Positive functioning as an outcome in its own right.
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4076 to 4100 of 6,178Outcome and clinical changes in patients 3, 6, 12 months after a severe or major hand injury--can sense of coherence be an indicator for rehabilitation focus?
Background: Our objective was to explore outcome and clinical changes in hand function, satisfaction in daily occupations, sleep disturbances, health and quality of life in consecutive patients after a severe or major hand injury. Our objective was also to investigate possible differences between groups according to severity of injury, presence of peripheral nerve injury and the patients' sense of coherence.
Methods: A postal questionnaire, including demographic data, disabilities of the arm, shoulder and hand (DASH), QoL (SF-36), EuroQol (EQ-5D VAS), hand function (VAS), satisfaction in daily occupation (SDO), was sent out 3, 6 and 12 months after injury to 45 consecutive patients with a severe or major hand injury. Sense of coherence (SOC) was evaluated at 6 months. For the descriptive study, non-parametric tests were used since almost all results were measured with ordinal scales, the…
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Comprehensive interview assessment of eating behavior 18-35 months after gastric bypass surgery for morbid obesity.
Background: Weight loss surgery induces a marked change in eating behavior. However, not much work has been done characterizing the eating behavior after weight loss surgery. We conducted a detailed analysis of patients' eating behavior 18-35 months after Roux-en-Y gastric bypass surgery, determined whether preoperative eating disorders might be associated with non-normative postoperative eating, and examined the association of such eating behaviors with weight loss and psychopathology.
Methods: A sample of 59 patients who had undergone Roux-en-Y gastric bypass was interviewed in person after surgery about a range of eating behaviors, including binge eating, chewing and spitting out food, picking at and nibbling food, and nocturnal eating and compensatory behaviors such as vomiting and laxative and diuretic misuse. An established semistructured interview was used. The prevalence of preop…
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Depression, anxiety, post-traumatic stress disorder and health-related quality of life and its association with social support in ambulatory prostate cancer patients.
The aim of this study is to identify anxiety, depression and post-traumatic stress disorder in prostate cancer patients and to investigate the association with social support and health-related quality of life. A total of 511 men who had undergone prostatectomy were surveyed during ambulatory follow-up care for an average of 27 months after surgery using standardised self-report measures (e.g. Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist--Civilian Version, Illness-Specific Social Support Scale, Short-Form Health Survey). Seventy-six per cent of patients evaluated their disease as 'not' or a 'little threatening'. The cancer diagnosis and uncertainty were most frequently reported as 'distressing', while medical treatment and doctor-patient interaction were most frequently evaluated as 'most helpful'. The number of patients reporting increased levels of psy…
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Sanders AE (2010)MEDLINE-indexed journal, not yet read by usSocial science & medicine (1982)42 citations A Latino advantage in oral health-related quality of life is modified by nativity status.
Explanations for the social gradient in health status are informed by the rare exceptions. This cross-sectional observational study examined one such exception, the "Latino paradox" by investigating the presence of a Latino advantage in oral health-related quality of life and the effect of nativity status on this relationship. A nationally representative sample of adults (n=4208) completed the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The impact of oral disorders on oral health-related quality of life was evaluated using the NHANES Oral Health Impact Profile. Exposures of interest were race, ethnicity and nativity status. Covariates included sociodemographic characteristics, smoking status, self-rated health, access to dental care and number of teeth. Unconditional logistic regression models estimated odds of impaired oral health-related quality of life for rac…
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The psychiatric sequelae of traumatic injury.
Objective: Traumatic injury affects millions of people each year. There is little understanding of the extent of psychiatric illness that develops after traumatic injury or of the impact of mild traumatic brain injury (TBI) on psychiatric illness. The authors sought to determine the range of new psychiatric disorders occurring after traumatic injury and the influence of mild TBI on psychiatric status.
Method: In this prospective cohort study, patients were drawn from recent admissions to four major trauma hospitals across Australia. A total of 1,084 traumatically injured patients were initially assessed during hospital admission and followed up 3 months (N=932, 86%) and 12 months (N=817, 75%) after injury. Lifetime psychiatric diagnoses were assessed in hospital. The prevalence of psychiatric disorders, levels of quality of life, and mental health service use were assessed at the follow-…
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The balance of give and take in caregiver-partner relationships: An examination of self-perceived burden, relationship equity, and quality of life from the perspective of care recipients following stroke.
Purpose: We examined the sense of being a burden to others or self-perceived burden (SPB) in people with stroke.
Method: A mail survey was completed by 57 former inpatients and their partner caregivers. The care recipient survey included measures of functional status, quality of life, marital satisfaction, equity in the relationship, and psychological distress, as well as SPB using the Self-Perceived Burden Scale (SPBS; Cousineau, McDowell, Hotz, & Hébert, 2003). The caregiver survey included similar measures in addition to a caregiver burden measure.
