpers (nurses) should have in order to alleviate the suffering of severe acute respiratory syndrome patients and their relatives. [source] Adolescent Obesity: Current Trends in Identification and ManagementJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 11 2004M. Anette Hagarty RN Purpose To discuss the prevalence, identification, and clinical manifestations of adolescent obesity for the advanced practice nurse in primary care. Data Sources Selected research and clinical articles. Conclusions Adolescent obesity has been historically attributed to inappropriate diet and exercise; however, recent research also attributes adolescent obesity to genetic factors and metabolic dysfunction. If left untreated, adolescent obesity may result in the metabolic complications of dyslipidemia, hypertension, cardiovascular disease, and early onset of type 2 diabetes. Implications for Practice Practitioners should focus on using the new body mass index (BMI) national guidelines for early identification of obesity. Essential to the management of this condition are education, parental involvement, behavior modification, and psychological support. [source] Quality of life in patients with facial steroid dermatitis before and after treatmentJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2008Z-H Liu Abstract Background, Improper long-term, even low-dose, topical corticosteroids, especially application to the face, could induce steroid dermatitis, which was refractory and detrimental to the quality of life. Objective, To evaluate the quality of life in patients with facial steroid dermatitis before and after the treatment of doxycycline and indomethacin plus support therapy. Study design, A prospective study. Setting, Outpatients of the Department of dermatology, the Third Hospital of Hangzhou, from August 2, 2004, to April 20, 2005. Subjects, Fifty consecutive outpatients completed the treatment. Intervention, The intervention is doxycycline 10 mg twice a day and indomethacin 25 mg twice a day for 4 weeks, cetirizine or loratadine 10 mg daily if pruritic, topical white petroleum if feeling dry and wet dressing if burning and oedema, plus psychological support and health education. Main outcome measure, The efficacy of the treatment was quantified using a 24-point steroid clinical score. The detriment of the quality of life was quantified using a 30-point Dermatology Life Quality Index. Results, The steroid dermatitis clinical score decreased significantly from 15.06 ± 4.61 at baseline to 4.52 ± 3.39 at 2 weeks after the end of treatment (week 6; P < 0.001). Twenty-one patients underwent a rebound phenomenon and the steroid dermatitis clinical score increased significantly from 13.71 ± 4.33 at baseline (week 0) to 19.24 ± 3.40 at 1 week after treatment (week 1; P < 0.001). Quality of life score decreased significantly from 13.76 ± 7.68 at baseline to 3.44 ± 2.57 at 2 weeks after the end of treatment (week 6; P < 0.001). Conclusions, The quality of life was profoundly affected by facial steroid dermatitis. Doxycycline and indomethacin plus support therapy might be effective in patients with facial steroid dermatitis. [source] Effectiveness and safety of treatments for degenerative ataxias: A systematic review,MOVEMENT DISORDERS, Issue 8 2009M.Mar Trujillo-Martín PhD Abstract The aim of this study was to determine the effectiveness and safety of available treatment alternatives for degenerative ataxias (DA). We systematically reviewed studies that assess pharmacological, rehabilitative, or psychological treatments in patients with DA. Studies were included if they fulfilled prespecified criteria. All included clinical trials were scored for methodological quality. Main outcome measures were clinical status of neurological disorder, adverse events, and patient-based factors. Twenty-five studies were included. Most studies were of small sample sizes, wide age variations, and low scientific validity. Only one study gave information on physical rehabilitation and none on psychological therapy. The remaining 24 studies reported on the effects of different pharmacological treatments. Outcomes such as functional capacity and psychological functioning of patients were evaluated by few studies. Some evidence supports that 5-hydroxytryptophan is more effective than placebo improving neurological symptoms in patients with Friedreich ataxia (FA), olivopontocerebellar atrophy, or cerebellar atrophy. Idebenone is more effective than placebo for halting and reversing the hypertrophic cardiomyopathy associated with FA, but it seems unable to improve neurological semiology. Limited evidence for other therapies was found. No relevant side effects for drugs that shown some degree of effectiveness were reported. Availability of quality studies to evaluate the safety and efficacy of treatments for most DA is scarce. No valid information on the actual value of physical rehabilitation and psychological support as treatments for DA is available. Further investigations with improved trial designs are necessary. © 2009 Movement Disorder Society [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] Leg clubs: A new approach to patient-centred leg ulcer managementNURSING & HEALTH SCIENCES, Issue 3 2000DNCERT, DipHE, Ellie Lindsay BSC(HONS) Abstract Loneliness is a significant health-care issue for many elderly patients in the community. The