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Biomedical subjects

V Soskolne

Publications and source records attributed to V Soskolne.

At least 19 recordsLinked to original sources
PubMed2007

The socio-cultural context of family caregiving and psychological distress: a comparison of immigrant and non-immigrant caregivers in Israel.

The study aimed to examine the differences in caregiving context and psychological distress outcome between non-immigrant and immigrant caregivers; to investigate these differences by relationship type; and to examine the factors related to psychological distress. Spouse or adult child caregivers (213 non-immigrants and 206 immigrants from the Former Soviet Union) were interviewed. Based on stress and appraisal conceptual framework, caregiving stressors, primary appraisal, psychosocial resources, secondary appraisal and psychological distress were measured. A series of two-way MANOVA, followed by ANOVA, was used to examine the differences by immigration status, by relationship type and their interaction. Hierarchical multiple linear regression was conducted to examine variables associated with psychological distress. Negligible differences in caregiving stressors, but significant differences in caregiving primary and secondary appraisal, psychosocial resources and psychological distress were found by immigration status and by relationship type, and significant interactions only in caregiving primary appraisal. The regression models showed that the differences in psychological distress by immigration status and by relationship type were fully explained by caregiving stressors (care recipient's problem behavior), psychosocial resources (mastery) and caregiving secondary appraisal (role overload, captivity, economic difficulties). The results suggest that socio-cultural background and role relationship shape caregiving appraisal and psychosocial resources, and that these factors explain psychological distress outcomes.

Aged↗
PubMed2004

Use of tranquilizers and sleeping pills among cancer patients is associated with a poorer quality of life.

PURPOSE: To evaluate the association between sleeping pill/tranquilizer (SP/T) use and quality of life (QOL) among cancer patients. PATIENTS AND METHODS: Oncology patients (n = 909) in three Israeli hospitals were interviewed in clinics, day centers and in-patient departments regarding SP/T use in the previous week. Crude and adjusted QOL scores, measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), were compared in users vs. non-users. RESULTS: Sleeping pill/tranquilizer use was self-reported by 234 (25.7%) participants, but rarely documented in medical charts. Factors associated with SP/T use were female gender (adjusted Odds ratio, OR: 1.79; 95% Confidence interval, CI: 1.22-2.62, age (OR: 4.6; 95% CI: 1.66-12.53 for age 70+), place of birth (OR: 1.97; 95% CI: 1.19-3.26 for Eastern Europe compared with Israel), concomitant use of painkillers (OR: 2.88; 95% CI: 1.97-4.20) and presence of cardiovascular disease (OR: 2.41; 95% CI: 1.48-3.91). Controlling these factors as well as disease status, users had a poorer QOL on all functional scales (p < 0.001) as well as global QOL. Furthermore, users reported increased severity of symptoms, especially fatigue, insomnia, pain, dyspnea and constipation (p < 0.01), compared to non-users. CONCLUSIONS: Use of SP/T, reported by one fourth of cancer patients, was associated with substantially poorer QOL and increased severity of symptoms. Causal inference is not possible given the cross-sectional design. Periodic inquiry regarding use of these medications in the Oncology Clinic is recommended since it may identify patients with poor QOL and unmet needs.

Adolescent↗
PubMed2001

Determinants of the use of complementary therapies by patients with cancer.

