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PubMed1999

Improvement in quality of life differs between women and men after coronary artery bypass surgery.

OBJECTIVE: To study improvement in quality of life (QoL) after coronary artery bypass grafting (CABG) in relation to gender. BACKGROUND: Women generally report worse QoL after CABG than men. However, women are older and more symptomatic prior to surgery, which should be considered in comparative analyses. METHODS: We studied consecutive patients who underwent CABG between 1988 and 1991 [n = 2121] with a QoL questionnaire containing the Physical Activity Score, the Nottingham Health Profile and the Psychological General Well-being Index prior to, 3 months, 1 year and 2 years after surgery. RESULTS: Females were older than men with more concomitant diseases preoperatively. QoL was improved on all postoperative occasions for both sexes. Improvement in the Physical Activity Score was somewhat, although not significantly, greater in males. Improvement in the Nottingham Health Profile was greater in females. General well-being showed no consistent pattern for improvement. CONCLUSIONS: QoL is significantly improved after CABG in both sexes throughout follow-up. There is a complex association between improvement in various aspects of QoL and gender.

Aged↗
PubMedDate not supplied

[A feeling of coherence and delayed sequelae of post-traumatic stress in persons persecuted for political reasons in Poland in the years 1944-56].

The paper presents the results of research of 100 persons persecuted for political reasons in Poland in the years 1944-56. The research aims to study the relations between the level of Sense of Coherence and delayed effects of post-traumatic stress disorder in personal functioning (which is manifested by anxiety, depression, lack of meaning of life, and low well-being), and in interpersonal functioning. Introduction of this article presents the problems connected with delayed effects of post-traumatic stress disorder, and the general principle of Antonovsky's salutogenic concept also characterizes the sense of coherence category (SOC). SOC is a generalized, long-lasting feeling of confidence that the world is comprehensible (internal and external environments are structured, predictable, and explicable). People with a high level of SOC see their life as having some purpose and that their life is worthy of personal investments, and see themselves as having the personal resources to cope with the difficulties. The data was collected with using: The Sense of Coherence Questionnaire, PTSD-Interview, Beck Depression Inventory, State-Trait Anxiety Inventory, Purpose in Life Test, The Psychological General Well-Being (PGWB) Index, and The Scale of Interpersonal Relationships. The results indicate that the strength of the sense of coherence is negatively correlated with level of anxiety, depression, enmity syndrome, and positive with meaning of life, psychological well-being, and pro-social relationships. The research confirmed the important role of a sense of coherence (SOC) in modifying experience of delayed consequences of post-traumatic stress in victims of political persecution.

Adult↗
PubMed1968

Some effects of discriminative training with equated frequency of reinforcement.

Pigeons were exposed to a multiple schedule which provided equally frequent reinforcement in the presence of two stimuli but which produced markedly different rates of key-pecking. Generalization gradients were displaced away from the stimulus associated with the lower rate of key-pecking. Another group of pigeons had similar training, except that a low rate of key-pecking was established in a stimulus with a much higher frequency of food reinforcement. In this case, the generalization gradients were not affected by the training on the schedule producing a low response rate.

Animals↗
PubMedDate not supplied

Fatigue in women with myocardial infarction.

This study measured fatigue in women 6 weeks after myocardial infarction. Fatigue was experienced by the women as chronic, generalized, intermittent, and longstanding. More than one third of the women attributed their fatigue directly to the heart attack or hospitalization. Significant relations were found between fatigue and the physiological dimension of the Sickness Impact Sale (SIP), the Perceived Health Assessment and Risk Protection Survey (PHARPS), and the site of infarction, as well as with the psychological dimension of the SIP. There was an inverse significant relation between fatigue scores and the Psychological General Well-Being (PGWB) Index. Although not reaching statistical significance, fatigue scores for women 65 and older were higher than for younger women.

Adult↗
PubMed2003

The first episode of psychosis: the experience of relatives.

