Positive functioning as an outcome in its own right.
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2476 to 2500 of 6,178Finnamore T, Lord S (2007)reviewMEDLINE-indexed journal, not yet read by usJournal of intellectual disabilities : JOID12 citations The use of Dementia Care Mapping in people with a learning disability and dementia.
Dementia Care Mapping is a method for evaluating quality of life in and quality of care of people with dementia and has been used widely in services for older adults. This article presents a report of Dementia Care Mapping for eight adults with learning disabilities and dementia. Trained 'mappers' observed individuals over a set period and recorded their behaviour every 5 minutes. The person was then assigned a wellbeing or illbeing value for each 5 minute period, based on the mapper's empathic judgement as to how the individual was feeling at that time. Any examples of particularly positive or negative events were also recorded and the results fed back to the staff team. Data were used to aid care planning, and outcomes are reported.
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Psychiatric issues in multiple sclerosis.
MDD and anxiety disorders are highly prevalent among persons who have MS and have been associated with decreased adherence to MS treatment and poorer functional status and quality of life. Effective treatment is available for MDD, but this disorder continues to be underdetected and undertreated by MS providers. Treatment with pharmacotherapy is particularly challenging in this patient population, given the somatic symptom overlap between MS and depression and the increased burden of side effects. Larger randomized, controlled trials are needed to elucidate further the effectiveness of pharmacotherapy and to identify subgroups of patients who would benefit from this type of treatment for depression. There have been few rigorous studies of the prevalence and impact of anxiety disorders, substance use disorders, or serious mental illness such as bipolar disorder or schizophrenia, in MS samp…
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Critical review of generic and dermatology-specific health-related quality of life instruments.
The measurement of health-related quality of life (HRQOL) is increasingly important in patients with skin diseases. Despite the availability of a variety of instruments and new psychometric techniques, there is no consensus as to which HRQOL instruments are to be preferred in dermatology. The objective of this review is to evaluate the generic HRQOL measures (i.e., health profiles) that have been used in dermatology (Short-Form-36 (SF-36) and -12, NHP, SIP, World Health Organization Quality of Life (WHOQOL)-100 and -BREF) and all dermatology-specific HRQOL measures (Dermatology Life Questionnaire Index, Skindex-29, -16, and -17, Dermatology Quality of Life Scales, and Dermatology-Specific Quality of Life). Criteria for evaluation were adapted from existing guidelines and included conceptual and measurement model, reliability, validity, responsiveness, item functioning, meaning of scores,…
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Total knee replacement: is it really an effective procedure for all?
Total knee replacement (TKR) is considered an effective intervention for the treatment of chronic knee pain and disability. Yet there is increasing evidence, based on research using patient-based outcome measures, that a significant proportion of patients experience chronic knee pain, functional disability, a poor quality of life and dissatisfaction after TKR. Although some poor outcomes after TKR are due to surgical technique and implant factors, much of the pain and disability after surgery is medically unexplained. A range of possible patient factors could contribute to a poor outcome after TKR. Socio-demographic factors that have been found to correlate with a poor outcome after TKR include female gender, older age and low socio-economical status. Medical factors that are highly predictive of pain and disability after TKR are a greater number of co-morbidities and a worse pre-operati…
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Spinal cord injury medicine. 6. Economic and societal issues in spinal cord injury.
Unlabelled: This self-directed learning module presents a variety of social and economic issues facing people with spinal cord injury (SCI). It is part of the study guide on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article focuses on the economic consequences of SCI, ethical issues in SCI, and the legislative efforts that have improved access and quality of life for people with disabilities. Costs of SCI include direct health care expenditures and lost earnings as a result of unemployment after SCI. Lifelong costs can be anticipated with the development of a comprehensive life care plan. Barriers to vocational reintegration continue to limit full participation for most people with SCI. Ethical issues central to SCI are related to the principles of autonomy and justice. As cure research beco…
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Garcia SF, Cella D, Clauser SB, Flynn KE, Lad T, Lai JS, Reeve BB, Smith AW, Stone AA, Weinfurt K (2007)reviewMEDLINE-indexed journal, not yet read by usJournal of clinical oncology : official journal of the American Society of Clinical Oncology300 citations Standardizing patient-reported outcomes assessment in cancer clinical trials: a patient-reported outcomes measurement information system initiative.
