Positive functioning as an outcome in its own right.
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2451 to 2475 of 6,178Does palliative care improve outcomes for patients with incurable illness? A review of the evidence.
Patients with incurable illness experience considerable physical and psychological distress, which negatively impacts their quality of life. Palliative care clinicians primarily seek to alleviate suffering, enhance coping with symptoms, and enable informed decision making. In this article, we review the efficacy of various palliative care interventions to improve patients' quality of life, physical and psychological symptoms, satisfaction with care, family caregiver outcomes, health-service utilization, and quality of end-of-life care. We have identified 22 randomized studies that evaluate the efficacy of various palliative care interventions. Palliative care research has been hampered by methodological challenges related to attrition and missing data due to progressive illness and death. In addition, interventions to date have varied widely in the focus and extent of services, with only…
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Maternal parental self-efficacy in the postpartum period.
Objective: To present an integrated literature review on maternal parental self-efficacy (MPSE) in the postpartum period.
Data sources: A literature search of CINAHL with full text and MEDLINE and PsycINFO from their start dates to February 2010.
Study selection: Inclusion criteria were English written research articles which reported the measurement of MPSE in the postpartum period.
Data extraction: Articles were reviewed based on purpose, theoretical framework, data collection method, sample, main findings and nursing implications for maternal parenting. In addition, data related to the instruments that were used to measure MPSE were included.
Data synthesis: Data revealed is a statistically significant increase in MPSE over time from baseline; a positive relationship between MPSE and number of children, social support, maternal parenting satisfaction and marital satisfaction; and a ne…
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Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan.
Polycystic ovary syndrome (PCOS) is of clinical and public health importance as it is very common, affecting up to one in five women of reproductive age. It has significant and diverse clinical implications including reproductive (infertility, hyperandrogenism, hirsutism), metabolic (insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, adverse cardiovascular risk profiles) and psychological features (increased anxiety, depression and worsened quality of life). Polycystic ovary syndrome is a heterogeneous condition and, as such, clinical and research agendas are broad and involve many disciplines. The phenotype varies widely depending on life stage, genotype, ethnicity and environmental factors including lifestyle and bodyweight. Importantly, PCOS has unique interactions with the ever increasing obesity prevalence worldwide as obesity-induced insulin resistance signif…
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The emotional brain and sleep: an intimate relationship.
Research findings confirm our own experiences in life where daytime events and especially emotionally stressful events have an impact on sleep quality and well-being. Obviously, daytime emotional stress may have a differentiated effect on sleep by influencing sleep physiology and dream patterns, dream content and the emotion within a dream, although its exact role is still unclear. Other effects that have been found are the exaggerated startle response, decreased dream recall and elevated awakening thresholds from rapid eye movement (REM)-sleep, increased or decreased latency to REM-sleep, increased REM-density, REM-sleep duration and the occurrence of arousals in sleep as a marker of sleep disruption. However, not only do daytime events affect sleep, also the quality and amount of sleep influences the way we react to these events and may be an important determinant in general well-being…
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Psychological outcomes with face transplantation: overview and case report.
Purpose of review: The purpose of this review is to provide guidance in a burgeoning new field of facial composite tissue transplantation. This review will contrast face transplant with solid organ transplantation, provide information to guide selection of face transplant candidates, and share information on psychological outcomes.
Recent findings: Previously published face transplant reports have not investigated body image, mood changes, perception of teasing, quality of life, self-esteem, or social reintegration quantitatively. Face transplantation appears to decrease depression and verbal abuse, and improve quality of life and social reintegration, though may not alter anxiety or self-esteem. The Psychosocial Adjustment for Illness Scale-Self-Report scale may have advantages over the SF-36 and World Health Organization Quality of Life (WHOQOL)-BREF rating scales for measuring psychol…
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Determinants of quality of life in people with epilepsy.
