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Results for “ADAPTATION, PSYCHOLOGICAL”

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PubMed2000

Quality of life changes during conformal radiation therapy for prostate carcinoma.

BACKGROUND: The objective of this study was to describe prospectively quality of life (QOL) before and after radiotherapy for patients with prostate carcinoma. METHODS: Forty-three patients with T1-T3 prostate carcinoma who underwent conformal external beam radiation therapy were randomized either to the complete European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaire (EORTC QLQ-C30) or the Medical Outcomes Study Group Short Form Health Survey (SF-36) at baseline, at 3 weeks and 6 weeks after initial treatment, and at 6 weeks and 5 months after the completion of radiotherapy. The measures were self-reported patient QOL, and values are given as the mean +/- standard error of the mean. Changes in QOL are described from baseline to the end of treatment in both questionnaire groups. RESULTS: Emotional role functioning, as measured with the SF-36 questionnaire, significantly improved from 68.2 +/- 9.9 at baseline to 93.3 +/- 5.2 at the end of therapy (P = 0.02). The EORTC QLQ-C30 questionnaire revealed consistent values of emotional functioning during treatment (72.7 +/- 5.9 at baseline) but showed a significant improvement 6 weeks after therapy (89.0 +/- 4.4; P = 0.01). Role functioning deteriorated from 80.1 +/- 6.5 at baseline to 62.5 +/- 8.8 at the end of radiotherapy (P = 0.02). Symptoms of fatigue were shown to increase significantly from 26.9 +/- 6.0 at baseline to 37.7 +/- 7.6 at the end of therapy (P = 0.02). No significant changes in the other dimensions were observed in either questionnaire. CONCLUSIONS: After radiotherapy for prostate carcinoma, patients experience a temporary deterioration of fatigue and role functioning, as measured with the EORTC QLQ-C-30. Despite physical deterioration, the authors observed an improvement in emotional functioning scores with both questionnaires. This may have been due to psychological adaptation and coping.

Aged↗

PubMed1991

Prediction of intention to exercise of individuals who have suffered from coronary heart disease.

The aim of the study was to understand the intention to exercise of individuals who suffer from CHD. A group of 161 cardiac patients completed a questionnaire that investigated intentions, attitudes, subjective norms, perceived barriers, habits, perceived difficulties, and personal normative beliefs with respect to exercising, as well as perceived severity of and perceived vulnerability to re-infarction. Regression of intention yielded an R2 of .41 (p less than .0001), with perceived barriers, habits, and perceived difficulties as the significant predictors. MANOVA indicated that high and low intenders differed (p less than .01) according to their perception of three barriers: difficulties in time management, difficulties in psychological adaptation, and laziness. These results suggest that new guidelines should be adopted for the development of cardiac rehabilitation exercise programs.

Coronary Disease↗

PubMedDate not supplied

Maximizing stroke recovery using patient self-care self-efficacy.

Self-care self-efficacy is a compensatory mechanism that may lead to improved psychological adaptation poststroke. Nurses working with stroke patients may use self-care self-efficacy interventions to help the patients achieve a successful recovery. This article describes the four components of self-efficacy, and discusses their application to stroke patients in rehabilitation. Self-care self-efficacy interventions have the potential to decrease depression and increase quality of life for patients after stroke, and may become a valuable tool for nurses who practice in rehabilitation settings. The use of self-care self-efficacy techniques by nurses helps to motivate patients to succeed in their self-care after stroke.

Aged↗

PubMedDate not supplied

Discrepancies between attainment and importance of life values and anxiety and depression in gastrointestinal cancer patients and their spouses.