PURPOSE: We performed a survey of Israeli oncology patients to examine the extent of their use of complementary therapies (CT) and to compare sociodemographic, psychologic, and medical characteristics, attitudes, and quality of life of users and nonusers of CT. PATIENTS AND METHODS: Questionnaires were administered to 1,027 patients attending ambulatory and inpatient hematology or oncology facilities at three hospitals. Medical information was extracted from charts. Univariate and multivariate comparisons of users and nonusers of CT were performed. RESULTS: A total of 526 participants (51.2%) had used CT since their diagnosis, and 357 patients (34.9%) had used CT recently (in the past 3 months). Factors that multivariate analysis found to be significantly associated (P <.05) with recent CT use were as follows: female sex; age 35 to 59 years; more education; coming to the hospital by private car; advanced disease status; having a close friend or a relative with cancer; and attending support groups or individual counseling. After controlling for these factors, individually examined psychosocial variables associated with recent CT use included the following (odds ratios [OR] with 95% confidence intervals [CI]): needs unmet by conventional medicine (OR, 2.76; 95% CI, 1.95 to 3.89); helplessness (OR, 1.39; 95% CI, 1.0 to 1.91); incomplete trust in the doctor (OR, 1.49; 95% CI, 1.08 to 2.06); and changed outlook or beliefs since the diagnosis of cancer (OR, 1.47; 95% CI, 1.07 to 2.02). Functional quality of life (including physical, emotional, social, and role function) and symptom (fatigue and diarrhea) scores were significantly worse for recent CT users compared with nonusers, controlling for age, sex, and current disease status. CONCLUSION: Characteristics associated with CT use include age, sex, education, and advanced disease. Significant associations between CT use and attending supportive psychotherapy, unmet needs, helplessness, and worse emotional and social function indicate considerable distress, suggesting that increased attention to psychosocial needs within oncologic settings is warranted.

Adolescent↗
PubMed2001

Barriers to getting needed services for Ryan White CARE clients.

To determine why HIV-infected persons do not access needed services, we interviewed clients of Ryan White CARE-funded agencies in San Francisco, San Mateo and Marin Counties. From July to September 1996, we interviewed 519 clients receiving services at 65 CARE-funded sites. Just over half the clients (54.5%) had at least one unmet service need in the previous four months; persons in an unstable living situation and those with lower perceived health status were significantly more likely to have an unmet need. For persons with unmet needs, agency barriers were most common (54.0%), followed by emotional issues (44.8%), lack of information (44.0%) and financial/practical barriers (19.4%). None of the client characteristics (sex, race/ethnicity, age, living situation, perceived health status and risk group) were consistently or significantly (p < 0.05) associated with specific barriers. We believe that the similarity between clients with and without unmet needs reflects the success of CARE in eliminating many barriers. However, the persistence of certain barriers and lack of sub-group-specific barriers suggests the need for individualized interventions to improve service delivery, publicize service availability and address the emotional barriers to accessing HIV-related care.

Adult↗
PubMed2001

STD history, self treatment, and healthcare behaviours among fishermen in the Gulf of Thailand and the Andaman Sea.

OBJECTIVE: Migrant populations are at higher risk for HIV infection. Access to health care and STD treatment is thought to lower this risk. This study aims to examine determinants of STD history and treatment and healthcare behaviours among fishermen in the Gulf of Thailand and the Andaman Sea. METHODS: A cross sectional survey of fishermen working on commercial fishing trawlers was conducted in four provinces in Thailand in early 1998. RESULTS: Of the 818 fishermen interviewed, 30% reported a history of STD, of which 31% reported self treatment of the last STD. 32% reported self care for general health while ashore. In multivariate analyses, a history of STD was significantly more often reported by older men compared with younger men, by owners and skippers compared with lower positions on the boat, and by men who have ever visited female sex workers. Self treatment of the last STD was related to being Burmese compared with being Thai, and to working as a steersman or ship hand compared with as a skipper. Self care for general health while ashore was significantly related to being Burmese or Khmer compared with being Thai, and to being unmarried compared with married. CONCLUSION: Burmese migrant fishermen and their needs should be targeted for culturally specific interventions to increase their understanding of STD treatment and improve their access to health care.

Adult↗
PubMed2001

Single parenthood, occupational drift and psychological distress among immigrant women from the former Soviet Union in Israel.