correlation between social isolation, poor compliance to treatment, and low healing rates for patients suffering from leg ulcers is well documented. Pain, odour, bandages etc. contribute to low self-esteem, depression and social stigma. Home visits by community nurses cannot provide the social and psychological support required by these patients. Responding to the holistic needs of this client group, the author set up Debenham Leg Club in 1995 to provide leg ulcer management in an informal, non-medical setting, where the emphasis is on social interaction, participation, empathy and peer support. This social model was conceived as a unique partnership between the district nurses and the local community, in which patients are empowered, through a sense of ownership, to become stakeholders in their own treatment. The value of the ,club' concept is evident in the happy, welcoming, uninhibited atmosphere that characterizes the clinic. Non-compliance to treatment has been virtually eliminated and evidence of greater healing rates has been illustrated through many patients whose long-standing ulcers have healed or greatly improved as a direct result of this change in approach. Patients' willingness to attend for systematic ,well leg' checks and ongoing health education has dramatically reduced the incidence of recurrence. [source] Symptoms of depression and anxiety in patients with thalassemia: Prevalence and correlates in the thalassemia longitudinal cohort,AMERICAN JOURNAL OF HEMATOLOGY, Issue 10 2010Lauren Mednick Thalassemia is an inherited blood disorder that requires lifelong adherence to a complicated and burdensome medical regimen which could potentially impact emotional functioning of patients. The importance of understanding and promoting healthy emotional functioning is crucial not only to psychological well-being, but also to physical health as it has been shown to impact adherence to medical regimens [1,4]. The current study aimed to [1] determine the prevalence of depressive and anxiety symptoms in adolescent and adult patients with thalassemia; and [2] explore possible demographic, medical, and psychosocial correlates of these symptoms in 276 patients (14,58 years old, M age = 27.83; 52% female). Overall, most patients did not report experiencing significant symptoms of anxiety and depression (33% of participants indicated experiencing symptoms of anxiety and 11% symptoms of depression). Females and older patients were more likely to experience these symptoms than males and younger patients. Symptoms of anxiety and depression were positively associated with self-report of difficulty with adherence and negatively associated with quality of life. Given these findings, regular screening for anxiety and depression symptoms could help to identify at-risk individuals to provide them with appropriate psychological support with the goal of improving both emotional and physical health. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source] Quality of life of children and adolescents after kidney or liver transplantation: Child, parents and caregiver's point of viewPEDIATRIC TRANSPLANTATION, Issue 3 2003S. Manificat Abstract: A cross-sectional study was performed to assess quality of life (QoL) after kidney or liver transplantation during childhood. Self-questionnaires explored children, adolescent and parent QoL. Seventy-five transplant children, 36 transplant adolescents, 67 mothers, 34 fathers and 67 caregivers filled out the questionnaires; they were compared with a reference population. Children reported a rather good QoL, but their extra-family involvement appeared not as satisfactory as that of the reference population children. Adolescents reported a very high QoL when completing the structured format scale; however, their responses to open-ended questions showed qualitative differences compared with those of a reference population: they expressed concern about their body or health, less pleasure than ordinary adolescents to manage by themselves, and a poor relationship with peers. Mothers indicated a deep impact of the child's illness on their own QoL, and the need for psychological support. In conclusion, a rather good QoL is a long-lasting feature of kidney and liver transplantation in children. Such an assessment is mandatory to identify remaining impairments in some selected areas, either in the recipient or family. [source] Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in TaiwanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2006CHIH-HUNG KO md Abstract, During the 2003 outbreak, severe acute respiratory syndrome (SARS) spread to more than 30 countries. Not only did it cause severe health problems but it also imposed a great psychological impact on the public. SARS emerged in Taiwan during April 2003. This study investigates the psychosocial impact and the associated factors of depression of the SARS epidemic in Taiwan when the epidemic had just been controlled. A total of 1552 respondents were recruited in the study by random selection from the telephone book. Demographic data, SARS experience, self-perceived health state, neighborhood relationships, and depression were surveyed by telephone interviewing. Respondents were grouped as ,impacted group' and ,non-impacted group' according to whether they or their friends and family had been quarantined, or suspected of being