Patients' satisfaction with life, viewed in terms of the discrepancy between the perceived attainment and subjective importance of various life values, is a less often studied phenomenon for understanding the psychological adaptation in cancer patients. The main aim of the present study is to investigate the relation between the degree of attainment and importance of life values on the one hand, and anxiety and depression, on the other. A consecutive series of 85 newly diagnosed patients with gastrointestinal (GI) cancers, 52 potentially cured and 33 with an advanced disease, and 26 spouses to the patients with an advanced disease participated. The patients and spouses of non-cured patients filled out questionnaires twice, close to the diagnosis and after 1 (non-cured patients) or 3 months. Overall, large discrepancies between the perceived attainment and importance of life values were associated with high anxiety and depression. For the patients (both cured and non-cured), the discrepancies decreased for several life values over time, as did anxiety and depression. For the spouses of the non-cured patients, there was no decrease either for life value discrepancies or for anxiety/depression. This suggests that patients, in contrast to their spouses, strive to achieve small discrepancies between the perceived attainment and importance of life values, as part of their adjustment to serious diseases, e.g. cancer.

Adult↗

PubMed2002

Psychoneuroimmunology of depression: clinical implications.

Psychoneuroimmunology is a field that investigates the interactions between the brain and the immune system. One important goal of this field of research is to translate basic research in order to understand how behavior affects health and resistance to disease in humans. This review evaluates the impact of depression on morbidity and mortality risk and asks whether neuroimmune mechanisms contribute to this association. Examples are drawn from three diseases: cardiovascular disease, infectious disease, and rheumatoid arthritis. Finally, the potential for biobehavioral interventions to impact psychological adaptation and the course of immune related disease is discussed.

Behavior Therapy↗

PubMed1995

Cyclosporine for the treatment of fulminant ulcerative colitis in children. Immediate response, long-term results, and impact on surgery.

PURPOSE: Emergency surgery for fulminant colitis is often complicated by high-dose steroid therapy, poor nutrition, and psychologic maladjustment. Cyclosporine is effective for fulminant ulcerative colitis in adults, resulting in avoidance of immediate surgery in 75 percent of patients and a 55 percent long-term remission rate. Over the last five years, we studied the effectiveness of cyclosporine in children with fulminant colitis. METHODS: Fourteen patients with ulcerative colitis (age, 7-20 years) received cyclosporine after satisfying the following criteria: 1) greater than five bloody diarrheal stools per day; 2) severe abdominal pain; 3) no improvement after ten days of bowel rest, 4) intravenous methylprednisolone (1-2 mg/kg/day); and 5) parenteral nutrition. Treatment was begun with oral cyclosporine (4.6-9.6 mg/kg/day), and the dose was adjusted to achieve whole blood trough levels measured with a monoclonal radioimmunoassay between 150 and 300 ng/ml. If improved, patients were discharged on oral cyclosporine, prednisone, and a regular diet. RESULTS: Eleven of 14 patients (78 percent) responded within two to nine days and were able to consume a normal diet, had three or less soft stools per day, and had no pain. One did not respond after ten days and underwent an ileal pouch-anal anastomosis procedure. Two patients elected surgery after 20 days of therapy and a partial response. Of 11 patients who left the hospital, 4 had recurrent symptoms after 2 to 11 months of taking therapeutic doses of cyclosporine and 3 flare ups while weaning from cyclosporine after 4 to 8 months. Three patients have been weaned from cyclosporine after 8 to 13 months and have remained in remission from six months to five years. One patient is about to complete a six-month course of cyclosporine. Overall ten (72 percent) have undergone surgery, including 7 of 11 who responded initially to cyclosporine and left the hospital. Weight (P < 0.001), albumin (P < 0.01), erythrocyte sedimentation rate (P > 0.05), and prednisone dose (P < 0.001) improved significantly in the seven patients on cyclosporine who responded initially, left the hospital, and subsequently underwent surgery. CONCLUSIONS: Cyclosporine is effective in achieving clinical remission in 80 percent of children with refractory fulminant colitis; however, within one year, most initial responders will require colectomy because of a flare up of the disease. In a majority of patients, the role of cyclosporine therapy is to rapidly ameliorate symptoms and prevent precipitous colectomy, improve nutrition and psychologic adaptation, and reduce the steroid dose leading to surgery in a well-prepared patient.

Abdominal Pain↗

PubMed1992

Colostomy plug devices: a possible new approach to the problem of incontinence.

