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Results for “Psychosocial functioning”

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PubMed1999

Differential effects of treatment modality on psychosocial functioning of cocaine-dependent men.

Changes in psychosocial functioning, including depression, anxiety, somatization, obsessive-compulsiveness, interpersonal sensitivity, confidence in the ability to resist taking drugs in different situations, and social adjustment are examined for male veterans entering treatment for cocaine dependence. The sample was comprised of African Americans (66%), Hispanics (8%), and Whites (26%) with a mean age of 35 years at intake. Participants were assessed at the end of 1 year and 2 years; during the follow-up period, participants utilized different combinations of treatment modalities. Paired t-tests showed significant improvement between intake and follow-up, both at the end of 1 year and 2 years, on the Beck Depression Inventory, on the depression, anxiety, obsessive-compulsiveness, and interpersonal sensitivity scores of the Symptom Check List (SCL-58), and in four role areas of social adjustment on the Social Adjustment Inventory. There were no significant differences between intake and follow-up on the somatization subscale of the SCL-58 and on the Drug Taking Confidence Questionnaire (DTCQ). Measures taken at Year 2 were not significantly different from Year 1. Repeated measures analysis of variance revealed that treatment modality did not differentially affect psychosocial functioning on nearly all measures, except on somatization, confidence in the ability to resist taking drugs in different situations, and social adjustment involving leisure time. However, a combination of inpatient, high-intensity outpatient, and self-help group participation and a combination of outpatient and self-help group participation were better than a combination of inpatient, low-intensity outpatient, and self-help participation in increasing the confidence in the ability to resist cocaine use in different situations and to reduce symptoms of somatization.

Adult↗

PubMedDate not supplied

Effects of cardiac rehabilitation on psychosocial functioning and life satisfaction of coronary artery disease clients.

This article details a quantitative, descriptive study that explored the effects of participation in two types of cardiac rehabilitation programs on psychosocial functioning and life satisfaction. Forty-seven clients with coronary artery disease (CAD) were included in the study sample. Data were collected during a home visit made 6 to 8 weeks after the coronary event. All subjects completed two data collection tools: the Sickness Impact Profile (SIP), which measured clients' psychosocial functioning, and the Quality of Life Index (QLI), which measured clients' life satisfaction. No significant differences were found between the two treatment groups in psychosocial functioning or life satisfaction. Psychosocial functioning and life satisfaction were found to be related strongly. Further research efforts are needed to document empirically the influence of cardiac rehabilitation participation on the client's quality of life.

Adaptation, Psychological↗

PubMed1991

The nature of elder impairment and its impact on family caregivers' health and psychosocial functioning.

This study assessed the nature of elder impairment and its impact on the health and psychosocial functioning of family caregivers. All caregivers were daughters or daughters-in-law living with an elderly parent. Contrary to expectations and previous research, no differences were revealed among caregivers of cognitively impaired, functionally impaired, and nonimpaired elderly relatives in terms of self-reported health or psychosocial functioning. Thus, other aspects of the caregiving context, such as familial generation, gender, and living arrangement, may affect caregiver health and psychosocial functioning more than the nature of the elder's impairment.

Adult↗

PubMed1993

Recovery after allogeneic marrow transplantation: prospective study of predictors of long-term physical and psychosocial functioning.

No prospective data have documented the physical and psychosocial functioning of patients before and after BMT. In this study 67 allogeneic transplant patients completed standardized self-report measures pre-transplant. Survivors were re-assessed at 90 days (n = 34) and 1 year (n = 31) post-transplant. Telephone interviews established 4-year work history and performance status. Physical function was most impaired at 90 days post-transplant, with a return to pre-transplant levels of functioning by 1 year in most areas. By 2 years post-transplant, 68% of patients had returned to full-time work. Only 9% of 4-year survivors failed to return to full-time occupations. Mean levels of anxiety and depression did not change over the first year. Pre-transplant, 27% of patients reported depression and 41% reported elevated anxiety. Greater emotional distress at 1 year was predicted by pre-transplant family conflict, non-married status and development of less severe chronic GVHD. Impaired physical recovery at 1 year was predicted by more severe chronic GVHD, pre-transplant physical impairment and family conflict. The large majority of long-term survivors returned to full-time employment with normal physical and psychosocial functioning, although recovery took longer than 1 year for approximately 40%. Family relationships were important determinants of physical and emotional recovery.