Patient-reported outcomes (PROs), such as symptom scales or more broad-based health-related quality-of-life measures, play an important role in oncology clinical trials. They frequently are used to help evaluate cancer treatments, as well as for supportive and palliative oncology care. To be most beneficial, these PROs must be relevant to patients and clinicians, valid, and easily understood and interpreted. The Patient-Reported Outcomes Measurement Information System (PROMIS) Network, part of the National Institutes of Health Roadmap Initiative, aims to improve appreciably how PROs are selected and assessed in clinical research, including clinical trials. PROMIS is establishing a publicly available resource of standardized, accurate, and efficient PRO measures of major self-reported health domains (eg, pain, fatigue, emotional distress, physical function, social function) that are relev…
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Cancer-related fatigue: the scale of the problem.
Fatigue is one of the most common and debilitating symptoms experienced by patients with cancer. Cancer-related fatigue (CRF) is characterized by feelings of tiredness, weakness, and lack of energy, and is distinct from the "normal" drowsiness experienced by healthy individuals in that it is not relieved by rest or sleep. It occurs both as a consequence of the cancer itself and as a side effect of cancer treatment, although the precise underlying pathophysiology is largely unknown. CRF may be an early symptom of malignant disease and is reported by as many as 40% of patients at diagnosis. Virtually all patients expect fatigue from cancer therapy. Up to 90% of patients treated with radiation and up to 80% of those treated with chemotherapy experience fatigue. CRF continues for months and even years ollowing completion of treatment in approximately one third of the patients with cancer. Th…
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Kayl AE, Meyers CA (2006)reviewMEDLINE-indexed journal, not yet read by usCurrent opinion in obstetrics & gynecology144 citations Side-effects of chemotherapy and quality of life in ovarian and breast cancer patients.
Purpose of review: Women diagnosed with ovarian cancer or breast cancer often face aggressive chemotherapy involving multiple treatment regimens. These treatments may be associated with significant side-effects that adversely impact patient quality of life. In this review, we will highlight recent research on side-effects of chemotherapy and the quality-of-life concerns of women with ovarian and breast cancer.
Recent findings: Adjuvant chemotherapy has demonstrated efficacy in the management of ovarian and breast cancers. In addition to physical side-effects, a subset of women receiving chemotherapy will experience significant cognitive dysfunction that adversely affects their perceived quality of life. Variables including disease response, treatment indication and extent of the patient's social support also influence quality-of-life ratings.
Summary: Although prolongation of survival re…
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Generic health-related quality-of-life assessment in children and adolescents: methodological considerations.
The health-related quality of life (HR-QOL) of children and adolescents is increasingly considered a relevant topic for research. Instruments to assess quality of life in children and adolescents of a generic as well as disease- or condition-specific nature are being developed and applied in epidemiological surveys, clinical studies, quality assurance and health economics. This paper attempts to give an overview on the state of the art of HR-QOL assessment in children as it relates to methodological and conceptual challenges. Instruments available in international or cross-cultural research to assess HR-QOL in generic terms were identified and described according to psychometric data provided and the width of application. In an initial literature search, several challenges in the assessment of child and adolescent HR-QOL were identified, ranging from conceptual and methodological to prac…
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Successes and failures of the teachable moment: smoking cessation in cancer patients.
Background: Successful cancer treatment can be significantly compromised by continued tobacco use. Because motivation and interest in smoking cessation increase after cancer diagnosis, a window of opportunity exists during which healthcare providers can intervene and assist in the quitting process.
Methods: The authors conducted a comprehensive literature review to discuss 1) the benefits of smoking cessation in cancer patients, 2) current knowledge regarding smoking cessation interventions targeted to cancer patients, and 3) treatment models and state-of the-art guidelines for intervention with cancer patients who smoke. The authors present clinical cases to illustrate the challenging nature of smoking cessation treatment for cancer patients.
