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Results for “Psychosocial functioning”

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PubMed2006

Interrelationships of psychiatric symptom severity, medical comorbidity, and functioning in schizophrenia.

OBJECTIVE: This cross-sectional study aimed to evaluate the interrelationships of psychiatric symptom severity, medical comorbidity, and psychosocial functioning in a sample of patients with schizophrenia by utilizing the baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE). METHODS: This study utilized baseline data from a multisite trial of antipsychotic pharmacotherapy, which collected data from 1,460 patients with schizophrenia at more than 50 sites in the United States between 2001 and 2003. Bivariate correlations were used to evaluate associations between schizophrenia symptoms and medical comorbidity, and multivariate regression models were used to determine the independent association between medical comorbidity and psychosocial functioning. RESULTS: Of the 1,424 participants in the study sample, 58 percent had at least one medical condition: 20 percent had hypertension, 11 percent had diabetes mellitus, and 9 percent had four or more medical conditions. Medical comorbidity was associated with poorer neurocognitive functioning and greater depressive symptoms. The number of medical conditions was not associated with more severe schizophrenia symptoms. Both the number of medical conditions and physical health status were only weak correlates of psychosocial functioning. CONCLUSIONS: In this sample of persons with schizophrenia, medical comorbidity was associated with depression and neurocognitive impairment but was a weaker correlate of psychosocial functioning or employment status than psychotic symptoms, depression, and neurocognitive impairment.

Adolescent↗

PubMed1996

Toe to hand transfer in children. Part 2: Functional and psychological aspects.

Forty children with congenital (85%) or acquired hand disorders underwent transfer of one or two toes to one hand. The children were reviewed with their parents and assessed for functional and psychosocial performance. There was some evidence that the older the child at the time of transfer, the better the range of motion. The passive range of motion was on average 60 degrees more than the active range of motion despite subsequent procedures such as tenolysis. All transfers recovered protective sensibility and the majority recovered good levels of two point discrimination and light touch perception. Almost all transfers were naturally incorporated into the use pattern of the limb for some or most of the time. Most parents and patients reported a very positive effect of this surgery on the child's psychosocial functioning.

Adolescent↗

PubMed1999

Megestrol acetate in advanced, progressive, hormone-insensitive cancer. Effects on the quality of life: a placebo-controlled, randomised, multicentre trial.

A randomised double-blind placebo-controlled multicentre trial was performed to investigate the effects of megestrol acetate (MA) on the quality of life (QoL), appetite, weight and survival of patients with advanced, incurable, hormone-insensitive cancer. QoL was assessed at the start of treatment and at 4, 8 and 12 weeks, using the EORTC-QLQ-C30 instrument. 255 patients were randomised to 320 mg of MA daily or placebo for 12 weeks. 244 patients were assessable at baseline, 190 at 4 weeks (placebo 94; MA 96), 150 at 8 weeks (placebo 69; MA 81) and 112 at 12 weeks (placebo 55; MA 57). A beneficial effect of MA on appetite loss was observed at week 4 (P < 0.0001) and possibly at week 8 (P = 0.058). Further weight loss during treatment was significant only in the placebo group. In the first 8 weeks, changes in mean global QoL were small and similar in both groups. By 12 weeks the decrease in mean global QoL was more pronounced in the MA group (P = 0.028), which was related to a deterioration in physical function, while psychosocial function was not affected. Survival was not affected by MA, and side-effects were mild. The results show that MA has a beneficial effect on appetite and that it may retard weight loss with no adverse impact on survival and with mild toxicity. However, MA does not appear to improve global QoL as measured by the EORTC QLQ-C30.

Adult↗

PubMed2006

Adaptive functioning, psychopathology and service use among 18-year-old boys with drunkenness-related alcohol use.