This article reviews evidence of quality of life (QOL) determinants in people affected by epilepsy, including detractors and promoters. Emerging factors of particular significance for QOL are highlighted, including seizure frequency, medication side effects, psychological comorbidity, and stigma and discrimination. This article also examines the role of resilience, interpreted in its widest sense, for promoting good QOL, even in the presence of poorly controlled seizures. The importance of addressing both clinical and wider psychosocial issues is highlighted and some possible directions for future research into QOL in epilepsy are suggested.
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Psychological intervention and health outcomes among women treated for breast cancer: a review of stress pathways and biological mediators.
Breast cancer is a common cancer among American women. The diagnosis, treatment, and the challenges of survivorship all have potential to increase women's levels of distress to levels that might influence their adaptation and possibly the course of their disease. Psychological distress can influence tumor progression via many different pathways (e.g., genetic changes, immune surveillance, pro-angiogenic processes). Psychological intervention has been shown to facilitate psychological adaptation to breast cancer. But can psychological intervention influence cancer relevant biological outcomes among breast cancer survivors? We review the literature on how psychological intervention can influence cancer relevant biological outcomes among breast cancer patients. We limited the present review to randomized controlled trials reported in the past 6 years that tested the effects of psychological…
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The challenges of colorectal cancer survivorship.
With advances in treatment, colorectal cancer (CRC) is being transformed from a deadly disease into an illness that is increasingly curable. With this transformation has come increased interest in the unique problems, risks, needs, and concerns of survivors who have completed treatment and are cancer-free. Research has shown that physical and mental quality of life for CRC survivors was inferior compared with age-matched individuals without cancer. Although issues and symptoms were most prominent during the first 3 years, long-term effects of treatment can persist and include fatigue, sleep difficulty, fear of recurrence, anxiety, depression, negative body image, sensory neuropathy, gastrointestinal problems, urinary incontinence, and sexual dysfunction. The unique challenges and issues of CRC survivors can and should be addressed by health care providers and the research community to en…
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The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies.
The present review provides an assessment of the efficacy and safety of benzodiazepine receptor agonists (BZRAs) and psychological and behavioral interventions for insomnia. These methods include relaxation techniques, sleep hygiene rules, stimulus control, sleep restriction and cognitive techniques, often also referred to as cognitive-behavioral therapy (CBT) when encompassing cognitive strategies and at least one kind of behavioral intervention. In order to provide a comprehensive assessment of the literature regarding the efficacy and safety of these standard treatments for insomnia, an integrative synthesis of the existing meta-analytic studies for each of the various treatment modalities was conducted. Where meta-analytic studies were not available, data from double-blind placebo-controlled randomized controlled trials (RCTs) were included. The summary findings from this review are …
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Religion, self-regulation, and self-control: Associations, explanations, and implications.
Many of the links of religiousness with health, well-being, and social behavior may be due to religion's influences on self-control or self-regulation. Using Carver and Scheier's (1998) theory of self-regulation as a framework for organizing the empirical research, the authors review evidence relevant to 6 propositions: (a) that religion can promote self-control; (b) that religion influences how goals are selected, pursued, and organized; (c) that religion facilitates self-monitoring; (d) that religion fosters the development of self-regulatory strength; (e) that religion prescribes and fosters proficiency in a suite of self-regulatory behaviors; and (f) that some of religion's influences on health, well-being, and social behavior may result from religion's influences on self-control and self-regulation. The authors conclude with suggestions for future research.
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Reich K (2009)reviewMEDLINE-indexed journal, not yet read by usJournal of the European Academy of Dermatology and Venereology : JEADV76 citations Approach to managing patients with nail psoriasis.