Results: Continued smoking after cancer diagnosis has substantial adverse effects on treatment effectiveness, overall survival, risk of second pri…
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Moyad MA (2005)reviewMEDLINE-indexed journal, not yet read by usUrologic oncology28 citations Promoting general health during androgen deprivation therapy (ADT): a rapid 10-step review for your patients.
Androgen deprivation for prostate cancer use to be applied only in the latter stage of the disease process, thus, the issue of promoting general health during this time was not a concern because the subject of life and death was more paramount. However, thanks to earlier detection of prostate cancer, there has been a general stage migration in this disease. Men are choosing these traditionally late stage therapies earlier and earlier. Therefore, the subject of quality of life on this treatment has now garnered as much attention as the survival issues. Cognitive or mental health concerns, cholesterol changes, hot flashes, osteoporosis, and other side effects are being addressed and treated with a variety of conventional medicines. However, the issue of the role of the patient or what men can do personally to promote better mental and physical health is desperately needed in this area. A v…
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Quality of life and psychological issues in peritoneal dialysis patients.
Both peritoneal dialysis (PD) and hemodialysis (HD) patients have diminished quality of life (QOL) scores compared to healthy patients. QOL tends to decline over time, with the perception of the quality of physical health deteriorating more than mental health. However, many patients continue to feel hopeless, anxious, and worry about finances, loss of sexual function, family burden, and loss of independence. Depression is the most widely acknowledged psychosocial factor seen in patients with chronic kidney disease. Major depression occurs in 25% of patients facing impending dialysis. Once on PD, the proportion with major depression sharply declines to approximately 6%. This may be due to adjustment to dialysis, but may also be because depressive symptoms are associated with an increased risk of death. A low QOL score and depression are associated with higher comorbidity, poorer nutrition…
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Psychosocial issues confronting young women with breast cancer.
The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychologic…
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Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders.
Insomnia is a pervasive problem for many patients suffering from medical and psychiatric conditions. Even when the comorbid disorders are successfully treated, insomnia often fails to remit. In addition to compromising quality of life, untreated insomnia may also aggravate and complicate recovery from the comorbid disease. Cognitive behavior therapy for insomnia (CBT-I) has an established efficacy for primary insomnia, but less is known about its efficacy for insomnia occurring in the context of medical and psychiatric conditions. The purpose of this article is to present a rationale for using CBT-I in medical and psychiatric disorders, review the extant outcome literature, highlight considerations for adapting CBT-I procedures in specific populations, and suggest directions for future research. Outcome studies were identified for CBT-I in mixed medical and psychiatric conditions, cancer…
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Symptomatic therapy and neurorehabilitation in multiple sclerosis.
Multiple sclerosis (MS) is associated with a variety of symptoms and functional deficits that result in a range of progressive impairments and handicap. Symptoms that contribute to loss of independence and restrictions in social activities lead to continuing decline in quality of life. Our aim is to give an updated overview on the management of symptoms and rehabilitation measures in MS. Appropriate use of these treatment options might help to reduce long-term consequences of MS in daily life. First, we review treatment of the main symptoms of MS: fatigue, bladder and bowel disturbances, sexual dysfunction, cognitive and affective disorders, and spasticity. Even though these symptomatic therapies have benefits, their use is limited by possible side-effects. Moreover, many common disabling symptoms, such as weakness, are not amenable to drug treatment. However, neurorehabilitation has bee…
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First-episode psychosis: psychopathology, quality of life, and functional outcome.
The burgeoning interest in investigating the first episode of schizophrenia and related disorders provides an opportunity to examine how this approach has assisted our understanding of the heterogeneity of psychopathology of this disorder and the trajectories of its outcome. We present a review of relevant literature on categorical versus dimensional perspectives on psychopathology, with special reference to early signs, its relationship with other patient- and system-related characteristics, and the status and determinants of functional outcome and quality of life. The findings from longitudinal studies of the dimensional psychopathology of first-episode psychosis suggest continuity of some psychopathological dimensions from premorbid through prodromal to post-onset phases of psychosis and some aspects of longer-term course. Short-term functional outcome improves after treatment of the …
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Breaking Bad News to Patients with Intracranial Tumors: The Patients' Perspective.