Results: SPB was found to be a prevalent and distressing concern. SPBS scores correlated with measures of functional status and mood; however, the correlations were highest for measures of family roles and work/productivity. Using equity theory as a basis to examine the SPB construct, care recipients who perceived themselves as overbenefiti…
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Culpepper L (2010)MEDLINE-indexed journal, not yet read by usThe Journal of clinical psychiatry32 citations Why do you need to move beyond first-line therapy for major depression?
Primary care clinicians need to move beyond first-line therapy for major depression. While initial treatment is ineffective in about two-thirds of patients, patients who have not responded to such initial treatments can be managed effectively. The severity of depression is as high in primary care as in specialty care settings. The risk of depression is currently elevated because economic hardship, job insecurity, and low socioeconomic status increase the likelihood of depression and treatment resistance. Depression worsens outcomes for medical comorbidities, such as cardiac disease, chronic obstructive pulmonary disease, and diabetes mellitus, and it increases the risk of rehospitalization. When depression is treatment-resistant (generally defined as not responding to 2 courses of treatment of adequate dose and duration), morbidity and mortality are increased, quality of life and functio…
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Surviving meningococcal septic shock in childhood: long-term overall outcome and the effect on health-related quality of life.
Introduction: The purpose of this study was to evaluate associations between long-term physical and psychological outcome variables in patients who survived meningococcal septic shock (MSS) in childhood.
Methods: The study population was made up of all MSS patients requiring intensive care treatment between 1988 and 2001.
Results: A total of 120 patients visited the follow-up clinic (age at paediatric intensive care unit (PICU) admission 3.1 years; follow-up interval 9.8 years; age at follow-up 14.5 years (all medians)). Four major outcomes were considered: 1) major physical sequelae (defined as major scars and/or orthopaedic sequelae) (29/120), 2) mild neurological impairments (39/120), 3) problem behaviour (defined as a total score above the 90th percentile of the reference groups on questionnaires to screen for psychopathology) (16/114) and 4) total intelligence quotient < 85 (18/115)…
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Social support as a moderator of positive psychological strengths and subjective well-being.
The present study was conducted to examine: (a) the relation of positive psychological strengths, i.e., hope, optimism, self-efficacy, and resiliency, with subjective well-being, and (b) the role of social support as a moderator of positive psychological strengths and subjective well-being. The following hypotheses were proposed: (a) that positive psychological strengths would be positively related with subjective well-being and social support; (b) social support would moderate the relation of positive psychological strengths with subjective well-being. 116 men and 64 women (M age=21.53 yr., SD=4.99, range=33) from India participated. Significant positive relationships were found for positive psychological strengths with subjective well-being and with social support network (family, friends, and others). Regression analysis showed social support significantly moderated the relations of p…
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Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an Internet survey.
Bariatric surgery is the most effective treatment for severe obesity. However, evidence suggests that maladaptive eating behaviors such as binge eating, grazing, and a loss of control when eating may impact postsurgical weight outcomes. The current study sought to characterize the weight outcomes, eating patterns, and perceived health-related quality of life of individuals 3-10 years following gastric bypass (GBP) surgery and to assess the relationships between eating behaviors, weight outcomes, and quality of life. Eligible participants (N = 497) completed an Internet survey of their eating behaviors, health-related quality of life, and weight history. Participants self-reported a mean maximum postsurgical loss of 81% of their excess weight and maintained a mean weight loss of 70% 3-10 years following surgery (mean 4.2 years). Eighty-seven percent reported weight regain ranging from 1 t…
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Environmental volunteering and health outcomes over a 20-year period.
Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period.
Design and methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and mortality that has followed a cohort of 6,928 adults since 1965. Using logistic and multiple regression models, we examined the prospective association between environmental and other volunteerism and three outcomes (physical activity, self-reported health, and depression), with 1974 volunteerism predicting 1994 outcomes, controlling for a number of relevant covariates.
Results: Midlife environmental volunteering was significantly associated with physical activity, self-reported health, and depressive symptoms.
Implications: This population-based st…
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Uhm DC (2010)MEDLINE-indexed journal, not yet read by usJournal of Korean Academy of Nursing3 citations [Effects on couples' communication, intimacy, conflict and quality of life by foot massage between immigrants].
Purpose: The purpose of this study was to evaluate the effects on immigrant couples' communication, intimacy, conflict and quality of life when using foot massage.
Methods: The research design consisted of pre-and-post test consecutive experimental design through a nonequivalent control group. Data were collected July 6, 2009 to February 27, 2010. The 36 couples were divided into two groups, experimental and control with 18 couples in each group. Foot massage was applied twice a week for 6 weeks by the couples in the experimental group.
