Positive functioning as an outcome in its own right.
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2651 to 2675 of 6,178Psychodermatological aspects of atopic dermatitis.
Psychodermatology is an evolving area of science that focuses on the interaction between the mind, skin and body. It is known that various neuroendocrine mediators - including adrenocorticotropin, β-endorphin, catecholamines and cortisol - are produced in response to stress. The resulting increase in endogenous glucocorticoids can disrupt the skin's barrier function, leaving it vulnerable to inflammatory disorders like atopic dermatitis (AD). In turn, AD is associated with high levels of stigmatization, social withdrawal, anxiety and depression among patients and their carers. It is well known that the stress caused by AD can make the symptoms of the disease worse. Therefore, the goal of psychodermatological treatment is not only to improve the condition of the skin, but also to teach patients/carers how to cope with the disease. This requires a multifaceted approach, and time and patien…
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Psychological and behavioral approaches to cancer pain management.
This review examines evidence for psychological factors that affect pain across the cancer continuum from diagnosis through treatment and long-term survivorship or end of life. Evidence is convincing that emotional distress, depression, anxiety, uncertainty, and hopelessness interact with pain. Unrelieved pain can increase a desire for hastened death. Patients with cancer use many strategies to manage pain, with catastrophizing associated with increased pain and self-efficacy associated with lower pain reports. A variety of psychological and cognitive behavioral treatments can reduce pain severity and interference with function, as indicated in multiple meta-analyses and high-quality randomized controlled trials. Effective methods include education (with coping skills training), hypnosis, cognitive behavioral approaches, and relaxation with imagery. Exercise has been tested extensively i…
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Communication and intimacy-enhancing interventions for men diagnosed with prostate cancer and their partners.
Introduction: The sexual dysfunction following prostate cancer treatments often leads to a reduction in intimate contact for couples. A number of psychosocial interventions have been developed to enhance intimacy in these couples. This paper reviews three of these interventions and is a summary of a presentation given as part of a symposium at the 2011 Cancer Survivorship and Sexual Health Meeting.
Aim: The goal of this presentation was to: (i) review three types of psychosocial interventions; and (ii) describe the methodological issues highlighted by these interventions.
Main outcome measures: Validated measures of relationship intimacy and communication.
Methods: To be selected, the interventions had to be: a randomized control trial, focus on a couples approach to therapy, and report at least one relationship outcome.
Results: The results were not consistent within or across studies, …
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Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges.
Introduction: Across the globe, children born with perinatal HIV infection (PHIV) are reaching adolescence and young adulthood in large numbers. The majority of research has focused on biomedical outcomes yet there is increasing awareness that long-term survivors with PHIV are at high risk for mental health problems, given genetic, biomedical, familial and environmental risk. This article presents a review of the literature on the mental health functioning of perinatally HIV-infected (PHIV+) adolescents, corresponding risk and protective factors, treatment modalities and critical needs for future interventions and research.
Methods: An extensive review of online databases was conducted. Articles including: (1) PHIV+ youth; (2) age 10 and older; (3) mental health outcomes; and (4) mental health treatment were reviewed. Of 93 articles identified, 38 met inclusion criteria, the vast majorit…
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Optimism and the experience of pain: benefits of seeing the glass as half full.
There is a strong body of literature that lends support to the health-promoting effects of an optimistic personality disposition, observed across various physical and psychological dimensions. In accordance with this evidence base, it has been suggested that optimism may positively influence the course and experience of pain. Although the associations among optimism and pain outcomes have only recently begun to be studied adequately, emerging experimental and clinical research links optimism to lower pain sensitivity and better adjustment to chronic pain. This review highlights recent studies that have examined the effects of optimism on the pain experience using samples of individuals with clinically painful conditions, as well as healthy samples in laboratory settings. Furthermore, factors such as catastrophizing, hope, acceptance and coping strategies, which are thought to play a role…
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Forced migration and mental health: prolonged internal displacement, return migration and resilience.
Forced internal displacement has been rising steadily, mainly due to conflict. Many internally displaced people (IDP) experience prolonged displacement. Global research evidence suggests that many of these IDP are at high risk for developing mental disorders, adding weight to the global burden of disease. However, individual and community resilience may act as protective factors. Return migration may be an option for some IDP populations, especially when conflicts end, although return migration may itself be associated with worse mental health. Limited evidence is available on effects of resettlement or return migration following prolonged forced internal displacement on mental health. Also, the role of resilience factors remains to be clarified following situations of prolonged displacement. The public health impact of internal displacement is not clearly understood. Epidemiological and…
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Personalised caregiver support: effectiveness of psychosocial interventions in subgroups of caregivers of people with dementia.