OBJECTIVE: The aim was to determine the extent of and the correlates of the distress and impact of care families of patients with first episode psychosis were experiencing when they first came for treatment. METHOD: Subjects were 238 individuals who had presented with a first episode of psychosis and their family members. Family members were assessed with the Psychological General Well-Being Scale, and the Experience of Caregiving Inventory. Patient data included assessment of positive and negative symptoms, depression, quality of life, and substance use. RESULTS: Family members of these first-episode patients were experiencing distress and difficulties. It was the family's appraisal of the impact of the illness that was associated with their psychological well-being. CONCLUSION: As the majority of these first episode families are keen to be involved early and have engaged in an intervention programme, the next step should be an evaluation of their involvement to determine if it is effective.

Adult↗
PubMed2006

Work-related life events, psychological well-being and cardiovascular risk factors in male Swedish automotive workers.

AIMS: To analyse the relationship between life events, social support, psychological well-being and cardiovascular risk factors in blue- and white-collar Swedish automotive workers. METHODS: Baseline questionnaire regarding life events, social support, depressed mood and mental strain and smoking habits. Follow-up questionnaire after 5 years included the Psychological General Well-being Inventory to assess various health variables. At baseline and follow-up, anthropometric data were obtained. Blood pressure, blood glucose and serum lipids were measured and smoking habits were surveyed. RESULTS: The blue-collar workers showed a profile indicating increased cardiovascular risk with a higher proportion of smokers, a higher waist to hip ratio and higher triglycerides. They also reported themselves to have worse general health and less emotional self-control, but were less anxious than the white-collar workers. Negative life events, especially those related to work seemed to affect the well-being of the blue-collar workers more adversely than the white-collar workers. Being nervous and depressed at baseline increased the risk of poor psychological well-being at the follow-up. Social support within this 5-year perspective was a factor which predicted psychological well-being in both worker categories. Increase in cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio was the only cardiovascular risk factor associated with the strain of life events but not with work-related events. CONCLUSION: Over a 5-year period, men who experienced negative, strongly stressful and work-related life events displayed poorer psychological well-being at follow-up regardless of worker category. Social support was protective.

Alcohol Drinking↗
PubMed1989

On the origins of contemporary structural theory: an appreciation of "Ego Psychology and the Problem of Adaptation".

Hartmann's monograph was one of four works which produced a major revision of psychoanalytic theory. Following a brief summary of the monograph, this essay assesses its impact on contemporary psychoanalytic thinking. It considers some confusions about and revisions of Hartmann's ideas and explores terrain first broached in this work which has become very influential but which has not yet been fully exploited. Lastly, this essay will consider Hartmann's hope that psychoanalysis would become a general psychology.

Adaptation, Psychological↗
PubMed1985

[Evaluation of psychological stress before general anesthesia].

Pre-operative fear is not only a psychologically stressing phenomenon for the patient, but also a considerable risk factor due to its somatical correlative. In a study, 150 patients who were to undergo planned surgery under general anaesthesia were questioned about their fears and worries concerning the anaesthetic. Self-rating scales and rating scales by doctors and a complaints analysis curve were used in addition to an interview system on illnesses and specific previous experiences. 54% of the patients were, according to specific criteria, assessed as being anxious or very anxious (for example diffused anxiety, premature weakening of the anaesthetic effect, worry about not waking up out of the anaesthetic). Several factors which could have an anxiety-lessening or increasing effect and which are of importance for the psychological preparation for an operation were deduced from the investigation.

Adaptation, Psychological↗
PubMed2005

Normative sleep data, cognitive function and daily living activities in older adults in the community.