AIMS: To study the associations between drunkenness frequency and adaptive functioning, psychopathology and service use among 18-year-old Finnish boys in a nation-wide population-based study. METHODS: Information about drunkenness frequency within the previous six months was collected from the Finnish boys born in 1981 (n = 2306) at the boys' obligatory military call-up in 1999. Self-report questionnaires were used to study demographic factors, adaptive functioning, risk behaviour, life events, and mental health service use. Psychopathology and adaptive functioning was assessed with the Young Adult Self-Report (YASR) questionnaire. RESULTS: Of the boys, 85% reported drunkenness within the previous 6 months. Most of the subjects were occasionally drunk: 39% reported drunkenness less than a month, and 35% less than once a week, while 10% reported being frequently drunk once a week or more often. Occasional drunkenness was associated with better adaptive functioning and psychosocial well-being in general. Refraining from drunkenness was associated with suicidal ideation and internalizing problems in the YASR scale. Frequent drunkenness associated with daily smoking, illicit drug use, and externalizing problems in the YASR scale, especially delinquent behaviour. In the multivariate analysis, number of friends, having a regular relationship and cigarette smoking had a linear association with frequency of drunkenness, while drunkenness-related alcohol use was less common among those with poor friendship quality. Among the participants, entering substance use treatment was rare (0.2%). Frequent drunkenness was found to be common among mental health service users. CONCLUSIONS: Among late-adolescent boys, occasional drunkenness is a normative alcohol use pattern and associates with social competence and good psychosocial functioning. Late-adolescent boys refraining from drunkenness in addition to those with frequent drunkenness may be in a need of mental health assessment. As entering substance use treatment is infrequent, establishing integrated services with multi-professional co-operation for late-adolescent males with frequent drunkenness is emphasized.

Adaptation, Psychological↗

PubMed2000

Negative consequences of hearing impairment in old age: a longitudinal analysis.

To determine whether functional and psychosocial outcomes associated with hearing impairment are a direct result or stem from prevalent comorbidity, we analyzed the impact of two levels of reported hearing impairment on health and psychosocial functioning one year later with adjustments for baseline chronic conditions. Physical functioning, mental health, and social functioning decreased in a dose-response pattern for those with progressive levels of hearing impairment compared with those reporting no impairment. Our results demonstrate an independent impact of hearing impairment on functional outcomes, reveal increasing problems with higher levels of impairment, and support the importance of preventing and treating this highly prevalent condition.

Activities of Daily Living↗

PubMed2004

Coping and family functioning predict longitudinal psychological adaptation of siblings of childhood cancer patients.

OBJECTIVE: To assess associations of coping and family functioning with psychosocial adjustment in siblings of pediatric cancer patients at 1, 6, 12, and 24 months after diagnosis. METHODS: Eighty-three siblings (ages 7-19 years) participated. Effects on anxiety, quality of life, behavioral-emotional problems, and emotional reactions to the illness were investigated. Data-analysis was performed with multilevel mixed modeling. RESULTS: Psychosocial functioning was impaired at 1 month but ameliorated over time. Adjustment problems were associated with high family adaptation and cohesion, older age, and female gender. Lower anxiety, insecurity, loneliness, and illness involvement were related to siblings' ability to remain optimistic. Insecurity and illness involvement were positively related to reliance on the medical specialist and a tendency to seek information about the illness. CONCLUSIONS: Siblings of pediatric cancer patients are most affected by the illness in the first months. Children at risk may be identified according to sibling age and gender and according to long-term family adaptation processes and sibling coping abilities.

Adaptation, Psychological↗

PubMed2005

Interdisciplinary treatment of failed back surgery syndrome (FBSS): a comparison of FBSS and non-FBSS patients.

Many patients enrolled in chronic pain centers suffer from failed back surgery syndrome (FBSS). However, there has been a paucity of research concerning how these patients differ from other chronic pain patients, and how to most effectively address their complex problems within an interdisciplinary chronic pain treatment environment. The current study represents the first large-scale examination of these issues, with two major aims: (1) to elucidate the differences between FBSS patients and other chronic lumbar pain patients; and (2) to clarify the role of injections in interdisciplinary treatment, particularly with FBSS patients. A total of 128 chronic lumbar pain patients who presented for treatment at an interdisciplinary center were included in the study. Patients completed various measures at pre-, mid-, and post-treatment intervals, including physical, functional, and psychosocial measures. Overall, both FBSS and Non-FBSS patients reported significantly decreased pain and disability, and significant improvements in physical and psychosocial functioning after interdisciplinary treatment. However, Non-FBSS patients were associated with greater reductions in self-reported pain and disability than FBSS patients. On the other hand, FBSS patients were significantly more improved on physical therapy measures, including Activities of Daily Living, Strength, and Fear of Exercise. Statistical comparisons of Injection (INJ) and No-Injection (No-INJ) groups yielded few significant findings.

