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676 to 700 of 2,047Child's symptom burden and depressive symptoms among caregivers of children with cancers: an argument for early integration of pediatric palliative care.
Background: Childhood cancers evoke various emotional reactions in caregivers which can impair their well-being and roles. Little is known about caregiving and which cancer-associated factors are related to caregiver's depression in resource-restricted settings. We sought to investigate if child's symptom burden is related to depressive symptoms in caregivers.
Methods: Seventy-two caregivers and children with cancers were administered questionnaires to elicit socio-demographic and disease-related data. Subsequently, the child's symptoms were profiled with Memorial Symptom Assessment Scale (MSAS 7-12); while screening for depressive symptoms in caregivers was done using the Center for Epidemiologic Studies Depression Scale-Revised (CES-DR).
Results: All the caregivers were parents, and largely mothers (83.7%). The mean ages of caregivers and children were 39±2 and 10±2 years respectively.…
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The Role of Resilience in the Clinical Management of Chronic Pain.
Chronic pain affects more individuals than does cancer, heart disease, and diabetes combined. Yet, our treatment options remain remarkably limited. Often, highly effective psychotherapeutic approaches are limited by many barriers such as access, reimbursement, and acceptability; however, resilience-based positive activity interventions could offer a promising alternative. These interventions are engaging, non-stigmatizing, and do not require a mental health professional for their provision. This article reviews the new, but limited, research exploring the use of positive activity interventions for the treatment of patients with chronic pain. The related psychological and biological mechanisms are addressed, as are suggestions for more systematically evaluating the potential for positive activity interventions to become an adjunct to or stand-alone intervention strategy for patients with …
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[Psychosomatics and psychotraumatology of refugees and migrants : A Challenge for the Internist].
Many refugees experience severely stressful events in their home countries, during migration and occasionally even after arrival in the country of destination. The individual reactions not only influence the mental health but also somatic well being. Traumatic events may have an essential impact on psychosocial functioning; moreover, the social circumstances during the integration process influence mental stability. Physicians play an important role in identifying possible traumatization and subsequently guiding towards adequate treatment; hence, the healthcare of refugees should regularly include psychosomatic and psychotraumatological aspects. Knowledge of screening instruments, trauma-informed care and interpreter-assisted communication are necessary to meet required standards.
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Kneebone II (2016)reviewMEDLINE-indexed journal, not yet read by usDisability and rehabilitation59 citations Stepped psychological care after stroke.
Purpose: Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. It is a challenge to manage these problems effectively, particularly in times of resource stringency. One proposal for how to do this has arisen out of an approach to general mental health management: a system of 'stepped care'. Such a system directs intervention by considering level of need, thereby making the most efficient use of available resources. It is the purpose of this article to articulate a stepped psychological care approach for emotional problems after stroke.
Method: Narrative review and elaboration of the model proposed by the Department of Health in England for the management of emotional problems after stroke.
Results: A stepped care model for the management of emotional problems after stroke is presented in detail, including descriptions of specific interventions and g…
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Weaver MS, Heinze KE, Bell CJ, Wiener L, Garee AM, Kelly KP, Casey RL, Watson A, Hinds PS, Pediatric Palliative Care Special Interest Group at Children’s National Health System (2016)reviewMEDLINE-indexed journal, not yet read by usPalliative medicine111 citations Establishing psychosocial palliative care standards for children and adolescents with cancer and their families: An integrative review.
Background: Despite standardization in disease assessments and curative interventions for childhood cancer, palliative assessments and psychosocial interventions remain diverse and disparate.
Aim: Identify current approaches to palliative care in the pediatric oncology setting to inform development of comprehensive psychosocial palliative care standards for pediatric and adolescent patients with cancer and their families. Analyze barriers to implementation and enabling factors.
Design: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines framed the search strategy and reporting. Data analysis followed integrative review methodology.
Data sources: Four databases were searched in May 2014 with date restrictions from 2000 to 2014: PubMed, Cochrane, PsycINFO, and Scopus. A total of 182 studies were included for synthesis. Types of studies included randomized and non-…
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Hui D, Bruera E (2016)reviewMEDLINE-indexed journal, not yet read by usNature reviews. Clinical oncology268 citations Integrating palliative care into the trajectory of cancer care.
