Whether and how people reach care.
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1851 to 1875 of 2,047Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy.
Unlabelled: The diagnosis of lung cancer in the advanced stage of illness, the poor prognosis associated with the disease, and the side effects of chemotherapy all have an impact on various dimensions of quality of life (QoL).
The purpose of the research: The current study was designed to describe the QoL and symptom distress of lung cancer patients undergoing chemotherapy and to explore the relationships between demographic/treatment-related characteristics and QoL.
Methods and sample: The sample consisted of 154 lung cancer patients undergoing chemotherapy. The symptom experiences and QoL of lung cancer patients undergoing chemotherapy were evaluated using the Memorial Symptom Assessment Scale and Quality of Life Index - Cancer Version.
Results: The lung cancer patients had low QoL scores. The scores on the Health and Functioning subscale were the lowest (20.33 ± 5.59), while those of …
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Implicit self-stigma in people with mental illness.
People with mental illness often internalize negative stereotypes, resulting in self-stigma and low self-esteem ("People with mental illness are bad and therefore I am bad, too"). Despite strong evidence for self-stigma's negative impact as assessed by self-report measures, it is unclear whether self-stigma operates in an automatic, implicit manner, potentially outside conscious awareness and control. We therefore assessed (i) negative implicit attitudes toward mental illness and (ii) low implicit self-esteem using 2 Brief Implicit Association Tests in 85 people with mental illness. Implicit self-stigma was operationalized as the product of both implicit measures. Explicit self-stigma and quality of life were assessed by self-report. Greater implicit and explicit self-stigma independently predicted lower quality of life after controlling for depressive symptoms, diagnosis, and demographi…
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A mixed-method approach to sense of coherence, health behaviors, self-efficacy and optimism: towards the operationalization of positive health attitudes.
This study discusses the results of a cross-sectional survey of healthy college students in Poland. More specifically, it describes, explores, and explains the relationships between psychological variables/models such as health behaviors (HB), sense of coherence (SOC), level of optimism (LOO), and self-efficacy (SE) among college students. These separate constructs have also been used to operationalize a positive health attitude (PHA) as a novel construct. The social survey was carried out at three higher education institutions in Poland in January 2006. The random sample of 455 undergraduate students was taken from five different faculties: Physiotherapy, Physical Education, Tourism and Recreation, English Philology and Polish Philology. Four reliable and validated research tools were used to collect the data: Juczynsky's Health Behaviour Inventory (HBI); Antonovsky's Sense of Coherence…
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Long term posttraumatic growth after breast cancer: prevalence, predictors and relationships with psychological health.
This study evaluated the prevalence and predictors of long term posttraumatic growth (PTG) after breast cancer, and relationships of PTG with psychological health in a random sample of 307 currently disease-free women 5-15 years after diagnosis. This cross-sectional study reveals long term posttraumatic growth scores comparable to those found in shorter term studies. Prevalence of a better appreciation of life is especially noteworthy. With the exception of perceived current sequelae of disease associated in a somewhat curvilinear fashion with PTG, demographic and medical variables are poor predictors of the issue. On the contrary, dispositional positive affectivity and adaptative coping of positive, active, relational, religious and to some extent denial coping have a strong effect on growth. Finally, PTG is slightly associated with mental quality of life and happiness. Findings are dis…
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Perceived determinants of mental health for bisexual people: a qualitative examination.
Objectives: We examined the determinants of mental health, as perceived by bisexual people, in order to begin understanding the disparities in the rates of mental health problems reported by bisexual people versus those reported by heterosexual people, and, in many studies, gay men and lesbians.
Methods: Our community-based participatory action research project comprised focus groups and semistructured interviews with 55 bisexual people across the province of Ontario, Canada.
Results: Perceived determinants of emotional well-being identified by participants could be classified as macrolevel (social structure), mesolevel (interpersonal), or microlevel (individual). In the context of this framework, monosexism and biphobia were perceived to exert a broad-reaching impact on participants' mental health.
Conclusions: Like other marginalized populations, bisexual people perceive experiences of…
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Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease.
Aims: To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease.
Background: Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations.
Method: A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses.
Results: Patients' (n = 78) mean age was 73.37 years (SD 7.52); 55.1% were male and 66.7% were married. Most (92.3%) had concurrent illnesses, and 48.7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good…
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Risk factors for bereavement outcome: a multivariate approach.
Bereavement increases the risk of ill health, but only a minority of bereaved suffers lasting health impairment. Because only this group is likely to profit from bereavement intervention, early identification is important. Previous research is limited, because of cross sectional designs, small numbers of risk factors, and use of a single measure of bereavement outcome. Our longitudinal study avoids these pitfalls by examining the impact of a large set of potential risk factors on grief depressive symptoms, emotional loneliness, and positive mood following recent bereavement (3 years maximum). Participants provided information 3 times over 6 months. A multivariate approach was chosen to avoid reporting spurious results due to confounding. As expected, risk factors were differentially related to different outcome measures. For example, being high in anxious attachment and having lost a par…
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Do illness perceptions predict pain-related disability and mood in chronic orofacial pain patients? A 6-month follow-up study.