Objective: Insight into the characteristics of caregivers for whom psychosocial interventions are effective is important for care practice. Until now no systematic reviews were conducted into the effectiveness of psychosocial interventions for caregiver subgroups.
Methods: To gain insight into this relationship between caregiver subgroups and intervention outcomes, a first review study was done. This study reviews the personal characteristics of caregivers of people with dementia for whom psychosocial interventions were effective.
Results: Electronic databases and key articles were searched for reviews on psychosocial interventions for caregivers studies published between January 1990 and February 2008. Based on these reviews, twenty-six studies met the inclusion criteria (i.e. having positive outcomes described in subgroups). Most positive effects were found in caregivers of people with…
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Shalev I (2012)reviewMEDLINE-indexed journal, not yet read by usBioEssays : news and reviews in molecular, cellular and developmental biology114 citations Early life stress and telomere length: investigating the connection and possible mechanisms: a critical survey of the evidence base, research methodology and basic biology.
How can adverse experiences in early life, such as maltreatment, exert such powerful negative effects on health decades later? The answer may lie in changes to DNA. New research suggests that exposure to stress can accelerate the erosion of DNA segments called telomeres. Shorter telomere length correlates with chronological age and also disease morbidity and mortality. Thus, telomere erosion is a potential mechanism linking childhood stress to health problems later in life. However, an array of mechanistic, methodological, and basic biological questions must be addressed in order to translate telomere discoveries into clinical applications for monitoring health and predicting disease risk. This paper covers the current state of the science and lays out new research directions.
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Advance care planning in COPD.
The review aims to discuss current concepts in advance care planning (ACP) for patients with COPD, and to provide a narrative review of recent trends in ACP and end-of-life care for patients with COPD. ACP, which involves patient-clinician communication about end-of-life care, can improve outcomes for patients and their families, and may be especially relevant for patients with COPD. Effective patient-clinician communication is needed to inform and prepare patients about their diagnosis, treatment, prognosis and what dying might be like. It is important for clinicians to understand patients' values and preferences for life-sustaining treatments as well for their site of terminal care. Unfortunately, discussions about ACP and end-of-life care in current practice are scarce, and their quality is often poor. ACP can improve outcomes for patients and their relatives. The challenge remains in…
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Neglected tropical diseases and mental health: a perspective on comorbidity.
Mental health conditions will be the largest contributor to the global health burden by 2030. Our review suggests that neglected tropical diseases (NTDs) predispose individuals to poor mental health. Factors predisposing to poor mental health include stigma and discrimination, exclusion from participating fully in society, reduced access to health and social services, lack of educational opportunities, exclusion from income-generation and employment opportunities, and restrictions in exercising civil and political rights. These characteristics are all features of NTDs, but the mental health of these sufferers has been ignored. This review raises an issue of concern and highlights the opportunities for research by psychiatrists and psychologists on NTDs.
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Evaluation of intrapsychic factors, coping styles, and spirituality of patients affected by tumors.
Background: In this study, we consider spirituality in terms of interpersonal, transpersonal, and intrapsychic processes. The goal of this study is to establish whether a spiritual perspective is correlated with more effective coping skills and intrapsychic processes.
Methodology:
Patients: Lung (n = 88, n. (age 62.8±10.1)) and large bowel cancer (n = 56; age (age 60.1±11.4)) (all stages).
Tests: SASB Questionnaire by L.S. Benjamin-intrapsychic processes; Scale of Coping Styles by A. Jalowiech; Brief Measure of Spirituality (BMMS); Spiritual Well Being Index by T. Daaleman and B. Bruce.
Results: There is a significant correlation among inner spirituality (IS) (Cronbach's α = 0.692), spiritual coping (SC) (Cronbach's α = 0.935) (described total variability-BMMS) and Spiritual Well Being (SWB) (Cronbach's α = 0.759). (Significant correlation among the three scales, Cronbach's α = 0.676.)Th…
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Advance care planning for people with dementia: a review.
Background: Few people with dementia have made advance plans for their health care. Advance care planning (ACP) is a process of discussion between an individual and their care providers that takes account of wishes and preferences for future care. We aimed to examine the facilitators and inhibitors to ACP in people with dementia. We also aimed to identify key themes in the literature and critically review the methodologies used.
Methods: We systematically searched the English language literature including PubMed, CINAHL, AMED, PsychINFO, EMBASE and BNI. We included empirical studies which reported the characteristics of the patient population, the type of advance care planning used and the study setting, and which involved people with dementia, family members or professional carers.
Results: We identified 17 studies (11 quantitative methods, one qualitative and five mixed methods). We fo…
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Individualizing glycemic targets in type 2 diabetes mellitus: implications of recent clinical trials.