infected. The psychosocial impact and associated factors were compared between the two groups. The ,impacted group' had higher depressive levels, poorer neighborhood relationships, poorer self-perceived health, and a higher economic impact than the ,non-impacted group'. The poorer self-perceived health and economic impact factors were associated with depression. The neighborhood relationship factor was negatively associated with depression for the ,impacted group', but not for the ,non-impacted group'. The ,impacted group' had experienced greater psychosocial impact possibly due to the SARS impact, the economic downturn, poor self-perceived health conditions, and decreased social support systems. An appropriate mental health intervention to improve the self-perceived health condition, to provide instrumental and psychological support for the ,impacted group', and to decrease the stigmatization and discrimination from the public could have buffered the psychological impact from this epidemic disaster. [source] Support needs and acceptability of psychological and peer consultation: attitudes of 108 women who had undergone or were considering prophylactic mastectomyPSYCHO-ONCOLOGY, Issue 8 2008Andrea F. Patenaude Abstract Objective: Prophylactic mastectomy (PM) offers 90% or greater reduction in risk of breast cancer to women at increased hereditary risk. Nonetheless, acceptance in North America is low (0,27%) and 25,50% of women electing surgery report psychological distress and/or difficulty adapting following PM. Most women also report reduced cancer worry postoperatively. Psychological consultation to aid decision-making and post-surgical coping is not routinely offered. This retrospective, cross-sectional study explored interest in and acceptability of psychological consultation for issues related to PM among 108 women who had undergone or were considering surgery. Method: Qualitative interviews were conducted with 26 healthy women who had undergone prophylactic mastectomy of both (bilateral) breasts (BPM), 45 women who had undergone prophylactic mastectomy of one breast (unilateral contralateral) (UPM) after diagnosis of invasive breast cancer in the other breast or ductal carcinoma in situ (DCIS), and 37 women who were considering having PM surgery. Results: Of the women who had undergone PM, more than half felt pre-surgical psychological consultation was advisable; nearly 2/3 thought post-surgical psychological consultation would be helpful. All women currently considering PM believed psychological consultation would aid decision-making and preparation for surgery. Strong support was reported in all groups for the emotional and informational value of speaking with a woman who had previously undergone PM. Conclusions: Narratives illustrate the nature and intensity of the need for psychological support and describe preferences for the role of the psychologist. Suggestions are offered for integration of psychological services for women deciding about or adapting to PM. Copyright © 2008 John Wiley & Sons, Ltd. [source] Case Report: Extracorporeal Membrane Oxygenation in Nonintubated Patients as Bridge to Lung TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010K. M. Olsson We report on the use of veno-arterial extracorporeal membrane oxygenation (ECMO) as a bridging strategy to lung transplantation in awake and spontaneously breathing patients. All five patients described in this series presented with cardiopulmonary failure due to pulmonary hypertension with or without concomitant lung disease. ECMO insertion was performed under local anesthesia without sedation and resulted in immediate stabilization of hemodynamics and gas exchange as well as recovery from secondary organ dysfunction. Two patients later required endotracheal intubation because of bleeding complications and both of them eventually died. The other three patients remained awake on ECMO support for 18,35 days until the time of transplantation. These patients were able to breathe spontaneously, to eat and drink, and they received passive and active physiotherapy as well as psychological support. All of them made a full recovery after transplantation, which demonstrates the feasibility of using ECMO support in nonintubated patients with cardiopulmonary failure as a bridging strategy to lung transplantation. [source] The Vulnerability and sexual abuse of people with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 2 2007Nicholas Guy Peckham Accessible summary ,,People with learning disabilities are more likely to experience sexual things happening to them when they do not want them to. This is called sexual abuse. ,,A group was started to help some women who have been sexually abused. ,,Women who wanted to attend the group were given information about it and asked on three separate occasions if they wanted to attend. Their carers helped them and went to a different group upstairs in the same building. ,,We found that the group helped the women feel less scared and depressed and helped the women's carers understand them better. ,,This research matters because it helped the women move on with their lives and will help others who want to start a group. Summary In his capacity as a Clinical Psychologist the author provides psychological support to people with learning disabilities living in hospital and in the community. Frequently, the