Unlabelled: In our study, we investigated the predictive value of illness beliefs as measured by the revised illness perception questionnaire (IPQ-R) in the context of other clinical predictors in patients with chronic orofacial pain over a 6-month follow-up period. Consecutive patients (152) referred to the interdisciplinary orofacial pain service at the Centre for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich received questionnaires to assess pain and pain-related disability, anxiety, depression as well as physical and mental quality of life at three time points: prior to treatment, 3 and 6 months after beginning of treatment.
Results: significant improvement was found over time for all outcome measures except mental quality of life. RESULTS of the regression analysis indicated that believing pain could have serious consequences on one's life (IPQ subs…
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Muslim views on mental health and psychotherapy.
Objectives: The aim of this research was to explore with a heterogeneous Muslim population their understanding of the concept of mental health and how any mental distress experienced by an individual can best be addressed.
Design: A qualitative approach was taken. Participants were interviewed, and data analysed thematically.
Methods: A sample of 14 Muslims was interviewed according to a semi-structured interview schedule. Participants were recruited via electronic mailing lists, and communications with local Muslim organizations. Interviews were transcribed verbatim, and data were analysed using thematic analysis.
Results: Thematic analysis identified seven operationalizing themes that were given the labels 'causes', 'problem management', 'relevance of services', 'barriers', 'service delivery', 'therapy content', and 'therapist characteristics'.
Conclusions: The results highlight the in…
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Daily experiences among mothers of adolescents and adults with autism spectrum disorder.
In the present study, 96 co-residing mothers of adolescents and adults with an autism spectrum disorder (ASD) participated in an 8-day diary study and reported on their daily experiences. In comparison with a nationally representative sample of mothers of children without disabilities, mothers of adolescent and adult children with ASD spent significantly more time providing childcare and doing chores, and less time in leisure activities. Fatigue, arguments, avoided arguments, and stressful events were also more common among mothers of individuals with ASD. However, mothers of individuals with ASD reported similar levels of positive interactions and volunteerism as the comparison group. Daily experiences were subsequently related to well-being in both groups. These findings highlight the need for family support services.
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Jang Y, Chiriboga DA (2010)MEDLINE-indexed journal, not yet read by usThe journals of gerontology. Series B, Psychological sciences and social sciences58 citations Living in a different world: acculturative stress among Korean American elders.
Using a sample of Korean American elders, this study examined internal mechanisms by which the level of acculturation influences mental health outcomes. We hypothesized that the impact of five domains of acculturation on mental distress (depressive symptoms and anxiety) would be mediated by individuals' subjectively appraised acculturative stress. The latter was indexed by measures of task-oriented and emotion-oriented stress. The results from structural equation modeling with 472 Korean American elders in Florida (M age = 69.9, SD = 7.04) provided support for the mediation model. Findings demonstrate that acculturation exerts an influence on mental health and that acculturative stress functions as a mediator in the linkage between the level of acculturation and mental distress. Findings suggest avenues for facilitating immigrant elders' positive adaptation and promoting their mental wel…
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Religiosity, spirituality, and cancer fatalism beliefs on delay in breast cancer diagnosis in African American women.
African American women are more likely than any other racial or ethnic group to present with a later stage of breast cancer at initial diagnosis. Delay in breast cancer detection is a critical factor in diagnosis at a later stage. Available data indicate a delay of 3 months or more is a significant factor in breast cancer mortalty. Numerous factors have been reported as contributing to delay in time to seek medical care including religiosity, spirituality, and fatalistic beliefs. This study examined the influence of religiosity, spirituality, and cancer fatalism on delay in diagnosis and breast cancer stage in African American women with self-detected breast symptoms. A descriptive correlation, retrospective methodology using an open-ended questionnaire and three validated measurement scales were used: the Religious Problem Solving Scale (RPSS), the Religious Coping Activity Scale (RCAS)…
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Coping strategies of adults with leukemia undergoing hematopoietic stem cell transplantation in Iran: a qualitative study.
Hematopoietic stem cell transplantation (HSCT) causes significant physical, social, psychological, and emotional stress in patients with leukemia. This qualitative study using semi-structured interviews explored the coping strategies of 10 adults with acute leukemia who were undergoing this form of treatment in transplantation units in a major hospital in Tehran, Iran, from 2009 to 2010. A content analysis identified eight themes and 13 subthemes that described the participants' coping strategies. The major themes were: attribution, denial and avoidance, connection with divine purpose, organizing treatment, seeking social support, modifying, reflection, and patience and resignation. A deeper understanding of the coping strategies that are used by patients with leukemia undergoing HSCT can help healthcare providers to encourage patients to use strategies that are likely to be more effecti…
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Factors explaining children's responses to intravenous needle insertions.