BACKGROUND: The study examined whether the combination of single parenthood and occupational drift in the context of immigration puts single mothers at higher risk for psychological distress compared to married mothers, and investigated the potential mediating and moderating psychosocial factors (social support, sense of coherence-SOC, fluency in Hebrew). METHODS: Participants were selected from random samples of married and unmarried mothers, recent immigrants to Israel from the Former Soviet Union, aged 25-50 years. A total of 221 single mothers and 241 married mothers were interviewed. RESULTS: No differences were found in occupational drift or in fluency in Hebrew between the groups. The levels of SOC and social support were significantly lower among the single mothers and mean scores of distress were significantly higher among single (1.48 +/- 0.75) compared to married mothers (1.21 +/- 0.65, p < 0.001). In multiple linear regressions on distress, no interaction of marital status and occupational drift was found. After inclusion of psychosocial variables, the association of marital status with distress was significantly mediated by SOC and more modestly by social support, and was moderated by social support: the beneficial effect of social support on distress was significantly greater for married mothers than for single mothers. CONCLUSIONS: The difference in psychological distress between single and married mothers during the first years after immigration is not due to occupational stressors but to psychosocial resources. Single parenthood should be viewed as a marker of psychosocial risk among immigrant women.

Adult↗
PubMed2000

HIV-1 prevalence, HIV-1 subtypes and risk factors among fishermen in the Gulf of Thailand and the Andaman Sea.

OBJECTIVE: Mobile populations are thought to be at high risk for HIV-1 infection. This study aims to determine the prevalence of HIV-1 infection, HIV-1 subtypes and socio-demographic and behavioural risk factors among fishermen in the Gulf of Thailand and the Andaman Sea. METHODS: A cross-sectional survey, consisting of face-to-face interviews and the collection of oral fluid samples, was conducted in Samut Sakorn, Ranong, Songkhla and Traat Provinces, Thailand, between January and April 1998. Oral fluid samples were double-tested for HIV-1 antibody by IgG antibody capture enzyme-linked immunosorbent assay and enzyme immunoassay, and confirmed by Western blot. The presence of subtypes B' and E was assessed using a peptide enzyme immunoassay. RESULTS: Of the 818 fishermen (582 Thai, 137 Burmese, 99 Khmer) 15.5% were HIV-1 positive: 14.6% among Thai, 16.1% among Burmese and 20.2% among Khmer. Of the 119 HIV-1 positive samples available for subtyping, 72 (61%) were subtype E, 15 (13%) were subtype B'; the subtype could not be determined for 32 (27%) samples. Sixteen per cent of subjects had ever visited a commercial sex worker outside Thailand. This behaviour was more prevalent among Khmer (40%) than among Thai and Burmese (12%). In univariate logistic regression analysis, being 25 to 32 years of age, compared with being older or younger; working as a fisherman between 4 and 10 years, compared with working for a shorter or longer period; being unmarried; being a steersman or mechanic, compared with being a skipper or ship hand; greater number of visits to commercial sex workers; having visited a commercial sex worker outside Thailand; alcohol or drug use before or during sex; being tattooed; and having a history of sexually transmitted disease were significantly related to prevalent HIV-1 infection. Male-to-male sex and injection drug use were rarely reported in this population. In multivariate analysis, being 25 to 32 years of age, being unmarried, having a tattoo and a greater number of visits to commercial sex workers remained in the model to predict HIV-1 prevalence. A history of drug injection was predictive for infection with HIV-1 subtype B'. CONCLUSIONS: These findings indicate a high HIV-1 prevalence among fishermen in the Gulf of Thailand and the Andaman Sea. Risk factor analysis suggests that heterosexual intercourse is the major mode of transmission in this population. Increased efforts to reduce the spread of HIV-1 among this epidemiologically important group are urgently needed.

Adult↗
PubMed1998

Factors associated with nonuse of condoms in heterosexual men and women attending an HIV testing clinic in Israel.