Psoriasis is a chronic inflammatory skin condition that affects approximately 2% of the population. Up to 50% of patients with psoriasis have concurrent nail psoriasis, with a lifetime incidence of 80% to 90%. Up to 30% of patients with skin psoriasis also have psoriatic arthritis (PsA) and of these, approximately 80% have nail disease. However, nail involvement is often overlooked by physicians, despite the significant burden it places on patients as a result of functional impairment of manual dexterity, pain and psychological stress. Affected nail plates often thicken and crumble, and because they are very visible, patients are usually concerned about the appearance of their nails, often causing them to avoid normal day-to-day activities (including work). In the longer-term, nail involvement may be a signal of a more severe form of psoriasis or a precursor of PsA. Conventional treatmen…
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Rapkin AJ, Winer SA (2009)reviewMEDLINE-indexed journal, not yet read by usExpert review of pharmacoeconomics & outcomes research122 citations Premenstrual syndrome and premenstrual dysphoric disorder: quality of life and burden of illness.
Premenstrual symptoms are distressing for up to 20% of reproductive-aged women and are associated with impairment in interpersonal or workplace functioning for at least 3-8%. Typical symptoms of premenstrual syndrome and the severe form, premenstrual dysphoric disorder, include irritability, anger, mood swings, depression, tension/anxiety, abdominal bloating, breast pain and fatigue. The symptoms recur monthly and last for an average of 6 days per month for the majority of the reproductive years. For women with premenstrual dysphoric disorder, the symptoms can be as disabling as major depressive disorder. It has been estimated that affected women experience almost 3000 days of severe symptoms during the reproductive years. Until two decades ago, there were no effective treatments for severe premenstrual syndrome. Even in 2000, almost three-quarters of women in the USA with premenstrual d…
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Wren BG (2009)reviewMEDLINE-indexed journal, not yet read by usThe Medical journal of Australia31 citations The benefits of oestrogen following menopause: why hormone replacement therapy should be offered to postmenopausal women.
Recently, two major epidemiological studies found that hormone replacement therapy (HRT) in postmenopausal women increased the risk of breast cancer. One of the studies also found that HRT increased the risk of cardiovascular disease and thrombosis. As a consequence, women were advised to cease this therapy. However, detailed analysis of these studies suggests that the conclusions may be erroneous. Other studies suggest that the timing of initiation of HRT for healthy women is critical to achieving a beneficial outcome. When begun within 5 years of menopause in healthy women, oestrogen-based HRT results in far greater benefits than adverse outcomes. There is substantial objective evidence that the benefits of HRT include: Reduced distressing symptoms of menopause. Reduced risk of osteoporotic fractures, dementia and colorectal cancer. Improved wellbeing, quality of life; improved vaginal…
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Skin toxicities associated with epidermal growth factor receptor inhibitors.
The use of epidermal growth factor receptor (EGFR) inhibitors in several epithelial tumors has increased considerably in recent years. Currently, they are approved in non-small cell lung cancer (NSCLC), pancreatic cancer, colorectal cancer and head and neck cancer. Skin toxicity is a class-specific side effect that is typically manifested as a papulopustular rash in the majority (45-100%) of patients receiving EGFR inhibitors. The skin toxicity is related to the inhibition of EGFR in the skin, which is crucial for the normal development and physiology of the epidermis. Although rarely life-threatening, skin toxicity may cause significant physical and psycho-social discomfort. Nevertheless, the presence and severity of skin rash is associated with improved clinical efficacy in patients receiving EGFR inhibitors. The goal of managing EGFR inhibitor-associated skin toxicity is to minimize t…
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Update on research and treatment of premenstrual dysphoric disorder.
Many women in their reproductive years experience some mood, behavioral. or physical symptoms in the week prior to menses. Variability exists in the level of symptom burden in that some women experience mild symptoms, whereas a small minority experience severe and debilitating symptoms. For an estimated 5%-8% of premenopausal women, work or social functioning are affected by severe premenstrual syndrome. Many women in this group meet diagnostic criteria for premenstrual dysphoric disorder (PMDD). Among women who suffer from PMDD, mood and behavioral symptoms such as irritability, depressed mood, tension, and labile mood dominate. Somatic complaints, including breast tenderness and bloating, also can prove disruptive to women's overall functioning and quality of life. Recent evidence suggests that individual sensitivity to cyclical variations in levels of gonadal hormones may predispose c…
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Psychological status in childhood cancer survivors: a report from the Childhood Cancer Survivor Study.