Results: There were statistically significant increases in communication (p=.011), intimacy (p<.001), quality of life (p=.017) between the couples in the experimental group compared to the control group. There was also a statistically significant decrease in conflict (p=.003) between the couples in the experimental group compared to the control group.
Con…
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Brush S, Budge D, Alharethi R, McCormick AJ, MacPherson JE, Reid BB, Ledford ID, Smith HK, Stoker S, Clayson SE, Doty JR, Caine WT, Drakos S, Kfoury AG (2010)MEDLINE-indexed journal, not yet read by usThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation85 citations End-of-life decision making and implementation in recipients of a destination left ventricular assist device.
Background: The use of left ventricular assist devices (LVADs) as destination therapy (DT) is increasing and has proven beneficial in prolonging survival and improving quality of life in select patients with end-stage heart failure. Nonetheless, end-of-life (EOL) issues are inevitable and how to approach them underreported.
Methods: Our DT data registry was queried for eligible patients, defined as those individuals who actively participated in EOL decision making. The process from early EOL discussion to palliation and death was reviewed. We recorded the causes leading to EOL discussion, time from EOL decision to withdrawal and from withdrawal to death, and location. Primary caregivers were surveyed to qualify their experience and identify themes relevant to this process.
Results: Between 1999 and 2009, 92 DT LVADs were implanted in 69 patients. Twenty patients qualified for inclusion (…
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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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Meaning in life as a mediator of ethnic identity and adjustment among adolescents from Latin, Asian, and European American backgrounds.
Establishing a sense of life meaning is a primary facet of well-being, yet is understudied in adolescent development. Using data from 579 adolescents (53% female) from Latin American, Asian, and European backgrounds, demographic differences in meaning in life, links with psychological and academic adjustment, and the role of meaning in explaining associations between ethnic identity and adjustment were examined. Although no generational or gender differences were found, Asian Americans reported higher search for meaning than Latin and European Americans. Presence of meaning was positively associated with self-esteem, academic adjustment, daily well-being, and ethnic belonging and exploration, whereas search for meaning was related to lower self-esteem and less stability in daily well-being. Presence of meaning mediated associations between ethnic identity and adjustment, explaining 28-52…
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Acceptance and commitment therapy as a treatment for problematic internet pornography viewing.
Despite the prevalence of problematic Internet pornography viewing and the breadth of intervention approaches to potentially address it, no studies to address this problem have been reported to date. An emerging treatment approach, Acceptance and Commitment Therapy (ACT), holds promise as a treatment for Internet pornography viewing because of its focus on processes hypothesized to underlie this maladaptive behavior. In the first experiment on the treatment of problematic Internet pornography viewing, 6 adult males who reported that their Internet pornography viewing was affecting their quality of life were treated in eight 1.5-hour sessions of ACT for problematic pornography viewing. The effects of the intervention were assessed in a multiple-baseline-across-participants design with time viewing pornography as the dependent variable. Treatment resulted in an 85% reduction in viewing at …
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Coping, sense of coherence and the dimensions of affect in patients with chronic heart failure.
Background: Living with chronic heart failure has an impact on several important dimensions of an individual's life. A patient's use of coping strategies may influence his or her health condition and emotional well-being.
Aim: To investigate factors that may relate to the coping strategies used by individuals with chronic heart failure and how the coping strategies are associated with positive and negative affect.
Methods: A cross-sectional research design was used. The participants provided demographic data and filled out three questionnaires: Sense of Coherence scale, Brief COPE and Positive Affect Negative Affect Schedule.
Results: No differences in relation to coping strategies were found with regard to New York Heart Association class. Substance use was associated with gender and age. Sense of coherence was negatively associated with denial, behavioural disengagement, venting and se…
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Self-blame, self-forgiveness, and spirituality in breast cancer survivors in a public sector setting.
Cognitive appraisal affects adjustment to breast cancer. A self-forgiving attitude and spirituality may benefit breast cancer survivors who blame themselves for their cancer. One hundred and eight women with early breast cancers completed questionnaires assessing self-blame, self-forgiveness, spirituality, mood and quality of life (QoL) in an outpatient breast clinic. Women who blamed themselves reported more mood disturbance (p < 0.01) and poorer QoL (p < 0.01). Women who were more self-forgiving and more spiritual reported less mood disturbance and better QoL (p's < 0.01). Interventions that reduce self-blame and facilitate self-forgiveness and spirituality could promote better adjustment to breast cancer.
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Careful selection and close monitoring of low-risk prostate cancer patients on active surveillance minimizes the need for treatment.
Background: With the advent of prostate-specific antigen (PSA) screening and the increase in the number of transrectal ultrasound-guided biopsy cores, there has been a dramatic rise in the incidence of low-risk prostate cancer (LRPC). Because > 97% of men with LRPC are likely to die of something other than prostate cancer, it is critical that patients give thought to whether early curative treatment is the only option at diagnosis.
