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Biomedical subjects

B Hedge

Publications and source records attributed to B Hedge.

16 recordsLinked to original sources
PubMed2005

Subjective quality of life in patients with chronic fatigue syndrome.

The aim of this study was to (1) assess Subjective Quality of Life (SQOL) of patients with Chronic Fatigue Syndrome (CFS) using a generic concept and to compare the findings with those in groups with mental disorders and healthy subjects, and (2) investigate whether and, if so, to what extent socio-demographic and clinical variables predict SQOL in CFS patients. Seventy-three patients diagnosed with CFS were randomly selected and interviewed from two specialised clinics. CFS was diagnosed using the Oxford Criteria. SQOL was assessed on the Manchester Short Assessment of Quality of Life (MANSA) and Health-Related Quality of Life (HRQOL) on the Medical Outcome Study Short-Form 36 (MOS) SF-36. A battery of mood and symptom questionnaires, including the Symptom Checklist Questionnaire (SCL-90-R), was administered to assess various aspects of symptomatology as potential predictor variables. Multiple regression analyses were conducted to identify predictors of SQOL. Overall, SQOL was low in CFS patients and less favourable than in groups with mental disorders and healthy subjects. Satisfaction was particularly low with life as a whole, leisure activities and financial situation. Whilst SQOL was only moderately correlated with HRQOL, the SCL-90-R score, especially SCL-90-R Depression scale score, was the best predictor of SQOL explaining 35% of the variance. HRQOL and generic SQOL appear distinct despite some overlap. The findings underline that SQOL is significantly disrupted in CFS patients. Depressive symptoms are statistically the strongest 'predictor' of SQOL, although the direction of the relationship is not established. These data suggest that treatment of depression associated with CFS, regardless of causation, could help to improve SQOL in CFS patients.

Adult↗
PubMed2005

Is the chronic fatigue syndrome an exercise phobia? A case control study.

OBJECTIVE: The aim of this study was to test whether patients with chronic fatigue syndrome (CFS) have an exercise phobia, by measuring anxiety-related physiological and psychological reactions to ordinary activity and exercise. METHODS: Patients and healthy but sedentary controls were assessed over 8 h of an ordinary day, and before, during and after an incremental exercise test on a motorised treadmill. To avoid confounding effects, those with a comorbid psychiatric disorder were excluded. Heart rate, galvanic skin resistance (GSR) and the amount of activity undertaken were measured, along with state and trait measures of anxiety. RESULTS: Patients with CFS were more fatigued and sleep disturbed than were the controls and noted greater effort during the exercise test. No statistically significant differences were found in either heart rate or GSR both during a normal day and before, during and after the exercise test. Patients with CFS were more symptomatically anxious at all times, but this did not increase with exercise. CONCLUSION: The data suggest that CFS patients without a comorbid psychiatric disorder do not have an exercise phobia.

Adult↗
PubMed2002

A comparison of patients with chronic fatigue syndrome attending separate fatigue clinics based in immunology and psychiatry.

Hospital clinics for patients with chronic unexplained fatigue are held in departments of various disciplines. This causes difficulties for referrers in choosing the appropriate clinic and for researchers in generalizing findings from one type of clinic to others. We randomly selected 37 outpatients attending an immunology fatigue clinic and 36 outpatients attending a psychiatry fatigue clinic, all of whom had chronic fatigue syndrome. We compared demographic factors, symptoms, disability, quality of life, psychological distress and illness attributions. The patients from the two clinics were closely similar in their specific symptoms, disability, quality of life, psychological distress and previous attendance to mental health professionals. Psychological distress was high and equal in the two samples. The proportion of men was greater among patients attending the immunology clinic. In a post-hoc analysis, 64% of immunology attenders attributed their fatigue to physical factors, compared with 31% of psychiatry clinic attenders (chi(2)=6.35, 1 d.f., P=0.01). These findings suggest that research data from one type of chronic fatigue clinic can be generalized to others. Clinically similar patients are referred to different clinics, and the choice of clinic may be influenced by the patients' illness beliefs. The high levels of emotional distress suggest that psychosocial management is as important as physical management in hospital outpatients with chronic fatigue syndrome, irrespective of its aetiology.

Adult↗
PubMed2001

Factors associated with self-disclosure of HIV serostatus to significant others.

OBJECTIVES: To examine rates and patterns of self-disclosure of HIV serostatus amongst individuals attending an out-patient HIV clinic in East London. DESIGN: A cross-sectional survey design was used. METHODS: A volunteer sample of 95 out-patient HIV clinic attendees completed a self-report questionnaire examining patterns of disclosure to self-identified significant others, reasons for disclosure and non-disclosure, satisfaction with social support (SSQ6), quality of life (MOS-30) and anxiety and depression (HADS). Self-disclosure was examined in relation to cultural background, gender, satisfaction with social support, and medical and psychological variables. RESULTS: Seventy-nine men and 16 women reported a mean disclosure rate of 68% to self-identified significant others. Five individuals had not disclosed their HIV status to anyone; 91% of individuals had informed their partner. Friends were more frequently informed (79%) than family (53%). Ethnicity (p <.001) and length of time since testing HIV seropositive (p <.05) emerged as significant predictors of disclosure. Global satisfaction with social support was negatively correlated with depression but was not associated with the total rate of HIV disclosure. Frequently reported reasons for non-disclosure included wanting to protect others from distress and fear of discrimination. CONCLUSIONS: Self-disclosure of HIV serostatus rates was highest for partners, followed by friends, and lowest for family members. Patterns of disclosure of HIV serostatus varied in relation to ethnicity. Fifteen years into the HIV epidemic, social stigma continues to contribute towards non-disclosure of diagnosis.