Journal Article↗

PubMed2004

Predictors of antisocial personality. Continuities from childhood to adult life.

BACKGROUND: Antisocial behaviour in adult life has its roots in childhood. AIMS: To explore the independent and joint effects of childhood characteristics on the persistence of antisocial behaviour into adult life. METHOD: A clinical sample of twins who were systematically ascertained in childhood was followed up 10-25 years later. A total of 225 twins were interviewed regarding childhood and adult psychiatric disorder, psychosocial functioning, and psychosocial and cognitive risk factors. RESULTS: In univariate analyses, childhood hyperactivity and conduct disorder showed equally strong prediction of antisocial personality disorder (ASPD) and criminality in early and mid-adult life. Lower IQ and reading problems were most prominent in their relationships with childhood and adolescent antisocial behaviour. In multivariate modelling childhood conduct disorder and hyperactivity predicted adult ASPD even when intervening risk factors were accounted for. The number of hyperactive and conduct symptoms also predicted adult outcome. CONCLUSIONS: Childhood disruptive behaviour has powerful long-term effects on adult antisocial outcomes, which continue into middle adulthood. The importance of number of symptoms, the presence of disruptive disorder, and intermediate experiences highlight three areas where interventions might be targeted.

Adolescent↗

PubMed1996

Improvement in quality of life in patients with heart failure who undergo transplantation.

BACKGROUND: Very few studies have examined quality of life longitudinally in heart failure patients from before or after heart transplantation. The purpose of this study was to compare quality of life of patients with heart failure at the time of listing for a heart transplant with that 1 year after the operation. Major dimensions of quality of life measured in this study were health, physical and emotional functioning, and psychosocial functioning. METHODS: A convenience sample of 148 patients (80% male and mean age 52 years) was recruited from a midwestern and southern medical center. Data were collected from chart review and six patient-completed instruments: the Heart Transplant Symptom Checklist, Sickness Impact Profile, Heart Transplant Stressor Scale, Jalowiec Coping Scale, Quality of Life Index, and Rating Question Form. Informed consent was obtained, and patients who agreed to participate in the study completed the booklet of self-administered instruments. Statistical analyses included frequencies, measures of central tendency, paired t-tests, and Wilcoxon signed-ranks tests. RESULTS: Total symptom distress decreased significantly overall from before to after heart transplantation (before = 0.19 versus after = 0.15, p < 0.0001). Patients rated themselves as having significantly poorer health while listed as a heart transplant candidate than at 1 year after surgery (before = 4.5 versus after = 7.5, p < 0.0001). Although the overall level of functional disability was fairly low before and 1 year after transplantation, patients still reported significant improvement after surgery (before = 0.21 versus 1 year after = 0.13, p < 0.0001). No significant differences were found in total stress, which was low to moderate (before = .026 versus 1 year after = 0.26, p = not significant), coping use (before = 0.48 versus 1 year after = 0.48, p = not significant), or coping effectiveness (before = 0.40) versus 1 year after = 0.42, p = not significant), from before to 1 year after heart transplantation. However, changes in types of symptoms, functional disability, stressors, and coping were noted over time. Overall satisfaction with life, which was fairly high at both time periods, increased significantly from the time of listing for a transplant to 1 year after surgery (before = 0.72 versus 1 year after = 0.82, p <0.0001), and overall quality of life improved significantly from before to after heart transplantation (before = 5.5 versus after = 7.8, p < 0.0001). CONCLUSIONS: End-stage heart failure patients had improved quality of life from before to 1 year after heart transplant due to less total symptom distress, better health perception, better overall functional status, more overall satisfaction with life, and improved overall quality of life. However, post-transplant patients still experienced some symptom distress, functional disability, and stress, but were coping well.

Adult↗

PubMed1998

Psychological adjustment after cardiac transplantation.