Adult↗

PubMed1990

Psychosocial function before and after gastric banding surgery for morbid obesity. A prospective psychiatric study.

UNLABELLED: The objective of this study was to measure psychosocial functioning in morbid obese patients before and after horizontal gastric banding surgery, and to analyse the relations between the changes in psychosocial functioning and preoperative variables and degree of weight loss. METHODS: One hundred and three patients undergoing horizontal gastric banding surgery from 1982-85 were personally interviewed and rated by the author on DSM-III axis 1, 2 and 5, the CPRS, demographic data and precoded clinical scales. The interviews and ratings were completed in the last week before the operation. In addition the patients completed questionnaires concerning psychic symptoms (SCL-90) and quality of life. Twenty-five patients also completed the questionnaires six months before the operation. The patients were followed up after one and three years. RESULTS: There were 66 women and 24 men with a mean age of 35.4 years. Their mean preoperative weight was 121.8 kg corresponding to a Broca Index of 1.72 and a Body Mass Index of 41.5. They had a mean SCL-90/GSI score of 0.99. Fourty-one percent got a diagnosis on DSM-III axis 1 and 22% a diagnosis on axis 2. Thirty-seven percent had made at least one contact with health services before the operation due to psychiatric problems. There were no strong relations between the relative preoperative weight and any other preoperative variable. The follow-up rate was 93%. The patients had a mean weight loss of 34.9 kg after one year and 31.5 kg three years after the operation. On group level the course and outcome of psychosocial functioning was a beneficial one. These changes were highly statistically significant and evident after one year, with only slight differences to the three years follow-up. The degree of weight loss explained a modest but statistically significant part of the variance in most of the psychosocial outcome variables when the preoperative level of the variable and the preoperative weight were controlled for. The degree of psychiatric contact in the follow-up period seemed to reflect another dimension. It was not related to the changes in the other psychosocial outcome variables, nor to the degree of weight loss, but was highly correlated to the degree of preoperative psychiatric contact. A group of patients with negative psychosocial outcome was identified. This group was characterized by a higher frequency of preoperative psychiatric help-seeking, than the rest of the patients. This pattern was most evident in a subgroup of 19% of the patients, who had a negative psychosocial reaction in spite of a sufficient weight loss.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1990

Malnutrition in cystic fibrosis: psychosocial functioning of patients and their families.

The relationship between nutritional status and psychosocial functioning was examined in 35 children with cystic fibrosis, aged 7-16 years. Twelve malnourished children and their families were compared with 23 well nourished children and their families. Established measures of adjustment and coping in the children, parents and families were used. Few statistically significant differences between the two groups emerged, and all comparisons of psychosocial functioning were not significant. The results of the study suggest that there is no relationship between the nutritional status of the child with cystic fibrosis and the current psychosocial adjustment and coping of child, parents and family.

Adaptation, Psychological↗

PubMed1986

Psychosocial functioning of adult epileptic and MS patients and adult normal controls on the WPSI.

The psychosocial functioning of adult epileptic outpatients (N = 68) as assessed by the Washington Psychosocial Seizure Inventory (WPSI) was compared to that of control groups of adult MS outpatients (N = 37) and normal subjects (N = 42). When all WPSI profiles were considered, the epilepsy group showed distinct difficulties in Emotional Adjustment and Adjustment to Seizures, whereas the MS group had difficulties only in Emotional Adjustment. However, the MS group had significantly higher Lie Scale scores than did normal subjects. The epilepsy group had significantly more emotional problems than normal subjects and significantly more problems adjusting to their disorder than did the MS group. However, when only valid WPSI profiles were considered, the only significant finding was that the epilepsy group (N = 44) and the MS group (N = 20) had more emotional problems than normal subjects (N = 35). The epilepsy group showed distinct difficulties in Emotional Adjustment and Adjustment to Seizures, whereas the MS group had difficulties in Emotional Adjustment, Interpersonal Adjustment, and Overall Psychosocial Functioning. Implications are discussed.

Adaptation, Psychological↗

PubMed1993

Mental health and psychosocial functioning in adolescents with congenital heart disease. A comparison between adolescents born with severe heart defect and atrial septal defect.

Twenty-six adolescents, aged 13-18 years, with severe congenital heart disease were matched for sex, age and living area with 26 adolescents with repaired atrial septal defect and regarded as physically fit. These two groups were compared according to somatic condition, psychopathology, psychosocial functioning and chronic family difficulties. A higher rate of psychiatric problems in the complex group, an association between psychosocial functioning and physical capacity, as well as an association between psychosocial functioning and chronic family difficulties were observed. These findings suggest that physical capacity is of crucial importance for mental health and functioning of adolescents with congenital heart disease. The association with chronic family difficulties also suggests that a comprehensive biopsychosocial approach is necessary in the treatment and rehabilitation of these patients.