problem behaviour highlighted in referral letters (such as sexualized behaviour, anger management or self-harm) is formulated as relating to a past history of abuse and neglect which they had experienced. In view of increasing client referrals and a limited research literature the author established a small team, developed and then piloted a survivors' group for women with a learning disability. The pilot achieved ethical approval and the survivors' group ran concurrently with an educational support group for their carers. For more details about this pilot study see Peckham (2005)Developing, delivering and evaluating a survivors group pilot in Northumberland for women with significant learning disabilities who have been sexually abused. Unpublished DClinPsych Thesis, University of Newcastle, Newcastle upon Tyne; and Peckham et al. (2007). These articles summarize the research literature in the area of sexual abuse and describe, in detail, the problem of delivering and evaluating a survivors' group for women with learning disabilities. [source] Assessment of quality of life in adults receiving long-term growth hormone replacement compared to control subjectsCLINICAL ENDOCRINOLOGY, Issue 1 2003I. A. Malik Summary objective There are few studies of quality of life (QOL) in adults with growth hormone deficiency (GHD) compared to matched control populations without GHD. These have shown impairments in a variety of QOL measures, which improve but do not normalize after short-term replacement with GH. There is little information on QOL in long-term treated GHD patients compared with controls without GHD. patients and methods A total of 120 adults with GHD who had received GH replacement for at least 1 year were identified from the neuroendocrine clinic. Patients were asked to complete eight QOL questionnaires and an Energy Visual Analogue Scale (VAS). Results were compared with 83 control subjects without GHD from the local population who agreed to complete seven of the QOL questionnaires (excluding Disease Impact scale) and the energy VAS. The eight questionnaires were a combination of generic and disease-specific questionnaires used to assess health related QOL, namely: Short Form-36 (SF-36), Nottingham Health Profile (NHP), Disease Impact, Life Fulfilment and Satisfaction scales, Mental Fatigue Questionnaire (MFQ) and Self Esteem scale, Hospital Anxiety Depression (HAD) scale and QOL-AGHDA (assessment of GHD in adults). results Eighty-nine patients returned questionnaires and 85 (71%) had complete data for analysis. The mean (SD) duration of GH replacement was 36·0 ± 26·4 (range 13,159) months. Mean age was 43·9 ± 15·8 years (37 males) in treated GHD patients compared to a mean age 41·7 ± 10·5 years (32 males) in the controls. Mean IGF-1 levels were 22·5 ± 13·6 nmol/l in the GHD patients and the mean dose of GH replacement was 1·2 ± 0·4 IU daily. Analysis of the QOL questionnaires from the GH treated patients revealed highly significant impairments in all measures (most P , 0·0001, except life fulfilment-material, P = 0·33) compared to the control population. conclusions This large population with treated GH deficiency have significant impairments in multiple aspects of QOL despite replacement with GH and other pituitary hormones for at least 1 year (mean 3 years). It is likely therefore that other factors in addition to GH deficiency must influence QOL in these patients. Further strategies to improve QOL in these individuals should therefore be considered, e.g. psychological support and treatments and physical treatments (such as exercise programmes). [source] Section Editor: Aad Tibben, email: Tibben@lumc.nl: Quality of life and psychological distress in patients with Peutz,Jeghers syndromeCLINICAL GENETICS, Issue 3 2010MGF Van Lier van Lier MGF, Mathus-Vliegen EMH, van Leerdam ME, Kuipers EJ, Looman CWN, Wagner A, Vanheusden K. Quality of life and psychological distress in patients with Peutz,Jeghers syndrome. Little is known about psychological distress and quality of life (QoL) in patients with Peutz,Jeghers syndrome (PJS), a rare hereditary disorder. We aimed to assess QoL and psychological distress in PJS patients compared to the general population, and to evaluate determinants of QoL and psychological distress in a cross-sectional study. PJS patients completed a questionnaire on QoL, psychological distress, and illness perceptions. The questionnaire was returned by 52 patients (85% response rate, 56% females, median age 44.5 years). PJS patients reported similar anxiety (p = 0.57) and depression (p = 0.61) scores as the general population. They reported a lower general health perception (p = 0.003), more limitations due to emotional problems (p = 0.045) and a lower mental well-being (p = 0.036). Strong beliefs in negative consequences of PJS on daily life, a relapsing course of the disease, strong emotional reactions to PJS, and female gender were major determinants for a lower QoL. PJS patients experience a similar level of psychological distress as the general population, but a poorer general health perception, more limitations due to emotional problems, and a poorer mental QoL. Illness perceptions and female gender were major predictors for this lower QoL. These results may help to recognize PJS patients who might benefit from psychological support. [source] | ||||||||||||||||||||||||||||