Over the past five decades, palliative care has evolved from serving patients at the end of life into a highly specialized discipline focused on delivering supportive care to patients with life-limiting illnesses throughout the disease trajectory. A growing body of evidence is now available to inform the key domains in the practice of palliative care, including symptom management, psychosocial care, communication, decision-making, and end-of-life care. Findings from multiple studies indicate that integrating palliative care early in the disease trajectory can result in improvements in quality of life, symptom control, patient and caregiver satisfaction, illness understanding, quality of end-of-life care, survival, and costs of care. In this narrative Review, we discuss various strategies to integrate oncology and palliative care by optimizing clinical infrastructures, processes, educatio…
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Barclay L, McDonald R, Lentin P (2015)reviewMEDLINE-indexed journal, not yet read by usInternational journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation92 citations Social and community participation following spinal cord injury: a critical review.
Evaluation of rehabilitation outcomes following acquired disability should include participation in social and community life. Evidence is needed to guide clinical practice to ensure that it is client-centered; therefore, findings from studies that report on social and community participation following spinal cord injury (SCI) need to be reviewed and synthesized. The objectives of this critical literature review are to examine the available evidence on social and community participation following SCI and to examine the factors that influence that participation. The barriers and facilitators will be identified and described in terms of the contextual factors - personal or environmental, as outlined by the International Classification of Functioning, Disability and Health. An additional objective is to appraise the quality of the evidence examined. A systematic literature search was comple…
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Providing comprehensive health services for young key populations: needs, barriers and gaps.
Introduction: Adolescence is a time of physical, emotional and social transitions that have implications for health. In addition to being at high risk for HIV, young key populations (YKP) may experience other health problems attributable to high-risk behaviour or their developmental stage, or a combination of both.
Methods: We reviewed the needs, barriers and gaps for other non-HIV health services for YKP. We searched PubMed and Google Scholar for articles that provided specific age-related data on sexual and reproductive health; mental health; violence; and substance use problems for adolescent, youth or young sex workers, men who have sex with men, transgender people, and people who inject drugs.
Results: YKP experience more unprotected sex, sexually transmitted infections including HIV, unintended pregnancy, violence, mental health disorders and substance use compared to older members…
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Holtzman CW, Shea JA, Glanz K, Jacobs LM, Gross R, Hines J, Mounzer K, Samuel R, Metlay JP, Yehia BR (2015)reviewMEDLINE-indexed journal, not yet read by usAIDS care125 citations Mapping patient-identified barriers and facilitators to retention in HIV care and antiretroviral therapy adherence to Andersen's Behavioral Model.
Andersen's Behavioral Model (ABM) provides a framework for understanding how patient and environmental factors impact health behaviors and outcomes. We compared patient-identified barriers/facilitators to retention in care and antiretroviral therapy (ART) adherence and evaluated how they mapped to ABM. Qualitative semi-structured interviews with 51 HIV-infected adults at HIV clinics in Philadelphia, PA, in 2013 were used to explore patients' experiences with HIV care and treatment. Interview data were analyzed for themes using a grounded theory approach. Among those interviewed, 53% were male and 88% were nonwhite; 49% were retained in care, 96% were on ART, and 57% were virally suppressed. Patients discussed 18 barriers/facilitators to retention in care and ART adherence: 11 common to both behaviors (stigma, mental illness, substance abuse, social support, reminder strategies, housing, …
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Determinants of women's satisfaction with maternal health care: a review of literature from developing countries.
Background: Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries.
Methods: The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporti…
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Greenbaum VJ (2014)reviewMEDLINE-indexed journal, not yet read by usCurrent problems in pediatric and adolescent health care59 citations Commercial sexual exploitation and sex trafficking of children in the United States.
Child commercial sexual exploitation and sex trafficking are global health problems requiring a multidisciplinary approach by individuals, organizations, communities, and national governments. The adverse emotional, physical, and social consequences for victims are legion and in many areas of the United States and the rest of the world, victim resources are scarce. Since violence, deprivation, abuse, and infection are so integral to the exploitation experience, victims may present for care to community and academic pediatric and adolescent health care providers. It is essential that medical professionals have the knowledge, skills, and resources to recognize victims, assess their needs, and treat them appropriately, including making key referrals for community services. However, to date medical information and resources regarding commercial sexual exploitation and sex trafficking has bee…
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Noonan B (2014)reviewMEDLINE-indexed journal, not yet read by usEuropean journal of oncology nursing : the official journal of European Oncology Nursing Society43 citations Understanding the reasons why patients delay seeking treatment for oral cancer symptoms from a primary health care professional: an integrative literature review.
Purpose: The purpose of this integrative literature review was to investigate existing research on the reasons why patients delay in seeking treatment for oral cancer symptoms from a primary health care professional.
Method: The systematic approach developed by Cooper (1984) was the guiding framework for this integrative review. Cooper (1984) identifies the process of conducting an integrative review as encompassing the following five stages: (a) problem formulation, (b) data collection, (c) evaluation of data points, (d) data analysis and interpretation, and (e) public presentation of results.