Psychological quality of life (QOL), health-related QOL (HRQOL), and life satisfaction outcomes and their associated risk factors are reviewed for the large cohort of survivors and siblings in the Childhood Cancer Survivor Study (CCSS). This review includes previously published manuscripts that used CCSS data focused on psychological outcome measures, including the Brief Symptom Inventory (BSI-18), the Medical Outcomes Survey Short Form-36 (SF-36), the Cantril Ladder of Life, and other self-report questionnaires. Comparisons and contrasts are made between siblings and survivors, and to normative data when available, in light of demographic/health information and abstracted data from the medical record. These studies demonstrate that a significant proportion of survivors report more symptoms of global distress and poorer physical, but not emotional, domains of HRQOL. Other than brain tumo…
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Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature.
Objective: This article reviews recent literature on adults' quality of life following hematopoietic stem cell transplantation (HSCT).
Methods: We identified 22 prospective reports with at least 20 participants at baseline through a search of databases (Medline and PsycInfo) and handsearching of articles published from 2002 to October 2007. If longitudinal data were not available or were scarce for a particular topic or time point, cross-sectional studies were reviewed.
Results: Although physical, psychological, and social aspects of quality of life tend to improve during the years following transplantation, a significant proportion of HSCT survivors experience persistent anxiety and depressive symptoms, fatigue, sexual dysfunction, and fertility concerns. Despite ongoing treatment side effects, the majority of HSCT survivors resume their work, school, or household activities.
Conclusion…
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Vachon ML (2008)reviewMEDLINE-indexed journal, not yet read by usSeminars in oncology nursing52 citations Meaning, spirituality, and wellness in cancer survivors.
Objectives: To explore the concepts of meaning, spirituality, and wellness in cancer survivors.
Data sources: Review and research articles, books, and personal experience as a nurse psychotherapist and as a cancer survivor.
Conclusion: Cancer survivors often rely on their religious and spiritual beliefs as a way of deriving meaning during their illness experience and survivorship, as well as a way of coping with and coming to terms with the concept of death. The measurement of religion and spirituality in health and cancer survivorship is challenging because of the difficulty in defining terms and in developing ways of measuring the concepts.
Implications for nursing practice: Nurses have the opportunity to explore the meaning of cancer and spirituality in the lives of their patients. Such discussions can allow for the introduction of concepts of wellness including changes in lifestyle h…
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Montazeri A (2008)reviewMEDLINE-indexed journal, not yet read by usJournal of experimental & clinical cancer research : CR462 citations Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007.
Background: Quality of life in patients with breast cancer is an important outcome. This paper presents an extensive overview on the topic ranging from descriptive findings to clinical trials.
Methods: This was a bibliographic review of the literature covering all full publications that appeared in English language biomedical journals between 1974 and 2007. The search strategy included a combination of key words 'quality of life' and 'breast cancer' or 'breast carcinoma' in titles. A total of 971 citations were identified and after exclusion of duplicates, the abstracts of 606 citations were reviewed. Of these, meetings abstracts, editorials, brief commentaries, letters, errata and dissertation abstracts and papers that appeared online and were indexed ahead of publication were also excluded. The remaining 477 papers were examined. The major findings are summarized and presented under se…
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Tan BH, Fearon KC (2008)reviewMEDLINE-indexed journal, not yet read by usCurrent opinion in clinical nutrition and metabolic care177 citations Cachexia: prevalence and impact in medicine.
Purpose of review: Cachexia is a progressive deterioration of body habitus associated with certain chronic diseases (e.g., cancer, chronic obstructive pulmonary disease, chronic heart failure, and chronic kidney disease). The aim of this article is to describe the prevalence and impact of cachexia (and precachexia) in such patients.