Objective: To identify a group of men with LRPC who may not require initial treatment and monitor them on our active surveillance (AS) protocol, to determine the percentage treated and the outcome and to analyze the quality-of-life data.
Design, setting, and participants: We defined patients eligible for AS as Gleason ≤ 6, PSA ≤ 10, and two or fewer biopsy cores with ≤ 20% tumor in each core.
Measurements: Kaplan Meier analysis was used to predict the 5-year t…
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Illness cognitions in head and neck squamous cell carcinoma: predicting quality of life outcome.
Goals of work: This paper presents an observational study of the longitudinal effects of cancer treatment on quality of life (QoL) in patients treated for head and neck squamous cell carcinoma (HNSCC), and evaluated the contribution of patients' baseline illness cognitions to the prediction of QoL 2 years after diagnosis.
Patients and methods: One hundred seventy-seven patients eligible for primary treatment for HNSCC completed the Illness Perception Questionnaire-Revised at baseline and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-30 at baseline, at 1-year and 2-year follow-ups.
Main results: Compared to baseline, patients reported better emotional functioning at both follow-ups (p < 0.001), worse social functioning at 12 months (p < 0.05), and better global health status at 24 months (p < 0.05). Patients' own implicit common sense be…
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Optimism, social support, and well-being in mothers of children with autism spectrum disorder.
This study used structural equation modeling to examine the relationship between multiple sources of social support (e.g., partner, family, and friends), optimism, and well-being among mothers of children with ASD. Social support was examined as a mediator and moderator of the optimism-maternal well-being relationship. Moreover, the role of optimism as a mediator of the social support-maternal well-being relationship was also evaluated. Results revealed that family support was associated with increased optimism that, in turn, predicted higher levels of positive maternal outcomes and lower levels of negative maternal outcomes. In addition, partner and friend support were directly associated with maternal outcomes. Implications for the development of interventions directed at increasing the quality of social support networks are discussed.
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Effects of internet use on health and depression: a longitudinal study.
Background: The rapid expansion of the Internet has increased the ease with which the public can obtain medical information. Most research on the utility of the Internet for health purposes has evaluated the quality of the information itself or examined its impact on clinical populations. Little is known about the consequences of its use by the general population.
Objective: Is use of the Internet by the general population for health purposes associated with a subsequent change in psychological well-being and health? Are the effects different for healthy versus ill individuals? Does the impact of using the Internet for health purposes differ from the impact of other types of Internet use?
Methods: Data come from a national US panel survey of 740 individuals conducted from 2000 to 2002. Across three surveys, respondents described their use of the Internet for different purposes, indicated…
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Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.
PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed a…
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Physical and psychological impairments of women with upper limb lymphedema following breast cancer treatment.
Objective: The aim of the study was to identify factors associated with worse physical and emotional functioning of breast cancer survivors with upper extremity lymphedema.
Methods: 1250 sets of questionnaires consisting of WHO-DAS II, EORTC QLQ-C30, EORTC QLQ-BR23 and GHQ-30 were mailed to women who underwent a breast cancer surgery at the Lower Silesian Oncology Center in Poland between January 1998 and December 2005.
Results and conclusions: The response rate was 33.47%. 117 women were included into a lymphedema group and 211 into a group without this complication. Women with lymphedema were more disabled (overall disability (DAS) score 39.78 versus 34.67; p<0.001), reported symptoms from the upper extremity (shoulder or arm pain and difficulties in arm movement) and from the operated breast (pain and swelling) 2-3 times more often, experienced poorer quality of life (global quality o…
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Paika V, Almyroudi A, Tomenson B, Creed F, Kampletsas EO, Siafaka V, Gkika S, Mavreas V, Pavlidis N, Hyphantis T (2010)MEDLINE-indexed journal, not yet read by usPsycho-oncology55 citations Personality variables are associated with colorectal cancer patients' quality of life independent of psychological distress and disease severity.
Objective: The aim of the present study was to test whether psychological distress and personality variables are independently associated with health-related quality of life (HRQOL) in colorectal cancer patients, after adjusting for age, gender, education and disease severity.
Methods: In a cross-sectional study of 162 colorectal cancer patients (response rate 65.6%), the following self-report instruments were administered: the Symptom Distress Checklist-90-R, the Sense of Coherence scale, the Life Style Index and the Hostility and Direction of Hostility Questionnaire. The outcome measures were the four components of the WHO Quality of Life Instrument, Short Form. We used hierarchical regressions to determine whether psychological distress mediates the relationship of personality and disease parameters with HRQOL.
Results: The overall proportion of the variance in the four components of …
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