The authors report their experience in the use of the Conseal (Coloplast S.p.A., Bologna, Italy) Colostomy Plug, a new device for the regulation of continence in patients with colostomies. The devices were tested on 57 patients divided into two groups: Group A (36 patients) fit with a two-piece Conseal system and Group B (21 patients) fit with a one-piece Conseal system. All patients had the same colostomy type, and all were trained for self-irrigation. The objectives of this randomized, prospective study were to determine compliance with the different systems, to identify the advantages, and to verify the possible different applications among the population of irrigated patients. The following results were obtained. Regarding compliance: Group A's results were excellent in 22.2 percent and good in 52.7 percent of patients. Group B had better compliance than Group A (excellent in 66.6 percent and good in 19 percent of patients). Regarding controlled evacuation, continence time, and silent gas emission: in Group A, the device permitted controlled evacuations (23.8 percent of patients practicing daily washouts) with silent and odorless gas emission (100 percent of cases). In Group B, the results concerning improvement in continence were good (33.3 percent of patients) and excellent concerning the emission of flatus. Regarding the potential use of both systems in different groups of self-irrigated patients: the study has revealed the Conseal Uni-system as being ideal for patients with a well-constructed stoma, slight gas distention, and a better psychologic adaptability to larger-sized systems. In all other cases, the alternative two-piece system is more suitable, owing to the better safety it offers.

Adult↗

PubMedDate not supplied

Summer camps for diabetic children in Beijing of China.

The first summer camp for diabetic children was held in 1984 in Beijing. Since then we have held summer camp every year, the last summer camp was the fifth camp in 1988. The purpose of summer camps for diabetic children are to train the patients and increase the skills of diabetics self-control practice. The recreation activities are also important for their good communication and psychological adaptation. The campers of camps were 28-35 diabetic children, totally 154 participants consisting of 73 boys and 81 girls. Most of the children were 10-14 years old. The staffs include pediatricians, nurses and others. The ratio of campers with staffs were 2.7-3.2. The session of the camps were always of five days length. The characters of activities in camps were all the arrangements must be for diabetic children, included planning diet, insuring the urine sugar exam, insulin injection before each meal, and give some lectures for training the managed skills of diabetes, meanwhile the recreation programs and exercise were also a consisting portion of activations. The summer camps were beneficial for diabetic children. They learned many useful techniques of diabetes and their capacity of life adaptation were increased, and the self-confidence enhanced their future daily life.

Adolescent↗

PubMed1994

Clinical implantation of the wearable Baxter Novacor ventricular assist system.

Implantation of the wearable Novacor electrically powered left ventricular assist system was performed on March 16, 1993, in a 44-year-old man hospitalized for an acute episode of myocardial decompensation after a 6-year history of dilated cardiomyopathy. He was rehabilitated fully and became ambulatory, awaiting a suitable cardiac graft for 59 days. He is now back to work, enjoying a normal life. This case illustrates the progress made by miniaturization of the external components of the system. General acceptance of the system and psychological adaptation to the new way of life were remarkable.

Adult↗

PubMed1991

Prevalence, onset, and risk of psychiatric disorders in men with chronic low back pain: a controlled study.

This study used structured diagnostic interviews and DSM-III criteria to assess lifetime prevalence and pre-morbid risk of psychiatric disorder in a sample of men with long-standing chronic back pain (CLPB) attending a primary care clinic. A control group of age and demographically matched men without history of back pain was also studied. Compared to controls, men with CLBP had significantly higher lifetime rates of major depression (32% vs. 16%), alcohol use disorder (64.9% vs. 38.8%), and a major anxiety disorder (30.9% vs. 14.3%). Almost all CLBP men ever experiencing a mood disorder reported recurrent, not single, episodes. The 6 month point prevalence of major depression, but not other disorders, was also significantly elevated for men with CLBP. In CLBP, the first episode of major depression generally (58.1%) followed pain onset. While the initial major depressive episode usually commenced within the first 2 years of established pain, late onset mood disorder was also common. By comparison in most cases (81%) onset of alcohol use disorders considerably preceded pain. When an age-matching procedure was used to gauge relative vulnerability to psychiatric illness in patients and controls, CLBP patients had significantly higher pre-pain rates of alcohol use disorder but not depression. After age of pain onset, CLBP subjects had over 9 times the risk of developing major depression, but had similar rates of developing alcoholism. We conclude that (1) alcohol use disorders rather than depression may increase risk of developing CLBP, and (2) risk of new onset and recurrent major depression remains high for men throughout their pain career. This suggests that psychological adaptation to long-standing pain may be less successful than previously thought, especially with regard to recurrent mood disorder.