OBJECTIVES: To examine gender differences in HIV-related knowledge, perceived vulnerability, beliefs in self-control, type of sexual partnership, and their associations with nonuse of condoms. METHODS: Heterosexual men and women who voluntarily attended an HIV testing clinic in Israel were asked to complete a self-report questionnaire. Scales of HIV knowledge and control and a single item for vulnerability were used. Type of sexual relationship (monogamous vs. nonmonogramous) and condom use in vaginal sex (never vs. ever) referred to the previous 6 months. Response rate was 84%; 154 men and 109 women participated. RESULTS: Beliefs in self-control did not form a reliable scale and single items were used. No statistically significant gender differences were found in knowledge, vulnerability, or beliefs in self-control. Levels of correct HIV-related knowledge were high, but so were some misconceptions. The vast majority (87%) perceived themselves as vulnerable to HIV infection. The beliefs in self-control were moderate in some items, and low in others. In logistic regression models, different factors were significantly associated with nonuse of condoms in the two genders: the belief that their lifestyle protected them against HIV infection (OR = 2.72, CI = 1.06-7.03) among men, and being monogamous (OR = 3.72, CI = 1.28-10.8) among women. CONCLUSION: Heterosexual men and women attending an HIV testing clinic need counseling to further lower misconceptions about HIV transmission and additional gender-specific counseling to address HIV-related beliefs.

Adult↗
PubMed1998

HIV knowledge, beliefs and sexual behavior of male heterosexual drug users and non-drug users attending an HIV testing clinic in Israel.

UNLABELLED: The aim of the study was to compare HIV-related knowledge, beliefs in self-control and sexual behavior of non-drug using and drug using heterosexual men. All individuals attending an HIV testing site during a two-month period were asked to complete a questionnaire anonymously. Data for 49 drug users (DU), most of them non-injectors, were compared to that of 94 non-drug using (non-DU) men with similar education levels (high school or less). Sexual behavior items refer to previous six months. FINDINGS: HIV-related knowledge was reported correctly by the majority of men in both groups, but the DU showed significantly more misconceptions (p < 0.01). Consistent but statistically insignificant lower levels of self-control were reported by the DU. Type of sexual relations and the number of regular sexual partners were not different between the groups: 55% of the DU and 67% of the non-DU were not monogamous. DU had either none or many casual partners (three or more), significantly different from the non-DU. The proportion of DU who never used condoms (65%) was higher as compared to non-DU men (43%, p < 0.05). However, when controlling for type of partnership, this difference was sustained only among monogamous men (82% of DU vs. 42% of non-DU never used condoms, p < 0.05). Condom use was significantly associated with age, HIV knowledge and sexual partnership in the DU. The greater deficiencies in HIV-related knowledge, and the prevalence of risk behaviors among DU require intensive individual and group counselling, specifically adapted for the needs and the culture of drug users in Israel and incorporated with social-influence-orientated change processes.

Adult↗
PubMed1996

Exposure to missile attacks: the impact of the Persian Gulf War on physical health behaviours and psychological distress in high and low risk areas in Israel.

The purpose of this study was to compare residents of an area (Tel-Aviv), which was severely afflicted by SCUD missiles during the Persian Gulf War (high risk region), to residents of a low-risk region (Jerusalem) in terms of: (a) changes in physical health, in use of medical or psychological services, and in health behaviours during the period of the war compared to the preceding month; (b) levels of psychological distress (somatization and anxiety) during the war; (c) characteristics of persons at highest risk for psychological distress. Respondents were randomly chosen and interviewed by telephone (N = 545 in Tel-Aviv, N = 406 in Jerusalem). The respondents in both regions reported significant yet similar deterioration in physical health status, and an increase in detrimental health behaviours during the Gulf War. Tel-Aviv residents had significantly higher levels of psychological distress as compared to residents of Jerusalem: in somatization 18 vs 12% respectively (OR = 2.44, CI = 1.39-4.28), in anxiety 34 vs 26% respectively (OR = 1.62, CI = 1.1-2.42). In addition to place of residence, age, ethnicity, religiosity and self-assessed health were identified as characteristics of persons at greater risk for psychological distress.