Adolescent↗

PubMed1995

Physical and psychosocial functioning of women and men after coronary artery bypass surgery.

OBJECTIVE: To assess whether physical and psychosocial functioning differs between women and men after coronary artery bypass surgery. DESIGN: Observational cohort study. SETTING: Major teaching hospital. PATIENTS: A total of 454 consecutive patients who received coronary artery bypass surgery from June 1989 through March 1990. MAIN OUTCOME MEASURES: Nurse reviewers collected data on the severity of coronary artery disease and coexisting illnesses from medical records. A mailed survey measuring instrumental activities of daily living (IADLs), social activities, mental health, and vitality was completed by 306 (70.2%) of 436 patients who were alive 6 months after surgery. Functioning on each scale was adjusted for age, marital status, education, severity of angina, recent myocardial infarction, congestive heart failure, and coexisting illnesses at the time of surgery. RESULTS: Before surgery, women were much more likely than men to have had class IV angina (50.9% vs 30.4%), a recent myocardial infarction (32.1% vs 18.0%), and congestive heart failure (34.0% vs 17.6%) (all P < .002). On a range from 0 (severe impairment) to 100 (no impairment), adjusted postoperative functioning was equivalent for women and men in IADLs (86.7 vs 89.1), social activities (95.2 vs 95.3), mental health (72.6 vs 76.0), and vitality (58.1 vs 62.5) (all P > .20). Women reported similar or greater adjusted improvements than men for IADLs (27.2 vs 19.6, P = .08), social activities (20.8 vs 8.0, P = .002), mental health (11.2 vs 5.7, P = .05), and vitality (22.2 vs 12.9, P = .04). CONCLUSIONS: Women were more severely ill than men at the time of coronary artery bypass surgery, but women and men reported similar physical and psychosocial functioning 6 months after surgery. These findings demonstrate important functional benefits of this procedure among both women and men.

Activities of Daily Living↗

PubMed1993

Swedish obese subjects (SOS)--an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined.

This part of an on-going intervention trial analyses impacts of obesity on psychosocial factors and health. The study sample comprised 800 obese men (BMI > or = 34 kg/m2) and 943 women (BMI > or = 38 kg/m2) ranging in age from 37 to 57 years. All participants completed standardized health-related quality of life measures, a validated obesity-specific eating inventory and study-specific questionnaires on current and past health status, use of medical care and medications, socioeconomic status, dietary habits, physical activity habits, weight history and familial history of obesity. Chronic patients and population samples were used as reference. The obese reported distinctly poorer current health and less positive mood states than the reference subjects, women being worse than men. Anxiety and/or depression on a level indicating psychiatric morbidity were more often seen in the obese and again women reported more affliction than men. Furthermore, the average poor mental well-being was worst than in chronically ill or injured patients, such as rheumatoid, cancer survivors and spinal cord injured persons. Predictors of perceived health and psychosocial functioning could be discerned using a comprehensive system of statistical analyses (16-28% explained variance). A background of both somatic and psychiatric morbidity was decisive for the health and psychosocial functioning in the obese; joint symptoms and angina pectoris dominated among somatic variables. Physical inactivity was the most prominent of traditional risk factors. The number of dieting attempts and body image were important weight correlates. Our results provide further evidence to the effect that severe obesity is a crippling condition.

Adult↗

PubMed1997

Physical and psychosocial functioning in patients undergoing autologous bone marrow transplantation--a prospective study.

The main purpose of this study was to evaluate prospectively physical and psychosocial functioning in patients with malignant blood disorders undergoing autologous bone marrow transplantation (ABMT), and relate the findings to the patients' coping capacity. Twenty patients participated in the study before ABMT, 14 survivors at the 2-6 month follow-up and 12 at the 8-12 month follow-up. Three standardized questionnaires were used: the EORTC QLQ-C30, the Hospital Anxiety and Depression (HAD) scale and the Sense of Coherence scale. No significant changes over time were found in the scores of the QLQ-C30 and HAD. Impaired social function, fatigue, dyspnea, financial problems and emotional distress were the most frequently reported deficits. Functional limitations were related to less successful coping. The results indicate that the patients in this study perceive their physical and psychosocial functioning as rather good before, as well as up to 1 year after the ABMT, as measured with the instruments used.