Adult↗

PubMed2004

Long-term care of the patient with the atrial defibrillator.

With an aging population, atrial fibrillation is becoming an increasingly common cause of hospital admission. Patients with recurrent, symptomatic persistent atrial fibrillation often require repeated admissions to the hospital for cardioversion. The development of the atrial defibrillator has empowered such patients to take charge of their condition and perform cardioversion on themselves at home. This liberates them from the worry of hospitalization and can increase patient confidence. The implantation of an atrial defibrillator, however, has some disadvantages, and long-term use of the device exposes patients to some of the psychological adaptations that occur in recipients of implantable devices. This article discusses in depth the patient selection process, the implantation procedure, the use of the atrial defibrillator, and problems that can arise during long-term follow-up.

Anti-Arrhythmia Agents↗

PubMed2004

Correlates of satisfaction for the relationship with their physician in type 2 diabetic patients.

In the context of an Italian nation-wide outcomes research program on type 2 diabetes, we investigated the contribution of both patient and setting-related factors to patient satisfaction with their relationship with their physicians. The level of patient satisfaction was measured using the American Board of Internal Medicine (ABIM) 14 patient satisfaction questionnaire. The main results were obtained using multilevel analysis, a statistical technique that takes into account the clustered nature of our data. Overall, 3563 patients were recruited by 101 diabetologists and 103 general practitioners (GPs). Information on patients' satisfaction was available for 2515 patients (71% of the whole sample). Patients' satisfaction was related to patient characteristics and attitudes, but not with physician's sex, age, speciality, and setting of care. In particular, patients who were less likely to delegate to physicians responsibility for diabetes management and those perceiving a lower degree of involvement in disease management showed lower levels of satisfaction. Lower satisfaction scores were also related to lower levels of school education, more severe clinical conditions, and lower psychological adaptation to diabetes. However, patients reporting higher levels of diabetes related worries and more frequent encounters with health care providers showed higher levels of satisfaction. In conclusion, patient satisfaction with physicians' humanness and communication skills is strongly related to personal characteristics, attitudes, expectations, and perceived health. In deciding the best decision-making approach to adopt in individual patients, it is of primary importance to measure how the patient perceives and engages in relationships.

Aged↗

PubMedDate not supplied

Work integration issues go beyond the nature of the communication disorder.

UNLABELLED: The ability to obtain and maintain employment is one of society's most valued life participation events and is often considered in measurements of quality of life (QOL). Many workplaces now require good communication skills and this may jeopardize the opportunity for persons with communication disorders (CD) to access interesting jobs. Sarno, Silverman, and Levita (1970) have long emphasized that functioning is a result of the interaction of psychosocial factors as well as communication disorder characteristics. The current study gathered perceptions from different groups of persons with CD, from service providers and employers on the barriers to work integration. The results show that many barriers are common across types of CD. Such examples are noise, tasks requiring speed, having to speak to groups of persons and the attitudes of others. Although some common barriers were identified between the service providers and the persons with CD, service providers placed more emphasis on psychological adaptation aspects than did persons with CD. Employers generated an equivalently long list of barriers but were also very concerned about job market issues. LEARNING OUTCOMES: As a result of this activity, the following learning outcomes will be realized: participants will be able to (1) identify barriers that service providers and persons with CD each perceive; (2) identify differences in the perceptions of each group concerning barriers; (3) learn ways to modify or eliminate barriers that interfere with successful employment among individuals with CD.

Aged↗

PubMed1999

Anger in chronic pain: investigations of anger targets and intensity.