Psychosocial function improves after cardiac transplantation but the extent of improvement is not established. Neither are the factors established that account for variability in function between patients following successful transplantation. We therefore compared illness-related dysfunction in patients following orthotopic cardiac transplantation (OCT) with that in angina-free patients following coronary artery bypass graft (CABG) and stable patients in heart failure awaiting transplantation (HF). We also measured two factors that might contribute to variation in function: emotional distress and concern with physical symptoms. Psychosocial function was as good in OCT as in CABG patients and, in both, was better than in HF patients. Differences in emotional distress and in physical symptoms showed a similar pattern and contributed to, but did not completely account for, differences in function. Concern with physical symptoms contributed to variability in functional impairment in HF but not CABG patients; transplantation strengthened this relationship. The results show that successful cardiac transplantation enhances psychosocial function to a level comparable with that after CABG, and suggest targets for psychological or educational intervention to improve quality of life after transplantation in patients whose recovery is inhibited by concern about physical symptoms.

Adaptation, Psychological↗

PubMed2004

Frequency of going outdoors: a predictor of functional and psychosocial change among ambulatory frail elders living at home.

BACKGROUND: This study investigated the relationship between the frequency of going outdoors among ambulatory frail elders living at home and subsequent functional and psychosocial changes. METHODS: In this 9-month prospective cohort study, data were collected via questionnaire from 112 frail elderly persons living at home and their families. Functional and psychosocial status at baseline and follow-up regarding activities of daily living, functional capacity, depression, self-efficacy for daily activities, self-efficacy for health promotion, and social support, were compared among 3 groups defined by the frequency of going outdoors: 1) more than 4 times a week, 2) 1-3 times a week, 3) less than once a week. At baseline, elders going outdoors more often were less functionally impaired, more socially active, and scored less depressed than elders going outdoors less often. RESULTS: There were significant differences in functional capacity (p=.0201) and intellectual activities (p=.0026) over time according to the frequency of going outdoors, even when controlling for baseline differences, and the scores of those who seldom went outdoors decreased rapidly. There were similar relationships between frequency of going outdoors and changes in self-efficacy for both daily activities (p=.0067) and for health promotion (p=.0245), with participants going outdoors most frequently improving significantly more. CONCLUSIONS: These results suggest that the frequency of going outdoors may be a useful and simple indicator to predict changes in functional capacity, intellectual activity and self-efficacy.

Activities of Daily Living↗

PubMed2000

Family functioning and psychosocial adjustment in overweight youngsters.

OBJECTIVE: To analyze the relationship between family functioning and psychosocial adjustment in Dutch overweight children and adolescents. METHOD: Seventy-three overweight (weight-for-height >P90) and 70 normal-weight youngsters between the ages of 10 and 16 years were recruited by school physicians during routine medical screening. The Family Dimension Scale, the Child Behavior Checklist, the Teacher Report Form, the Self-Perceived Competence Scale, and the Body-Esteem Scale were filled out, as well as a specific weight-related questionnaire. RESULTS: Both parents and teachers report more behavior problems in overweight children, particularly in the younger than 13 age group. Lower body-esteem was found in older overweight girls, whereas in older overweight boys higher levels of body-esteem were found. More significant relationships were found with the weight-related Parental Concern Scale than with the Family Dimension Scale. DISCUSSION: The results suggest that a developmental psychological approach reveals important age and sex differences. Weight-related instruments may be more useful than general questionnaires.

Adolescent↗

PubMed2006

Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure.

BACKGROUND: After the Fontan procedure, patients are at risk for suboptimal health status related to their complex healthcare experience, physiological limitations, medical complications, and guarded long-term prognosis. METHODS AND RESULTS: In the Pediatric Heart Network cross-sectional study of Fontan survivors 6 to 18 years of age, parents completed the Child Health Questionnaire, and scores were related in multivariable analysis to patient and medical characteristics obtained from medical record review. For 537 patients (mean age at study, 11.9 years; 60% male) with a median age at Fontan of 2.8 years (range, 0.7 to 14.6 years), parent-reported patient morbidities included deficits in vision in 33%, speech in 27%, and hearing in 7%, as well as problems with attention in 46%, learning in 43%, development in 24%, behavior in 23%, anxiety in 17%, and depression in 8%. Child Health Questionnaire summary scores were significantly lower than the US population sample for Physical Functioning (mean Z score, -0.47+/-1.19; P<0.001) and Psychosocial Functioning (-0.28+/-1.08; P<0.001). Parent-reported medical conditions and long-term and current medical problems explained the greatest amount of variation in the Physical Functioning scores. Parent-reported patient conditions, including behavior, learning, anxiety, and attention problems and depression, explained the greatest amount of variation in the Psychosocial Functioning scores. Lower family income had a negative impact on both Physical and Psychosocial Functioning. CONCLUSIONS: There are deficits in health status in children and adolescents after the Fontan procedure. Strategies to address this problem might emphasize coordinated and effective prevention, detection, and management of noncardiac and psychosocial conditions, as well as specific targeting of patients from low-income households.