STUDY OBJECTIVES: To present normative data of sleep-wake characteristics and to examine risk factors associated with extreme values (i.e., in the 5 lower and upper percentiles of the distribution) in older adults. DESIGN: Cross-sectional telephone survey SETTING: The metropolitan area of Paris, France. PARTICIPANTS: A total of 7010 randomly selected households were contacted. Among them, 1264 households included at least 1 resident 60 years of age or older; 1026 subjects agreed to participate (participation rate: 80.9%). INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Subjects were interviewed with the Sleep-EVAL System about their sleeping habits and sleep and psychiatric disorders. In addition, the system administered to all the participants the Psychological General Well-Being Schedule, the Cognitive Difficulties Scale (Mac Nair-R), and an independent living scale. The median nighttime sleep duration was 7 hours without significant difference between the age groups. Factors positively associated with the 5 percentile (4 hours 30 minutes or less) of nighttime sleep duration were obesity, poor health, insomnia, and insomnia accompanied by daytime sleepiness and cognitive impairment. At the other extremity (95th percentile), long sleep (9 hours 30 minutes or more) was associated with organic disease, lack of physical exercise, and lower education. A daytime sleep duration of 1 hour or more (95th percentile) was associated with being a man, cognitive impairment, high blood pressure, obesity, and insomnia. Long sleep latency (95th percentile at 80 minutes) was associated with anxiety, lower education, poor health, insomnia without excessive daytime sleepiness, and obstructive sleep apnea syndrome. Obesity and loss of autonomy in activities of daily living was associated with both early (9 PM or earlier) and late bedtime (1 AM or later) and early (< or = 5 AM) and late (> or = 9 AM) wake-up time. CONCLUSIONS: This study illustrates the usefulness of normal distributions of sleep parameters in the general population to calculate different risk factors associated with extreme values of the normal distribution.

Activities of Daily Living↗
PubMed2000

Upper gastrointestinal symptoms in North America: prevalence and relationship to healthcare utilization and quality of life.

The aim of this study was to determine the prevalence of upper gastrointestinal symptoms (UGIS) in a general population and quantify the relationship of those symptoms to healthcare utilization and quality of life. In-person interviews were conducted with 2056 United States and Canadian residents selected at random. Subjects reported frequency and severity for 11 symptoms, prescription and over-the-counter medication use, primary care and specialty physician visits in prior three months, and completed the Psychological General Well-Being Scale. For analyses, subjects were classified into four mutually exclusive symptom groups: gastroesophageal reflux disease (GERD) -like, GERD plus motility-like (GERD+), ulcerlike, and motility-like. Of the total sample, 51.4% reported the occurrence of at least one UGIS in the prior three months. Subjects in the GERD+ and ulcer groups used more prescription medications and were more likely to see a physician about the symptoms (P<0.001). Subjects with symptoms demonstrated poorer quality of life compared to subjects with no symptoms. The prevalence of UGIS in the general population is high and symptoms are associated with significant health-care utilization and poorer quality of life.

Adult↗
PubMed2000

Psychological impact of genetic testing for Huntington's disease: an update of the literature.

Genetic testing has been available for Huntington's disease for longer than any other adult onset genetic disorder. The discovery of the genetic mutation causing Huntington's disease made possible the use of predictive testing to identify currently unaffected carriers. Concerns have been raised that predictive testing may lead to an increase in deaths by suicide among identified carriers, and these concerns set in motion research to assess the psychological impact of predictive testing for Huntington's disease. This review article provides an overview of the literature and draws implications for clinical practice. About 10%-20% of people at risk request testing when approached by registries or testing centres. Most of the evidence suggests that non-carriers and carriers differ significantly in terms of short term, but not long term, general psychological distress. Adjustment to results was found to depend more on psychological adjustment before testing than the testing result itself. Although risk factors for psychological sequelae have been identified, few adverse events have been described and no obvious contraindications for testing people at risk have been identified. The psychological impact of testing may depend on whether testing was based on linkage analysis or mutation detection. Cohorts enrolled in mutation detection programmes have higher levels of depression before and after testing, compared with people who sought genetic testing when linkage analysis was available. There is evidence that people who choose to be tested are psychologically selected for a favourable response to testing. The impact of testing on people in settings where less intensive counselling protocols and eligibility criteria are used is unknown, and genetic testing is therefore best offered as part of comprehensive specialist counselling.

Humans↗
PubMedDate not supplied

Sociodemographics, general health, and psychologic health in uninvestigated dyspepsia: a comparison of public and private patients.