The study was designed to assess the frequency and intensity of patients' anger directed toward various potential targets and how intensity of anger toward different targets was related to the chronic pain experience. Ninety-six chronic pain patients who were referred for a comprehensive evaluation completed questionnaires to assess their levels of anger, pain, distress, and disability. Approximately 70% of the participants reported to have angry feelings. Most commonly, patients reported to be angry with themselves (74%) and health care professionals (62%). The relevance of anger to chronic pain experience seemed to vary across targets. Anger toward oneself was significantly associated with pain and depression, whereas only overall anger was significantly related to perceived disability. The results suggest that anger should be conceptualized as a multifactorial construct. In addition to presence, intensity, and expression of anger, targets of anger may be important to better understand psychological adaptation to chronic pain.

Adult↗

PubMed2001

The evolution of prestige: freely conferred deference as a mechanism for enhancing the benefits of cultural transmission.

This paper advances an "information goods" theory that explains prestige processes as an emergent product of psychological adaptations that evolved to improve the quality of information acquired via cultural transmission. Natural selection favored social learners who could evaluate potential models and copy the most successful among them. In order to improve the fidelity and comprehensiveness of such ranked-biased copying, social learners further evolved dispositions to sycophantically ingratiate themselves with their chosen models, so as to gain close proximity to, and prolonged interaction with, these models. Once common, these dispositions created, at the group level, distributions of deference that new entrants may adaptively exploit to decide who to begin copying. This generated a preference for models who seem generally "popular." Building on social exchange theories, we argue that a wider range of phenomena associated with prestige processes can more plausibly be explained by this simple theory than by others, and we test its predictions with data from throughout the social sciences. In addition, we distinguish carefully between dominance (force or force threat) and prestige (freely conferred deference).

Journal Article↗

PubMed1992

Effects of early mother-twin relationships from birth to age 3, on twin bonding.

Findings from an earlier phase of this research project clearly pointed to the mother's psychological adaptation inherent to the specificities of triadic interaction. Mothers' attitudes were classified in a typology ranging from "early twinness" where the two babies are treated as though they were a single unit, to attempt to create two dyadic relationships. The current program deals with the effects of the type of parent-child relationship at one year on the emergence of twin bonding. Sixty-eight families of twins (26MZ, 24DZ same sex, 18DZ different sex) are followed up from birth to the age of 3 using a method based on clinical interviews, videotaped observations, and questionnaires. The data cover mothers' rearing attitudes towards organization of babycare and outward signs of twinness, maternal representations of the relationship between the twins and observation of the children's interaction in a standardized game situation. The findings are discussed in terms of zygosity, and parental SCS.

Attitude↗

PubMed2002

Response shift in the measurement of quality of life in hearing impaired adults after hearing aid fitting.

UNLABELLED: REASON FOR THE STUDY: Response shift is the change in the meaning of one's self-evaluation of a target construct, like quality of life (QOL). The objective of this study was to investigate whether response shift in the measurement of generic and specific QOL occurred in persons with a relatively mild health condition. For this purpose hearing impairment was used as a research model. MAJOR FINDINGS: Response shift effects were observed in the scores on the dimensions of hearing related QOL. In the scores on overall hearing related QOL, and in the scores on the generic control items, no response shift occurred. CONCLUSIONS: This study showed that response shift effects can take place in a relatively mild condition as well. The occurrence of response shift in QOL ratings over time could have large implications for the estimation of the effectiveness of medical interventions and for the use of these estimations in cost-effectiveness analyses. After a successful treatment the conventional change could be an underestimation of the effectiveness of the treatment, although it has also been argued that psychological adaptation is a welcome capacity of human beings, and that then-test changes do no justice to this capacity.

Adolescent↗

PubMed2005

Couple-focused group intervention for women with early stage breast cancer.

This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions of a couple-focused group intervention or usual care. Intent-to-treat growth curve analyses indicated that participants assigned to the couples' group reported lower depressive symptoms. Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners, and women with more physical impairment benefited more from the intervention group than did women with less impairment. Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention.

Adult↗