Journal Article↗
PubMed1992

Unique patterns of bereavement in HIV: implications for counselling.

OBJECTIVE: The aim of this study was to examine the nature and extent of bereavement problems in HIV + ve clients and the counselling input required. DESIGN: Ninety individuals referred consecutively for counselling by the medical teams after HIV diagnoses were included in the study. Specific bereavement data was gathered by each counsellor according to schedule and semi-structured interviews for all 90 subjects. These data were analysed in conjunction with medical referral letters. SETTING: HIV positive clients attending for treatment at an inner London Hospital. SUBJECTS: The subjects were 91% males and 9% females, mean age 33.82 years (SD 7.2, range 15 to 50 years, mode 28). 44.8% were diagnosed as HIV + ve (asymptomatic), 42.5% had an AIDS diagnosis and the remainder were coded as AIDS Related Complex or unclear. MAIN OUTCOME MEASURES: The subjects were monitored for the presence or absence of bereavement issues, the nature and extent of the reactions and counselling input. The occurrence of single and multiple bereavements was monitored, as were the relationship to the index patient and the health status of the bereaved. RESULTS: Bereavement was mentioned in 28.2% of referrals from medical practitioners yet 43.1% of the patients had been bereaved and used bereavement counselling. 43% spontaneously commenced the session with bereavement issues. They had lost 348 people (average of 12.9 deaths per person reporting). These were overwhelmingly due to AIDS with only 12 (5.6%) not HIV related. 65% linked the bereavement to their own death. Emotional reaction seemed to be independent of the relationship with the deceased but linked with the diagnosis status of the bereaved. CONCLUSION: The emotional consequences of a loss can be severe and long term. The advent of AIDS/HIV has revealed a wave of deaths in a population unused to facing traumatic loss to this extent. There are particular features surrounding AIDS and HIV infection which may differ dramatically from other sorts of loss and challenge previously held notions of bereavement such as the age of the clients, the fact that bereavements are often multiple the illness state of the bereaved person, the taboo surrounding AIDS which often presents barriers to wider social support and the catalogue of losses which any individual has to face. The frequency and high rate of bereavement, often not noted by referrers, suggests similarity with disaster literature in terms of counselling demand.

AIDS-Related Complex↗
PubMed1990

Group intervention with HIV seropositive patients and their partners.

Persons with HIV infection and AIDS may have complex psychosocial needs. Many find it difficult to share fears and feelings so are unlikely to join traditional support groups, although they lack crucial social support. As they frequently report a need for more information it was proposed to use an 'information' group as an opportunity to provide not only information but also social support. Fourteen homosexual men with HIV infection or their partners, who lacked social support were recruited to a closed 'information' group. Sessions comprised an informative talk by an invited speaker, and a discussion. The group was evaluated after 12 sessions and again 16 months later. The group was positively evaluated by a majority of members. It appeared beneficial that the group was closed, and that there was a mixture of people. It proved important that the sessions were structured with an informative topic to stimulate conversation. Follow up indicated that long term coping skills had been fostered. In the short term, however, the group did not reduce the need for individual counselling. It is suggested that group intervention is better seen as an adjunct to individual counselling rather than as an alternative.

Adaptation, Psychological↗
PubMed1990

The impact and use of written leaflets as a counselling alternative in mass antenatal HIV screening.

Pre-test counselling has been seen as a pre-requisite for HIV screening. As HIV moves into the heterosexual community, the role of HIV screening in ante-natal care has increased. As vertical transmission is the major contributor to perinatal infection HIV screening of pregnant women has become a reality. The pregnant population comprises large numbers, the practical difficulties of routine pre-test counselling and the informational demand from pregnant women themselves has necessitated the provision of ante-natal leaflets about HIV infection and AIDS. A survey of 24 London hospitals revealed only three leaflets in use, two from one hospital and one from an AIDS Charity. A content evaluation of the leaflets revealed varying readability, elements of bias and presentation factors which may all affect the usefulness of such leaflets. An in depth qualitative group on the leaflet with highest readability revealed particular concerns and highlighted the fact that the leaflets could be seen as additions and addendums to counselling but were not sufficient in themselves.

Counseling↗
PubMed1984

Behavior and bladder disturbance of enuretic children: a rational classification of a common disorder.

A group of 126 enuretic children were evaluated as to their psychiatric and neurological states, functional bladder volume and environmental circumstances. Few differences were found when the children were grouped according to presence or absence of social disadvantage, the presence of a family history of enuresis, or the nature of onset of enuresis. No classification differentially predicted response to treatment. However, children with an associated psychiatric disorder had significantly lower bladder volumes and had more developmental delays. It is concluded that the classifications of primary or secondary enuresis, or familial or non-familial, etc., are of little practical value. When psychiatric disorder is found, it is probably related to other constitutional abnormalities. Rather than there being two separate groups of enuretic children with behavior disorder and low functional bladder volume, these two abnormalities are found in conjunction.

Child↗
PubMed1978

Trial of an alpha-adrenolytic drug (indoramin) for nocturnal enuresis.

The investigation of methods of treatment known to be effective in controlling nocturnal enuresis may yield information on the pathophysiology of the condition. An attempt has been made to mimic the known alpha-adrenolytic action of imipramine by treating a group of 14 enuretic school-children with a competitive alpha-adrenoceptor blocking substance, indoramin. Treatment in the doses used had no significant effect on night-wetting frequency.

Adrenergic alpha-Antagonists↗