Activities of Daily Living↗

PubMed1977

Psychosocial function in women treated for vaginal agenesis.

The psychosocial functioning of 23 women treated both surgically and nonsurgically for vaginal agenesis was assessed by means of a retrospective questionnaire. Subjects were also physically examined to evaluate anatomic outcome. It was concluded that the patients psychological adjustment before treatment and the sensitivity of her family and medical advisors during treatment took precedence over anatomic results in the eventual resolution of this disorder. Sexual function, emotional stability, self-image, and choice of marital partner in these women are described in some detail and are, in general, far healthier than had been depicted in earlier psychological reports.

Adaptation, Psychological↗

PubMed1998

Age-related perception of stature, acceptance of therapy, and psychosocial functioning in human growth hormone-treated girls with Turner's syndrome.

This study evaluated the perception of stature, acceptance of therapy, and psychosocial functioning in relation to age at onset and time on treatment during 2 yr of GH therapy in 31 girls with Turner's syndrome grouped by age (group A: 3.7-5.8 yr, n = 9; group B: 7.2-11.8 yr, n = 13; group C: 12.5-16.4 yr, n = 9). The growth response after 2 yr was significant in the 3 groups when calculated in terms of growth norms for untreated Turner girls (mean increase in height SD score: +1.2, +1.5, and +1.1, respectively). The effect was less marked in terms of growth norms for normal girls, particularly in group B (+0.5 SD score). Height was perceived as a problem by most patients, except in the youngest girls at the start of treatment (group A) and in the majority of the adolescents after 2 yr of GH therapy (group C), without evidence of relation to growth response during therapy. The GH injections were fairly well accepted by all patients, except those younger than 6 yr. In all patients, expected adult height was unrealistic and became more realistic with age, whereas no consistent changes were observed in relation to growth response to GH therapy. The Child Behavior Checklist revealed elevated mean scores at the behavioral subscales of attention problems (group A and B), social problems, withdrawal, and anxiety-depression (most obviously in group B). No significant changes were seen during GH therapy. In group C, an elevated mean social problem score at the Youth Self Report and a low mean social self-esteem score at the Self-Esteem Inventory were observed before therapy and showed a significant improvement during 2 yr of GH treatment. These results, however, might be biased due to an increase in social desirability during therapy. We conclude that the perception of height, acceptance of GH therapy, and psychosocial functioning in girls with Turner's syndrome show important differences between age groups, with only slight changes observed during GH therapy.

Adolescent↗

PubMed1995

Personality and psychosocial function after brain injury.

A total of 74 brain-injured patients and 46 non-neurologically matched controls consecutively admitted to a specialist medical rehabilitation unit, were administered the 'Headley Court psychosocial rating scale' and four questionnaires examining personality traits of 'locus of control', 'use of humour', 'optimism' and 'easy-going disposition'. Both pre- and post-injury personality ratings were obtained. The relatives of all participants were sent the same scales. Personality changes are reported in each of the four areas; however, time post-injury appears to be a significant factor in the type of change reported; in this cross-sectional study, at 6 and 12 months post-injury, changes are noted in all variables except locus of control, whereas at 18 months post-injury only 'easy-going disposition' showed significant change, at 24 months post-injury changes were noted in all variables except optimism, and at 30 months post-injury no changes were noted. In the present study, examining a period of 2.5 years post-injury, the personality changes remain static once they have occurred. Despite widespread reports in the literature on the importance of pre- and post-trauma personality to good psychosocial functioning, the present study found that it was only an 'easy-going disposition' post-trauma that was consistently related to good psychosocial functioning. Reasons for this are discussed.

Adaptation, Psychological↗

PubMed1993

Effects of transitory cognitive impairment on psychosocial functioning of children with epilepsy: a therapeutic trial.

The authors report a trial of the use of anti-epileptic medication to treat possible cognitive deficits due to subclinical epileptiform EEG discharges in 10 children with psychosocial and educational problems associated with epilepsy. Medication intended to suppress the EEG discharges was added to the children's existing drug regime. In all instances, epileptiform activity, assessed by 24-hour periods of ambulatory monitoring, was reduced on active medication compared with placebo. In general, there was improvement of psychosocial function on active treatment: eight children improved, there was no change in one and one deteriorated. No psychosocial deterioration attributable to adverse effects of the medication was detected in those completing the trial. Despite possible confounding factors, the findings are in accordance with the view that subclinical EEG discharges can impair psychosocial function, which may be ameliorated by anti-epileptic medication.