Objective: Bad news refers to information that subjectively impedes a patient's future prospects. Patients with intracranial tumors potentially face numerous pieces of bad news. This study assessed the patients' perspective regarding the content of bad news, patients' preferences for the communication of bad news, and clinical consequences of mismatch of patients' communication preferences.
Methods: We included 42 patients with an intracranial tumor shortly after neurosurgical tumor removal. Patients' preferences for communication of bad news was assessed via the Measure of Patients' Preferences Scale. Various areas of patients' psychosocial well-being were included (e.g., depression or quality of life).
Results: At this early stage of the disease trajectory, patients with a brain tumor had already received on average 2.2 (standard deviation, 1.38; range, 0-6) pieces of bad news. For mos…
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Mona Eklund; Elisabeth Argentzell; Ulrika Bejerholm and 2 others (2017)cohort or longitudinalMEDLINE-indexed journal, not yet read by usBMC Psychiatry34 citations
Wellbeing, activity and housing satisfaction – comparing residents with psychiatric disabilities in supported housing and ordinary housing with support
BACKGROUND: The home is imperative for the possibilities for meaningful everyday activities among people with psychiatric disabilities. Knowledge of whether such possibilities vary with type of housing and housing support might reveal areas for improved support. We aimed to compare people with psychiatric disabilities living in supported housing (SH) and ordinary housing with support (OHS) regarding perceived well-being, engaging and satisfying everyday activities, and perceived meaning of activity in one's accommodation. The importance of these factors and socio-demographics for satisfaction with housing was also explored. METHODS: This naturalistic cross-sectional study was conducted in municipalities and city districts (n = 21) in Sweden, and 155 SH residents and 111 OHS residents participated in an interview that included both self-reports and interviewer ratings. T-test and linear r…
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Psychiatric disorders among infertile men and women attending three infertility clinics in Riyadh, Saudi Arabia.
Background and objectives: No study has assessed psychiatric disorders among infertile men and women seeking fertility treatment in Saudi Arabia. Therefore, we sought to measure the rate of psychiatric disorders in this population.
Design and setting: This was a cross-sectional observational study among patients attending infertility clinics at three referral hospitals in Riyadh, Saudi Arabia, between January 2013 and September 2014.
Patients and methods: 406 patients (206 women and 200 men) participated in the study. The approved Arabic version of the MINI tool was used to assess 18 common psychiatric illnesses.
Results: The response rate was 81%. Of the men surveyed, only 4.5% self-reported having a psychiatric disorder. Of the women surveyed, only 10.2% reported having a psychiatric disorder. However, using the MINI scale, psychiatric illness was documented in 30% of males and 36.9% o…
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Jaglal SB, Haroun VA, Salbach NM, Hawker G, Voth J, Lou W, Kontos P, Cameron JE, Cockerill R, Bereket T (2013)cohort or longitudinalMEDLINE-indexed journal, not yet read by usTelemedicine journal and e-health : the official journal of the American Telemedicine Association54 citations Increasing access to chronic disease self-management programs in rural and remote communities using telehealth.
Objective: This study examined whether a telehealth chronic disease self-management program (CDSMP) would lead to improvements in self-efficacy, health behaviors, and health status for chronically ill adults living in Northern Ontario, Canada. Two telehealth models were used: (1) single site, groups formed by participants at one telehealth site; and (2) multi-site, participants linked from multiple sites to form one telehealth group, as a strategy to increase access to the intervention for individuals living in rural and remote communities.
Subjects and methods: Two hundred thirteen participants diagnosed with heart disease, stroke, lung disease, or arthritis attended the CDSMP at a preexisting Ontario Telemedicine Network studio from September 2007 to June 2008. The program includes six weekly, peer-facilitated sessions designed to help participants develop important self-management ski…
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Psychological distress in parents of children with advanced cancer.
Importance: Parent psychological distress can impact the well-being of childhood cancer patients and other children in the home. Recognizing and alleviating factors of parent distress may improve overall family survivorship experiences following childhood cancer.
Objectives: To describe the prevalence and factors of psychological distress (PD) among parents of children with advanced cancer.