Results: Despite different research designs employed and sample sizes ranging from 15 to 559, three major themes emerged from the 16 studies included in the review, all of which are directly related to the reasons why people delay seeking treatment for oral cancer symptoms: Patient Sociodemographi…
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The intergenerational transmission of inequality: maternal disadvantage and health at birth.
Health at birth is an important predictor of long-term outcomes, including education, income, and disability. Recent evidence suggests that maternal disadvantage leads to worse health at birth through poor health behaviors; exposure to harmful environmental factors; worse access to medical care, including family planning; and worse underlying maternal health. With increasing inequality, those at the bottom of the distribution now face relatively worse economic conditions, but newborn health among the most disadvantaged has actually improved. The most likely explanation is increasing knowledge about determinants of infant health and how to protect it along with public policies that put this knowledge into practice.
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Social and psychological factors underlying adult vaccination behavior: lessons from seasonal influenza vaccination in the US and the UK.
This article reviews the evidence base on the social and psychological factors that facilitate or hinder vaccination among adults. The authors categorized these factors into eight themes: social influence, disease-related factors, vaccine-related factors, habit, general attitudes toward health and vaccines, awareness and knowledge, practical barriers and motivators and altruism. Although there were many commonalities between both settings, the authors also indentifiedimportant differences. A better understanding of social and psychological aspects of vaccination across contexts and vaccines remains a priority.
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Afghan immigrant women's knowledge and behaviors around breast cancer screening.
Background: This community-based participatory research was conducted to provide a preliminary understanding of how Afghan women in Northern California view their breast health.
Methods: Results were based on demographics and in-depth semi-structured interviews conducted with 53 non-English-speaking first-generation immigrant Muslim Afghan women 40 years and older.
Results: Findings showed low levels of knowledge and awareness about breast cancer and low utilization of early-detection examinations for breast cancer among participants.
Conclusions: The findings also suggest a significant need for a community-based breast health education program that recognizes the unique social, cultural, and religious dynamics of the Muslim Afghan community.
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Behavioral intervention technologies: evidence review and recommendations for future research in mental health.
Objective: A technical expert panel convened by the Agency for Healthcare Research and Quality and the National Institute of Mental Health was charged with reviewing the state of research on behavioral intervention technologies (BITs) in mental health and identifying the top research priorities. BITs refers to behavioral and psychological interventions that use information and communication technology features to address behavioral and mental health outcomes.
Method: This study on the findings of the technical expert panel.
Results: Videoconferencing and standard telephone technologies to deliver psychotherapy have been well validated. Web-based interventions have shown efficacy across a broad range of mental health outcomes. Social media such as online support groups have produced disappointing outcomes when used alone. Mobile technologies have received limited attention for mental heal…
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Adolescents and vaccines in the western world.
Recent data have shown that the immune protection evoked by vaccines given in the first years of life progressively weakens, and that this is associated with a higher than expected incidence of vaccine-preventable diseases in adolescents and young adults. Furthermore, the greater circulation of pathogens among adolescents and young adults leads to a high risk of infection in unvaccinated or not fully vaccinated younger children. These findings, together with the availability of vaccines specifically developed to prevent infections that typically occur during adolescence, have induced a number of experts to suggest radical changes in the immunisation schedules usually recommended by health authorities. The most important of these relate pertussis, meningococcal and human papillomavirus vaccines but, although they are based on unexceptionable scientific premises, the suggestions have been …
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The state of engagement in HIV care in the United States: from cascade to continuum to control.
The National HIV/AIDS Strategy and the promise of treatment as prevention have garnered considerable attention from the policy, practice, and scientific communities, with the treatment cascade becoming the sentinel image illustrating the domestic human immunodeficiency virus (HIV) epidemic. The cascade depicts prevalence estimates for sequential steps from HIV diagnosis through viral suppression, the most striking of which is that >50% of persons diagnosed with HIV are not in medical care. This heterogeneous group includes individuals not linked to medical care following HIV diagnosis and those entering care who are not retained, requiring reengagement from a range of community settings. This review synthesizes the state of engagement in HIV care in the United States, focusing on research, practice, and policy considerations. Included are conceptual frameworks, a review of health implica…
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Cognitive-behavioral guided self-help for eating disorders: effectiveness and scalability.