Adaptation, Psychological↗
PubMed1996

Depressive symptoms in hospitalized patients: a cross-sectional survey.

OBJECTIVE: To evaluate the level of depressive symptoms among medical inpatients, and to examine the associations with sociodemographic, medical, and psychosocial characteristics. METHODS: A point prevalence study (1 day) of all adult medical patients hospitalized at Hadassah University Hospital. Patients who were too incapacitated to be interviewed were excluded. The questionnaire included sociodemographic data, social supports (MOS Social Support Scale), Multidimensional Health Locus of Control (MHLC), and depressive symptoms (CES-D scale). Medical data were collected from the patients' charts. Of the 331 eligible patients, 256 (77%) were interviewed. RESULTS: The level of depressive symptoms was high (mean = 21, s.d. = 12). About 60 percent of the patients had scores above 16, which is the suggested cut-off point for psychopathology. A multifactorial analysis of covariance showed that higher scores of depression were significantly (p < 0.01) associated with being a female, with lower scores of internal and higher scores of external health locus of control and only marginally (p = .08) with medical diagnosis (multiple R2 = .33, multiple R = .58). Depressive symptoms were not associated with age, education, marital status, social supports, type of admission, ward, or length of stay prior to evaluation. CONCLUSIONS: The high levels of depressive symptoms found across medical and most of the personal and social characteristics in this first survey of its kind in Israel may reflect a reaction to the event of hospitalization; sex and locus of control may be suggested as risk markers of elevated depression to be used for screen and prompt psychiatric consultation in this population.

Adult↗
PubMed1995

How many HIV infections are there in Israel? Reconstructing HIV incidence from AIDS case reporting.

BACKGROUND: The reporting of AIDS cases to Israel's Ministry of Health is believed to be accurate, but the completeness of HIV surveillance is unknown. We implement a model that reconstructs HIV incidence in Israel from AIDS case reports excluding Ethiopian immigrants. METHODS: We apply the well-known method of backcalculation to AIDS cases reported to the Ministry of Health. The data are adjusted statistically to account for reporting delays and the elimination of AIDS Related Complex reporting. The analysis also accounts for the impact of differential administration of antiretroviral therapy to HIV-infected persons over time. RESULTS: Excluding Ethiopian immigrants, we find that the cumulative number of HIV infections reported to the Ministry of Health through December 1993 (1,011) is not statistically different from the model's estimate of 922 (z = 1.04; p = 0.30), though the reported number of new infections in recent years exceeds the modeleted rate. CONCLUSIONS: The low HIV incidence estimated among non-Ethiopian Israelis is consistent with other studies of sexually transmitted diseases and HIV-related risky behavior in Israel. This result counters the hypothesis that an explosive HIV epidemic will occur. That the number of recently reported new infections exceeds the estimate from the model could indicate that the reporting system is catching up with the extant spread of disease, or that the model is missing some aspect of the dynamics of HIV in Israel. We suggest that comparing future annual HIV incidence rates to the model's upper bound of 80 infections per year will enable resolution of this issue over time.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Follow-up evaluation of discharge planning by social workers in an acute-care medical center in Israel.

This paper describes the outcomes of a study in which an early and comprehensive discharge planning protocol was used by social workers in an acute-care center in Israel. Comparison patients received standard social work services provided by the department. Telephone follow-up interviews were conducted at 3-weeks and 2-months intervals post discharge. The expected outcomes of reduced rates of emergency room visits and readmissions, or greater satisfaction with health services were not achieved. Rather, the study group patients had significantly higher rates of emergency room visits, and tended to be less satisfied with discharge planning and significantly less satisfied with post-hospital health services. No differences in readmission rates were observed. The study patients were more likely to be discharged to a home-care program and to have received such services or still be in the LTC institutions to which they had been referred at follow-ups. The difference in rate of emergency room visits between the two groups decreased when controlling for type of service and for satisfaction in a regression model. Implications for social work practice are discussed.