Background: Previous research shows that numerous child, parent, and procedural variables affect children's distress responses to procedures. Cognitive-behavioral interventions such as distraction are effective in reducing pain and distress for many children undergoing these procedures.
Objectives: The purpose of this report was to examine child, parent, and procedural variables that explain child distress during a scheduled intravenous insertion when parents are distraction coaches for their children.
Methods: A total of 542 children, between 4 and 10 years of age, and their parents participated. Child age, gender, diagnosis, and ethnicity were measured by questions developed for this study. Standardized instruments were used to measure child experience with procedures, temperament, ability to attend, anxiety, coping style, and pain sensitivity. Questions were developed to measure paren…
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Developing the evidence base for peer-led services: changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives.
Objective: The purpose of this analysis was to evaluate the outcomes of two statewide initiatives in Vermont and Minnesota, in which self-management of mental illness was taught by peers to people in mental health recovery using Wellness Recovery Action Planning (WRAP).
Methods: Pre-post comparisons were made of reports from 381 participants (147 in Vermont and 234 in Minnesota) on a survey instrument that assessed three dimensions of self-management: 1) attitudes, such as hope for recovery and responsibility for one's own wellness; 2) knowledge, regarding topics such as early warning signs of decompensation and symptom triggers; and 3) skills, such as identification of a social support network and use of wellness tools.
Results: Significant positive changes in self-management attitudes, skills and behaviors were observed on 76% of items completed by Vermont participants (13 of 17 survey…
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The meaning of hope from the perspective of Chinese advanced cancer patients in Hong Kong.
Aim: This article reports a study to examine the meaning of hope from the perspective of Chinese advanced cancer patients in Hong Kong.
Methods: Semi-structured interviews were conducted with a convenience sample of advanced cancer patients recruited from the palliative care unit of a local hospital. Data were saturated after 17 participants were interviewed. Qualitative content analysis was adopted to analyse the data.
Findings: Hope as experienced by the participants was found to consist of five components: living a normal life, social support, actively letting go of control, reconciliation between life and death, and wellbeing of significant others.
Conclusions: While hope is related to the wellbeing of patients with advanced cancer, successful palliative care partly depends on an awareness of the importance of hope in the end-of-life context and cultural sensitivity to the meanings b…
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Predictors of parenting stress among Malaysian mothers of children with Down syndrome.
Background: Having children with intellectual disability can be stressful for most parents. Currently there are very few studies focusing on parenting stress among mothers of children with Down syndrome (DS) in Asia. The present study examined the level of parenting stress experienced by Malaysian mothers of children with DS and evaluated the child and maternal factors that contributed to parenting stress based on Hill's ABC-X Model (Hill 1949).
Methods: We conducted a cross-sectional study of mothers of children with DS between the ages of 2-12 years during February-June 2008 in Kedah, a state in Peninsular Malaysia. We used self-administered questionnaires to gather data on parenting stress, child's birth history and current behavioural problems, as well as the maternal sociodemographic characteristics, coping styles and psychological well-being. Parental Stress Scale (PSS) was used to…
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Neill SJ (2010)MEDLINE-indexed journal, not yet read by usJournal of child health care : for professionals working with children in the hospital and community34 citations Containing acute childhood illness within family life: a substantive grounded theory.
Acute childhood illness is a universal experience for children and families. This paper presents the central process of a Glaserian grounded theory study which explored family management of acute childhood illness at home. Twenty-nine interviews were conducted with 15 families of children 0-9 years of age. Constant comparative analysis generated the substantive grounded theory 'Containing acute childhood illness within family life'. This informal social rule was identified from families' persistent desire to do the right thing, for their child and in the eyes of others in social life. Families perceived that they were expected to contain illnesses which are defined as minor and to seek medical help for 'real' illnesses. Considerable uncertainty was evident around defining the illness and the legitimacy of seeking medical help. Their concern with the latter indicates doctors' role as mora…
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What psychosocial factors influence adolescents' oral health?
Few studies have examined, comprehensively and prospectively, determinants of oral-health-related quality of life. The aim of this study was to examine the relationships between psychosocial factors and oral health status, health perceptions, and quality of life. Measures of symptom and functional status, health perceptions, quality of life, oral health beliefs, and psychological (sense of coherence, self-esteem, health locus of control) and social factors (parents' income and education) were collected from 439 12- and 13-year-olds at baseline and six-month follow-up, together with a clinical examination at baseline. Structural equation modeling indicated that increased levels of caries and more symptoms predicted more functional limitations, and, cross-sectionally, greater functional impact was associated with worse health perceptions, which were linked to lower quality of life. Sense o…
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Disease trajectories and ACT/RCPCH categories in paediatric palliative care.