Recent findings: Owing to the wide spectrum of clinical presentation and lack of an 'all-inclusive' definition, it is difficult to estimate the true prevalence of cachexia. Perhaps 2% of the population suffer from precachexia (characterized by weight loss in association with a chronic disease). The significant increase in obesity of the general population (which can mask significant muscle wasting) confounds such simple estimates of the true prevalence of cachexia. In contrast, a multidimensional characterization of the cachectic state (including weight loss,…
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Loneliness and the health of older people.
Background: The intense focus on major psychiatric disorders in both contemporary psychiatric research and clinical practice has resulted in the relative neglect of less definable constructs such as loneliness and how such entities might impact on health outcomes. The purpose of this review is to raise awareness among physicians and psychiatrists of the medical impact and biological effects of loneliness as well as making the argument that loneliness should be a legitimate therapeutic target.
Methods: Using Pubmed we searched the literature for research and review papers looking at loneliness as a construct, how it is measured and its health effects. We reviewed the relevant papers and have summarized their main findings.
Results: Loneliness has strong associations with depression and may in fact be an independent risk factor for depression. Furthermore loneliness appears to have a signi…
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Outcomes of epilepsy surgery in adults and children.
Surgery is widely accepted as an effective therapy for selected individuals with medically refractory epilepsy. Numerous studies in the past 20 years have reported seizure freedom for at least 1 year in 53-84% of patients after anteromesial temporal lobe resections for mesial temporal lobe sclerosis, in 66-100% of patients with dual pathology, in 36-76% of patients with localised neocortical epilepsy, and in 43-79% of patients after hemispherectomies. Reported rates for non-resective surgery have been less impressive in terms of seizure freedom; however, the benefit is more apparent when reported in terms of significant seizure reductions. In this Review, we consider the outcomes of surgery in adults and children with epilepsy and review studies of neurological and cognitive sequelae, psychiatric and behavioural outcomes, and overall health-related quality of life.
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Treatment of existential distress in life threatening illness: a review of manualized interventions.
Understanding the factors that underlie existential suffering at the end of life has become the focus of a growing body of research. A number of studies have concluded that existential questions can be distressing for some patients. Other studies have shown that existential concerns are an important dimension of quality of life and can increase a patient's risk for suicidal ideation and desire for death. Over the years, a number of psychological interventions have been developed aimed at addressing such suffering in patients with cancer. In this paper, we review the evidence supporting the importance of existential concerns in terminally ill patients, describe eight manualized interventions explicitly addressing existential themes, and evaluate the effectiveness of these interventions. Similarities and differences between each intervention are noted, and clinical and empirical considerat…
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Quality of life of family caregivers of cancer survivors: across the trajectory of the illness.
Background: Cancer affects not only the quality of life (QOL) of individuals with the disease but also that of their family members and close friends. The impact on various aspects of the family caregivers' QOL is significant throughout the trajectory of the illness. The authors reviewed literature on the QOL of family caregivers at the acute and middle- to long-term survivorship phases as well as the bereavement phase.
Methods: By using several databases, the authors searched the literature published in English from 1996 through July 2007. Keywords searched included cancer, carcinoma, family, family member, caregivers, and quality of life. Several criteria were used to guide the literature review: Articles had to be published in refereed journals and had to use rigorous methods, sample, and validated measures.
Results: The findings suggested that the QOL of family caregivers of individu…
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Forgiveness, health, and well-being: a review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness.
The extant data linking forgiveness to health and well-being point to the role of emotional forgiveness, particularly when it becomes a pattern in dispositional forgivingness. Both are important antagonists to the negative affect of unforgiveness and agonists for positive affect. One key distinction emerging in the literature is between decisional and emotional forgiveness. Decisional forgiveness is a behavioral intention to resist an unforgiving stance and to respond differently toward a transgressor. Emotional forgiveness is the replacement of negative unforgiving emotions with positive other-oriented emotions. Emotional forgiveness involves psychophysiological changes, and it has more direct health and well-being consequences. While some benefits of forgiveness and forgivingness emerge merely because they reduce unforgiveness, some benefits appear to be more forgiveness specific. We r…
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