Design: Cohort study embedded within a randomized clinical trial (Pediatric Quality of Life and Evaluation of Symptoms Technology [PediQUEST] study).
Setting: Multicenter study conducted at 3 children's hospitals (Boston Children's Hospital, Children's Hospital of Philadelphia, and Seattle Children's Hospital).
Participants: Parents of children with advanced (progressive, recurrent, or refractory) cancer.
Main outcome measure: Parental PD, as measured by the Kessler-6 Psychological Distress Scale.
Res…
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Vaingankar JA, Subramaniam M, Chong SA, Abdin E, Orlando Edelen M, Picco L, Lim YW, Phua MY, Chua BY, Tee JY, Sherbourne C (2011)cohort or longitudinalMEDLINE-indexed journal, not yet read by usHealth and quality of life outcomes47 citations The positive mental health instrument: development and validation of a culturally relevant scale in a multi-ethnic Asian population.
Background: Instruments to measure mental health and well-being are largely developed and often used within Western populations and this compromises their validity in other cultures. A previous qualitative study in Singapore demonstrated the relevance of spiritual and religious practices to mental health, a dimension currently not included in exiting multi-dimensional measures. The objective of this study was to develop a self-administered measure that covers all key and culturally appropriate domains of mental health, which can be applied to compare levels of mental health across different age, gender and ethnic groups. We present the item reduction and validation of the Positive Mental Health (PMH) instrument in a community-based adult sample in Singapore.
Methods: Surveys were conducted among adult (21-65 years) residents belonging to Chinese, Malay and Indian ethnicities. Exploratory…
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Risk factors for acute and chronic postoperative pain in patients with benign and malignant renal disease after nephrectomy.
Aims: This longitudinal study was performed in order to analyze the incidence of and perioperative risk factors for the development of chronic postsurgical pain (CPSP) in patients after nephrectomy.
Methods: For baseline data acquisition, valid instruments were used for scoring sociodemographic, psychological, psychosocial, pain, pain treatment, and comorbidity factors: the Mainz Pain Staging System (MPSS) for pain chronicity, the Chronic Pain Grading Questionnaire (CPGQ), the Neuropathic Pain Scale (NPS), the Hospital Anxiety and Depression Scale (HADS), the Short Form 12 (SF-12) for health-related quality of life, the Habitual Well-Being Questionnaire (HWBQ), the Symptom Check List (SCL-8) for detecting psychosomatic dysfunction, and the Weighted Illness Check List (WICL) for evaluation of comorbidities and their impact on activities of daily living. Pain intensities were recorded over…
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Gerotranscendence and Alaska Native Successful Aging in the Aleutian Pribilof Islands, Alaska.
The population of the United States is aging and by 2045 it is projected that approximately 1 in every 6 Alaskans will be 65+. Delivering healthcare and meeting the needs of older Alaskans in their community is critical to supporting healthy aging and community sustainability. Alaska Native (AN) Elders are underserved with very few studies providing an emic perspective on their experience aging. This research opens the door and allows us a glimpse of the AN Elder experience of aging: the values, beliefs, and behaviors that allow them to age well. This study highlights the characteristics and activities of AN Elders in the Aleutian and Pribilof Islands to further develop the model of AN successful aging. There are many theories of aging and this study explores a cross-cultural understanding of gerotranscendence - the personal and interpersonal changes that result from successful aging or …
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Yoga meets positive psychology: examining the integration of hedonic (gratitude) and eudaimonic (meaning) wellbeing in relation to the extent of yoga practice.
The present study aims to explore the existence of a relationship between the extent of yoga practice and two dimensions of psychological wellbeing: meaning in life and gratitude. Both of the variables are positive psychology constructs; there is theoretical affinity and empirical evidence that they are related to overall psychological wellbeing. One hundred and twenty four participants aged 18 years and above, with yoga experience ranging from none to over six years, responded to a number of scales. The extent of yoga practice was measured by the number of years during which individuals practiced yoga at least two times a week. Participants responded to the following scales: MLQ (Meaning in Life Questionnaire) and GQ-6 (Gratitude Questionnaire). This study hypothesised that the number of years practicing yoga would be positively correlated to the score obtained on the aforementioned sca…
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