Activities of Daily Living↗
PubMed1993

Bringing it home: Israeli social workers implement leadership program values.

To date, ten Israeli senior social workers have graduated from the Mount Sinai Leadership Exchange Program. This report describes the impact of the program on the activities back home of the first six graduates, two of whom had graduated in 1989, two in 1990, and two in early 1991. The report evaluates the outcomes of the exchange program in terms of change in the graduates' knowledge, attitudes, and beliefs, and in their actions within their organizations and at a national level.

Academic Medical Centers↗
PubMed1993

Sexual behavior of homosexual and bisexual men attending an HIV testing clinic in Jerusalem 1986/7-1990.

We investigated whether the sexual practices of homosexual and bisexual men attending the Jerusalem AIDS Clinic had changed between 1986/7 and 1990. The responses of a group of 79 homosexual and bisexual men to a questionnaire in 1986/7 were compared to the responses of a group of 37 homosexuals/bisexuals in 1990. Consistent yet statistically insignificant differences in sexual behavior between the 1990 and 1986/7 groups were observed: More individuals were using condoms (53% vs 36% respectively), and at an earlier age. The practice of anal sex was less common (48% vs 67% respectively) and that of oral sex more common (46% vs 27% respectively). These differences were not confounded by the level of education between the two groups. Analyzed separately for homosexuals and bisexuals, the increase in condom use was more noticeable among homosexuals compared with bisexuals, while the decrease in anal sex was greater in bisexuals compared with homosexuals. These results may indicate a trend towards safer sexual behavior in this at risk population, but further studies are needed to support or refute these observations.

AIDS Serodiagnosis↗
PubMed1993

Sexual behavior of heterosexual men and women attending an HIV testing clinic.

The prevalence of high risk sexual behaviors was assessed among heterosexual men (n = 154) and women (n = 109) voluntarily attending an HIV testing clinic in Jerusalem. Men were found to be involved more frequently than women in nonmonogamous relationships (66% vs. 45% respectively, P < 0.001), to have more casual partners (21% vs. 11% had three or more casual partners, P < 0.01), and to report passive oral sex (71% vs. 50%, P < 0.01) and anal sex (23% vs. 12%, P < 0.05). Condom use was not a very common practice, and was higher among men than among women (57% vs. 47% in vaginal sex, and 30% vs. 19% in oral sex respectively, NS). Appropriate counselling for this population attending the clinic is advised and urgently needed.

Adolescent↗
PubMed1993

A culturally specific educational program to reduce the risk of HIV and HBV transmission among Ethiopian immigrants to Israel II: Evaluating the effect of the training program on veteran immigrant trainees.

We describe the evaluation of a program for training veteran Ethiopian immigrants to be health educators/cultural mediators. This educational intervention project was designed to lower the risk of transmission of HIV and HBV among the immigrants who arrived in Israel in "Operation Solomon", May 1991. The training program was designed to teach the biomedical model of HIV transmission and its prevention, and to allow the trainees to explore their feelings about people with HIV/AIDS in order to enable them to teach these issues appropriately to the general community of immigrants from Ethiopia, and to work with individuals with HIV among them. It also trained them in teaching skills and in imparting the knowledge in a culturally appropriate manner. The evaluation of changes in knowledge was done at three time points: at the beginning of a 3-day training seminar (A), its end (B) and after 7 half-day training sessions comprising the whole training program 4 months later (C). We also evaluated the changes in their attitudes and feelings about teaching these subjects and their estimate of their teaching skills at two time points (B and C). The data were collected from a written questionnaire. We also monitored their teaching through direct observation by people who spoke Amharic, and through the trainees completing a self-monitoring form. The monitoring and evaluation efforts were built into the structure of the program (including the interventions themselves). They include several complementary approaches: qualitative and quantitative, structured and semi-structured, reported and observed.

Acquired Immunodeficiency Syndrome↗