Adolescent↗

PubMed1998

Relationship between hunger and psychosocial functioning in low-income American children.

OBJECTIVE: Using large-scale surveys from nine states, the Community Childhood Hunger Identification Project (CCHIP) estimates that 8% of American children under the age of 12 years experience hunger each year. CCHIP operationalizes child hunger as multiple experiences of parent-reported food insufficiency due to constrained resources. The current study examined the relationship between food insufficiency and school-age, low-income children's psychosocial functioning. The study also assessed the interinformant (parent versus child) reliability and time-to-time reliability of the CCHIP measure. METHOD: Two hundred four school-age children and their parents from four inner-city public schools were interviewed using parent, teacher, and clinician report measures of psychosocial functioning. Ninety-six children and their parents were reinterviewed 4 months later. RESULTS: Hungry and at-risk for hunger children were twice as likely as not-hungry children to be classified as having impaired functioning by parent and child report. Teachers reported higher levels of hyperactivity, absenteeism, and tardiness among hungry/at-risk children than not-hungry children. Parent and child reports of hunger were significantly related to each other, and time-to-time reliability of the CCHIP measure was acceptable. CONCLUSIONS: Results of this study suggest that intermittent experiences of food insufficiency and hunger as measured by CCHIP are associated with poor behavioral and academic functioning in low-income children. The current study also supports the validity and reliability of the CCHIP measure for assessing hunger in children.

Adolescent↗

PubMed1992

[Incidence of psychiatric syndromes and the psychosocial functional level of patients with HIV-1 infection].

There are not yet unselected studies on psychopathological syndromes in the course of HIV-infection in German-speaking countries. In a group of 55 patients in different stages of the infection two psychiatric explorations were done within an interval of about one year. The findings were analysed by the Brief Psychiatric Rating Scale (BPRS). The degree of psychosocial functioning was estimated using the GAF-scale (axis 5 of DSM-III-R). The diagnosis of dementia was based on DSM-III-R-criteria. Most of the patients (72%) showed normal or only slightly remarkable psychopathologic findings at both times. A significant increase in psychopathologic conspicuousness in the course of the disease was only found for the subscore BPRS 2 ("anergia"). Dementia was seen in five patients (9%) and only in the stage of manifest immune deficiency syndrome (WR 6). All-together there was only a slight decrease of psychosocial functioning detectable (median on the GAF-scale 75), which only in dementia showed a significant reduction.

AIDS Dementia Complex↗

PubMed1997

Intrainstitutional relocation. Effects on residents' behavior and psychosocial functioning.

INTRODUCTION: Relocation effects in the elderly have been a topic of gerontologic research for many years. Prior research, however, has focused on individuals who could make a cognitive appraisal of the relocation process. With a greater prevalence of cognitive impairments and/or psychiatric illnesses in long-term care residents, research is needed to clarify the impact of relocation on these individuals. OBJECTIVE: The purpose of this study was to determine how intrainstitutional relocation affects behavior and psychosocial functioning in residents with and without cognitive, mood, and/or psychotic disorders. METHOD: This prospective study followed 78 residents being relocated intrainstitutionally in a health-related facility that was undergoing major renovations. Medical and nursing information was collected at 1 month pre-move and at 1 and 3 months post-move. Five areas of behavioral and psychosocial functioning (self-care, disoriented behavior, depressed/anxious mood, irritable behavior, and withdrawn behavior) were assessed using the Multidimensional Observation Scale for Elderly Subjects (MOSES). RESULTS: A significant increase was seen in the number of medical visits (p = .04) from time of relocation to 1 month post-move. The groups diagnosed with mood disorder and psychotic disorder had a statistically significant weight loss (p = .04) between 1 month pre-move and 1 month post-move. The study revealed an increase in the number of residents who fell immediately after relocation, but the increase did not reach statistical significance (p = 12). Residents who fell after relocation had resided at the facility for a longer time than the remainder of the sample (p = .08). Residents with a diagnosis of cognitive impairment showed a statistically significant difference in self-care (p = 0.01) and withdrawn behavior (p = 0.01) at 3 months post-move. Extensive relocation preparation and support may have been the main contribution to diminishing the stress of relocation over time and across diagnostic categories.

Adaptation, Psychological↗