One of the first steps in the management of patients with type 2 diabetes mellitus is setting glycemic goals. Professional organizations advise setting specific hemoglobin A(1c) (HbA(1c)) targets for patients, and individualization of these goals has more recently been emphasized. However, the operational meaning of glycemic goals, and specific methods for individualizing them, have not been well-described. Choosing a specific HbA(1c) target range for a given patient requires taking several factors into consideration, including an assessment of the patient's risk for hyperglycemia-related complications versus the risks of therapy, all in the context of the overall clinical setting. Comorbid conditions, psychological status, capacity for self-care, economic considerations, and family and social support systems also play a key role in the intensity of therapy. The individualization of HbA(…
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Understanding the experience of caregivers: a focus on transitions.
Objectives: To review the current knowledge on the challenges and benefits of informal family caregiving; and propose two conceptual frameworks for studying transitions common to patients with cancer and their family caregivers through the trajectory of the disease process leading to better, more focused, individualized interventions;
Data sources: A review of current and classic literature on patients with cancer and their caregivers.
Conclusion: Caregivers often take on burdens that they are not prepared for. As they become overwhelmed with the work, they often neglect themselves, leading to physical and emotional illnesses. Not all caregivers perceive the same amount of burden. Careful assessment of each caregiver/cared-for dyad to individualize their support is critical to supporting them along the journey of a cancer diagnosis.
Implications for nursing practice: Operationalizing con…
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Assessment and treatment of psychosocial comorbidities in patients with neuropathic pain.
Chronic neuropathic pain is a prevalent problem that eludes cure and adequate treatment. The persistence of intense and aversive symptoms, inadequacy of available treatments, and impact of such pain on all aspects of functioning underscore the important role of several psychosocial factors in causing, maintaining, and amplifying the perception of pain severity, coping adequacy, adaptation, impaired physical function, and emotional distress responses. Moreover, these factors have an influential role in response to treatment recommendations. In this article, we (1) review the prevalence and nature of emotional distress, (2) describe and propose methods for screening and comprehensive psychosocial assessment, and (3) review evidence supporting the potential complementary role of psychosocial treatments of patients with chronic pain. The cognitive-behavioral perspective and treatment approac…
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The societal burden of osteoporosis.
Osteoporosis currently affects 10 million Americans and is responsible for more than 1.5 million fractures annually. The financial burden of osteoporosis is substantial, with annual direct medical costs estimated at 17 to 20 billion dollars. Most of these costs are related to the acute and rehabilitative care following osteoporotic fractures, particularly hip fractures. The societal burden of osteoporosis includes these direct medical costs and the monetary (eg, caregiver time) and nonmonetary costs of poor health. The aging of the US population is expected to increase the prevalence of osteoporosis and the number of osteoporotic fractures. Growth of the older adult population will pose significant challenges to Medicare and Medicaid, which bear most of the cost of osteoporosis. Efforts to address the looming financial burden must focus on reducing the prevalence of osteoporosis and the …
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Towards a functional neuroanatomy of pleasure and happiness.
The pursuit of happiness is a preoccupation for many people. Yet only the pursuit can be promised, not happiness itself. Can science help? We focus on the most tractable ingredient, hedonia or positive affect. A step toward happiness might be gained by improving the pleasures and positive moods in daily life. The neuroscience of pleasure and reward provides relevant insights, and we discuss how specific hedonic mechanisms might relate to happiness or the lack thereof. Although the neuroscience of happiness is still in its infancy, further advances might be made through mapping overlap between brain networks of hedonic pleasure with others, such as the brain's default network, potentially involved in the other happiness ingredient, eudaimonia or life meaning and engagement.
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The role of mindfulness in positive reappraisal.
Mindfulness meditation is increasingly well known for therapeutic efficacy in a variety of illnesses and conditions, but its mechanism of action is still under debate in scientific circles. In this paper, we propose a hypothetical causal model that argues for the role of mindfulness in positive reappraisal coping. Positive reappraisal is a critical component of meaning-based coping that enables individuals to adapt successfully to stressful life events. Mindfulness, as a metacognitive form of awareness, involves the process of decentering, a shifting of cognitive sets that enables alternate appraisals of life events. We review the concept of positive reappraisal in transactional stress and coping theory, then describe research and traditional literature related to mindfulness and positive reappraisal, and detail the central role of mindfulness in the reappraisal process. With this unders…
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Progression of Parkinson's disease in the clinical phase: potential markers.
Neuromodulatory or even neuroprotective therapy could soon be available for Parkinson's disease (PD), raising the question of how we should define and measure disease progression. Reported evidence suggests that several symptoms worsen with disease duration. Bradykinesia, rigidity, and activities of daily living deteriorate faster at the beginning of the disease, and this deterioration is paralleled by a decline in functional presynaptic dopaminergic activity, as shown by imaging techniques. Cognitive, speech, sleep, and gait difficulties might progress linearly in proportion to disease duration. Reduced variability in heart rate, orthostatic dysfunction, and visual hallucinations start to develop at mid-stage disease and are more common in late stages than earlier stages. In this Review, we summarise our current understanding of the progression of PD-associated symptoms and markers and …
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Health behaviors, medical care, and interventions to promote healthy living in the Childhood Cancer Survivor Study cohort.