The objective of this study was to provide a preliminary description of trajectories of life-limiting conditions (LLCs) using qualitative experiential data. Semi-structured interviews were conducted with families of children with LLCs, selected to encompass all Association for Children's Palliative Care (ACT)/Royal College of Paediatrics and Child Health (RCPCH) categories, using a schedule developed from focus groups of professionals. Thirty out of 76 families agreed to participate. Four of these were unsuitable. In nine out of 26 families, their child had died. In eight out of the 26, two individuals were interviewed. Twenty-four mothers, nine fathers, one sibling and two foster-carers were interviewed in total. The interview schedule was developed from data from four themed focus groups, comprising 25 professionals from 14 backgrounds. Thirty-four milestones in five phases were identi…
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Barriers and facilitators of African American participation in Alzheimer disease biomarker research.
African Americans experience a greater risk of Alzheimer disease (AD), but are underrepresented in AD research. Our study examined barriers and facilitators of AD research participation among African Americans. Investigators conducted 11 focus groups with African American participants (n=70) who discussed barriers and facilitators to AD research participation including lumbar puncture studies. The moderator and comoderator independently reviewed the transcripts, identified themes, and coded transcripts for analysis. Participants were predominately female (73%) with a mean age of 52 years (range 21 to 86 y). Concerns and attitudes were consistent across education, socioeconomic status, and sex. Mistrust was a fundamental reason for nonparticipation. Additional barriers included insufficient information dissemination in the African American community, inconvenience, and reputation of the r…
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British prisoners-of-war: from resilience to psychological vulnerability: reality or perception.
In contemporary culture, soldiers held as prisoners-of-war (POWs) or as hostages are considered at significant risk of mental illness, in particular post-traumatic stress disorder (PTSD). This assumption contrasts with the psychiatric orthodoxy of the First World War when it was concluded in both Britain and Germany that POWs were protected against 'war neurosis'. Although 'barbed wire disease' was identified during time of captivity, post-release effects were not recognized. The repatriation of 'protected' POWs in 1943 prompted a reassessment of the psychological impact of imprisonment when servicemen of previous good character began to behave aberrantly. Rehabilitation programmes were designed to enable soldiers to re-adapt to service or civilian roles. Difficulties of adjustment were cast in social and cognitive terms, and corrective measures were occupational and educational. Psychia…
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Acculturation strategies and mental health in gay, lesbian, and bisexual youth.
In this article, we examine the impact of acculturation strategies on minority stress and mental health in lesbian, gay, or bisexual (LGB) youth in Flanders, Belgium. Building on previous identity minority studies and on the social stress model, we investigate how LGB youth acculturate within both the LGB subculture and mainstream society and how this correlates with their mental health. Our sample is taken from an online survey and represents 561 LGB youth aged 14 through 21. The four traditional acculturation strategies are represented in this population (integration, separation, marginalization, assimilation). Bisexual boys are mostly absent from separation and integration strategies; gay and lesbian youth in middle adolescence are significantly more represented in the separation strategy compared to their late adolescence counterparts. Further, our findings suggest the relevance of i…
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Hypothetical and factual willingness to participate in biobank research.
In the debate on biobank regulation, arguments often draw upon findings in surveys on public attitudes. However, surveys on willingness to participate in research may not always predict actual participation rates. We compared hypothetical willingness as estimated in 11 surveys conducted in Sweden, Iceland, United Kingdom, Ireland, United States and Singapore to factual participation rates in 12 biobank studies. Studies were matched by country and approximate time frame. Of 22 pairwise comparisons, 12 suggest that factual willingness to participate in biobank research is greater than hypothetical, six indicate the converse relationship, and four are inconclusive. Factual donors, in particular when recruited in health care or otherwise face-to-face with the researcher, are possibly motivated by factors that are less influential in a hypothetical context, such as altruism, trust, and sense …
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Cultural interrelationships and the lived experience of Pakistani breast cancer patients.
Aim: There is a paucity of British and international literature on the psychological, sociological and cultural correlates of breast health in ethnic minority women.
Methods: This two centre qualitative study was part of a larger study that aimed to examine the influence of culture on the lived experience of Pakistani Muslim breast cancer patients. Thirty six patients attending hospital out-patient breast cancer clinics in Lahore, Pakistan and London, UK were recruited to the study. Women were predominantly married, 20-76 years of age with an average of three children. Semi-structured interviews were undertaken. Interview data were analysed using thematic analysis.
Results: Five themes emerged: Discovery and reaction to the disease; disclosure to family; developing emotions; emerging reality; long term uncertainty.
Conclusions: Data infer that irrespective of city of residence, the cultu…
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