Adolescent↗

PubMed1983

Factors related to the early phase of rehabilitation following aortocoronary bypass surgery.

Physical and psychosocial functioning of 30 male patients prior to and 3 months following aortocoronary bypass surgery were compared. Relationships between rehabilitation outcome and selected physical, psychosocial, and health care system variables were examined. Although patients' perceptions of their health improved after surgery, there was little improvement in physical and psychosocial functioning, and vocational functioning declined. When the outcome variables were regressed on their possible explanatory variables, the variance in exercise tolerance and energy expenditure on household activities remained unexplained. Energy expenditure on postoperative leisure activities was related to fear of injury. Preoperative psychosocial functioning, depression, and postoperative perception of health explained postoperative psychosocial functioning. Postoperative perception of health dependent on the number of bypass grafts and spouse's/family's fear of patients' injury.

Activities of Daily Living↗

PubMed2003

A review of the functional and psychosocial outcomes of edentulousness treated with complete replacement dentures.

Loss of natural teeth has functional and psychosocial consequences that can, in many cases, be rectified with complete replacement dentures. However, the outcome of complete denture therapy is variable, and relies on patient factors, as well as the skill of the clinician and laboratory technician making the dentures. This article reviews recent literature on the outcomes of edentulousness and complete denture therapy.

Adaptation, Psychological↗

PubMed1989

Parental care and overprotection of children with cystic fibrosis.

Parental overprotection has often been clinically associated with the psychological maladjustment of children with a chronic disease. The purpose of this study was to examine parental care and overprotection in children with cystic fibrosis compared to healthy controls. Results indicated no differences in the level of parental care or overprotection between controls and children with cystic fibrosis. However, a number of significant correlations were found between parental care and overprotection and children's psychosocial functioning. In particular, positive correlations were found between parental overprotection and poor psychosocial functioning in children with cystic fibrosis, whereas, poor psychosocial functioning in healthy children was associated with lack of parental care. Parental overprotection and care appear to play important roles in the emotional and psychological functioning of healthy and chronically ill children.

Adaptation, Psychological↗

PubMedDate not supplied

Nutritional, functional and psychosocial correlates of disability among older adults.

PURPOSE: The purpose of the present study was to examine the nutritional, functional and psychosocial correlates of disability among 54 older adults aged 65 years of age or older. METHODS: Using validated questionnaires and tests, nutritional risk (Mini-Nutritional Assessment), functional capacity (mobility, balance, endurance, grip strength and lower extremity strength), the psychosocial factors (life satisfaction, depression, and social support) and level of disability of the participants were examined. RESULTS: The study showed that functional mobility was the strongest correlate of disability, even after controlling for age, gender and residential living status (p<.05). Life satisfaction and nutrition risk had marginal significance as being related to disability. CONCLUSION: The results of the present study have implications for the development of evidence-based health promotion interventions for older adults.

Activities of Daily Living↗

PubMedDate not supplied

The use of implant-supported prostheses in the functional and psychosocial rehabilitation of tumor patients.

PURPOSE: The present study investigated the residual functional constraints as well as the psychosocial rehabilitation of tumor patients following prosthetic treatment with implant-supported dentures. MATERIALS AND METHODS: A clinical examination and semistructured interview were performed in 66 of 132 consecutive patients who underwent tumor resection and subsequent implant-supported restoration between 1985 and 1997. RESULTS: Functional and psychosocial constraints were improved by between 91% (general comfort) and 47% (social reintegration) of all cases, but these constraints were never fully compensated for. Restrictions in tongue mobility, loss of sensation, and radiotherapy-induced hyposalivation led to problems in chewing and swallowing, which were hardly improved by prosthetic rehabilitation. The best subjective assessments referred to appearance, followed by masticatory improvement and denture retention. CONCLUSION: Functional impairment cannot be fully compensated by implant-supported prosthodontic reconstructions, but such treatment contributes essentially to general well-being and relief of disease-related social restrictions.

Adolescent↗