Childhood cancer survivors are at risk for medical and psychosocial late effects as a result of their cancer and its therapy. Promotion of healthy lifestyle behaviors and provision of regular risk-based medical care and surveillance may modify the evolution of these late effects. This manuscript summarizes publications from the Childhood Cancer Survivor Study (CCSS) that have examined health behaviors, risk-based health care, and interventions to promote healthy lifestyle practices. Long-term survivors use tobacco and alcohol and have inactive lifestyles at higher rates than is ideal given their increased risk of cardiac, pulmonary, and metabolic late effects. Nearly 90% of survivors report receiving some form of medical care. However, only 18% report medical visits related to their prior cancer that include discussion or ordering of screening tests or counseling on how to reduce the spe…
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Health promotion through forgiveness intervention.
The purpose of this article is to offer evidence-based forgiveness interventions clinically useful to nurses in holistic health promotion for individuals, families, and communities. Forgiveness interventions are developed and described within four approaches inspired by midrange nursing theorists who have adapted their theories from Bandura's Social Learning Theory and Frankl's Theory of Meaning. Interventions are also assimilated from a comprehensive review of theoretical and research literature. The four interventional approaches include persuasive information, vicarious experience, awareness of physiological reactions, and enactive attainment. Barriers to implementation are discussed as well as ways to individualize the interventions.
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Praissman S (2008)reviewMEDLINE-indexed journal, not yet read by usJournal of the American Academy of Nurse Practitioners91 citations Mindfulness-based stress reduction: a literature review and clinician's guide.
Purpose: To provide nurse practitioners (NPs) with clinical research about Mindfulness-Based Stress Reduction (MBSR) and demonstrate its usefulness for reducing stress in a variety of populations.
Data sources: A literature review was conducted using the following databases: EBSCO, Cinahl, Pschyline, and Medline. English language articles published between 2000 and 2006 in peer-reviewed journals were reviewed. Search terms "mindfulness,""meditation," and "stress" were used. Additional information was obtained through select, reputable Internet sites.
Conclusions: MBSR is an effective treatment for reducing stress and anxiety that accompanies daily life and chronic illness. MBSR is also therapeutic for healthcare providers, enhancing their interactions with patients. No negative side effects from MBSR have been documented.
Implications for practice: MBSR is a safe, effective, integrative …
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Goals of care toward the end of life: a structured literature review.
Goals of care are often mentioned as an important component of end-of-life discussions, but there are diverse assessments regarding the type and number of goals that should be considered. To address this lack of consensus, we searched MEDLINE (1967-2007) for relevant articles and identified the number, phrasing, and type of goals they addressed. An iterative process of categorization resulted in a list of 6 practical, comprehensive goals: (1) be cured, (2) live longer, (3) improve or maintain function/quality of life/ independence, (4) be comfortable, (5) achieve life goals, and (6) provide support for family/caregiver. These goals can be used to articulate goal-oriented frameworks to guide decision making toward the end of life and thereby harmonize patients' treatment choices with their values and medical conditions.
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Body image issues in women with breast cancer.
Diagnosis and treatment of breast cancer affects women physically as well as psychologically. There are many obvious and real factors that are related to psychological distress in women coping with breast cancer, such as facing a life-threatening illness, painful and impairing treatments, and significant role changes. Although these factors are clearly important, issues related to body image in women faced with breast cancer can also add to psychological distress. Women, in general, are concerned with their appearance, their weight, and their body, with recent studies suggesting 89% of women reported concerns with weight. Such premorbid concerns are often deeply ingrained and can contribute to psychological distress in women treated for breast cancer. The present article is a summary of the literature that has examined body image issues and related psychological adjustment in women with …
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Effectiveness of opioids in the treatment of chronic non-cancer pain.
For thousands of years, opioids have been used to treat pain, and they continue to be one of the most commonly prescribed medications for pain. It is estimated that 90% of patients presenting to pain centers and receiving treatment in such facilities are on opioids. Opioids can be considered broad-spectrum analgesics that act at multiple points along the pain pathway. Unfortunately, opioids also have the potential for great harm, with multiple side effects and potential complications, some of which are lethal. They are also uniquely addictive, which can lead to misuse and diversion. We reviewed the relevant English literature and did thorough manual searches of the bibliographies of known primary and review articles. We utilized pain relief as the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, improvement in work status, …
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