Given the well-documented shortage of cognitive-behavioral therapy (CBT) for eating disorders, there is a compelling need for advances in dissemination. Guided self-help based on cognitive-behavioral principles (CBTgsh) provides a robust means of improving implementation and scalability of evidence-based treatment for eating disorders. It is a brief, cost-effective treatment that can be implemented by a wide range of mental health providers, including non-specialists, via face-to-face contact and internet-based technology. Controlled studies have shown that CBTgsh can be an effective treatment for binge eating disorder and bulimia nervosa, although it is contraindicated for anorexia nervosa. Several studies have shown that CBTgsh can be as effective as more complex specialty therapies and that it is not necessarily contraindicated for patients with comorbid conditions. Mental health prov…
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Johnson MD (2012)reviewMEDLINE-indexed journal, not yet read by usThe American psychologist57 citations Healthy marriage initiatives: on the need for empiricism in policy implementation.
The association between marriage and well-being has led to policies that promote marital interventions and discourage divorce. These include federal initiatives specifically targeting poor couples and couples of color. While there are many prospective studies on marriage that have informed some couple interventions, the studies that are included in this literature sampled predominantly White and middle-class couples. By comparison, far less is known about the longitudinal predictors of relationship satisfaction and status for poor couples and couples of color. Therefore, it is unsurprising that preliminary data on applying current interventions to the couples targeted by these federal initiatives have been disappointing. In this article, I detail three concerns with these initiatives, propose a course of psychological research to address deficits in what is known about poor couples and c…
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Socioeconomic disparities in home health care service access and utilization: a scoping review.
Unlabelled: Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services.
Objective: To determine what is known from existing literature about socioecono…
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Racial disparities in organ donation and why.
Purpose of review: High prevalence of comorbidities such as diabetes, hypertension, obesity, hepatitis B and C, in minority groups, results in racial minorities being disproportionally represented on transplant waiting lists. Organ transplantation positively impacts patient survival but greater access is limited by a severe donor shortage.
Recent findings: Unfortunately, minority groups also suffer from disparities in deceased and living donation. African-Americans comprise 12.9% of the population and 34% of the kidney transplant waiting list but only 13.8% of deceased donors. Barriers to minority deceased donation include: decreased awareness of transplantation, religious or cultural distrust of the medical community, fear of medical abandonment and fear of racism. Furthermore, African-Americans comprise only 11.8% of living donors. Barriers to minority living donation include: unwillin…
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Lund EM (2011)reviewMEDLINE-indexed journal, not yet read by usTrauma, violence & abuse29 citations Community-based services and interventions for adults with disabilities who have experienced interpersonal violence: a review of the literature.
This study provides a review of the peer-reviewed literature from 1995 to 2010 on violence-related service, prevention, and intervention programs for people with disabilities. A comprehensive literature search resulted in a total of 16 articles, 6 related to service programs and 10 related to intervention and prevention programs. The services articles revealed a noticeable disconnect between the violence services programs' perceived accessibility and the perception of their accessibility in the disability community. Most of the intervention and prevention articles focused exclusively on abuse prevention for adults with intellectual disabilities and generally had small samples and lacked controlled conditions. Very few methods of abuse treatment for people with disabilities have been empirically evaluated. Efforts should be made to improve accessibility and increase cross-collaboration be…
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Incentives and barriers to lifestyle interventions for people with severe mental illness: a narrative synthesis of quantitative, qualitative and mixed methods studies.
Aim: To examine the evidence for incentives and barriers to lifestyle interventions for people with severe mental illness.
Background: People with severe mental illnesses, particularly those with schizophrenia, have poorer physical health than the general population with increased mortality and morbidity rates. Social and lifestyle factors are reported to contribute to this health inequality, though antipsychotic therapy poses additional risk to long-term physical health. Many behavioural lifestyle interventions including smoking cessation, exercise programmes and weight-management programmes have been delivered to this population with promising results. Surprisingly little attention has been given to factors that may facilitate or prevent engagement with these interventions in this population.
Data sources: Eight electronic databases were searched [1985-March 2009] along with the Cochra…
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Colorectal cancer: national and international perspective on the burden of disease and public health impact.
Colorectal cancer is a significant cause of morbidity and mortality in the United States and throughout the world. The importance of this disease to gastroenterologists cannot be understated, given that screening and surveillance colonoscopy are dominant segments of clinical practice. The United States is the only country in the world where incidence and mortality rates from colorectal cancer are reported to be decreasing significantly, but health disparities in cancer screening, treatment, and survival persist. Health disparities are also evident worldwide, where the impact of this disease is staggering. In fact, rates of cancer are increasing in many parts of the world. Eliminating barriers to cancer screening and treatment could lead to substantial gains in quality and quantity of life and decrease the burden of colorectal cancer on public health. Programmatic and opportunistic screen…
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