GOALS: To compare the dyspepsia severity, general health, and psychologic health of patients with uninvestigated dyspepsia presenting in private and public settings. STUDY: Patients in this cross-sectional study were recruited from the Houston Veterans Administration (VA) General Medicine Outpatient Clinic and from the nearby private practice of a family physician. To be included, patients had to be at least 18 years of age and had to report a history of dyspepsia (epigastric discomfort) without alarm of at least 1 week's duration. Clinical information was obtained. Dyspepsia severity was measured using dyspepsia-related health scales, general health was measured using the Short Form 36, and psychologic health was measured using six scales. RESULTS: The authors enrolled 159 patients (59 VA). There were no differences in VA and private patients in most of the clinical characteristics related to dyspepsia. Compared with the private patients, the VA patients had worse scores on all Short Form 36 subscales, had lower expectations for treatment outcome, were more depressed, and had less optimism about life. CONCLUSIONS: Burden of illness and psychologic factors such as patient expectations are known to have important effects on patient outcomes. Striking differences in these factors exist in patients with uninvestigated dyspepsia seen in private and public settings. In the future, these factors must be taken into account both in conducting studies in dyspepsia and in interpreting the results for different practice settings.

Adult↗
PubMed2002

Can improvement in well-being and functioning be distinguished from depression improvement in antidepressant clinical trials?

The Inventory of General Life Functioning (GLF), a self-evaluation scale for patients, was developed for use in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. The scale was designed to evaluate patient general well-being and functioning, areas not adequately covered by standard depression scales. We used the patient self-report version of the GLF in two imipramine-controlled clinical trials during the development of the antidepressant venlafaxine. In these double-blind studies, outpatients with depression received placebo (n = 158), venlafaxine (n = 152), or imipramine (n = 149) for up to 6 weeks. We examined the internal consistency and factor structure of the GLF, its correlation with standard depression rating scales, and its sensitivity to differential treatment effects. We found the scale to be internally consistent and moderately correlated with physician-rated measures of depression. A reported two-factor structure (general well-being and functioning) was evaluated by factor analysis. When analyses were restricted to patients who completed at least 4 weeks on therapy, the GLF displayed sensitivity to differential treatment effects. The GLF total and factor subscales demonstrated the superiority of an active therapy (venlafaxine) to placebo; the GLF factor and a 7-item subscale using only items derived from Dupuy's psychological general well-being index (PGWB) demonstrated an advantage for one active therapy (venlafaxine) over another (imipramine). The GLF is a useful complement to the standard depression rating scales because it may assess additional dimensions of the depressive syndrome.

Activities of Daily Living↗
PubMed1995

Migraine patients experience poorer subjective well-being/quality of life even between attacks.

The aim of the present study was to compare the general well-being of migraine patients between attacks with that of an age- and sex-matched control group. One hundred and forty-five consecutive and eligible patients at the Gothenburg Migraine Clinic were asked about their well-being and their complaints. Using three self-administered standardized questionnaires, the Minor Symptoms Evaluation Profile (MSEP), Subjective Symptoms Assessment Profile (SSAP) and the Psychological General Well-Being (PGWB) Index, evaluable responses were obtained from 138 migraine patients. Compared with control subjects, migraineurs perceived more symptoms and greater emotional distress as well as disturbed contentment, vitality and sleep. It is concluded that the general well-being of the migraine patient is impaired, even between the attacks.

Adult↗
PubMedDate not supplied

Impact of uncertainty, social support, and prenatal coping on the psychological well-being of high-risk pregnant women.

BACKGROUND: The effects of uncertainty and social support on the psychological well-being of high-risk pregnant women may be influenced by their prenatal coping strategies. OBJECTIVE: The purpose of this study was to investigate whether prenatal coping strategies (preparation for motherhood, avoidance, positive interpretation of events, and prayer) mediate the effects of uncertainty and social support on the psychological well-being of high-risk pregnant women. METHODS: A cross-sectional, descriptive, correlational design was used. The convenience sample consisted of 105 high-risk pregnant women 18-34 years of age and at 24-36 weeks gestation. The main measures were Mishel Uncertainty in Illness Scale, Medical Outcomes Study Social Support Survey, Prenatal Coping Inventory, and Psychological General Well-Being Index. Data analysis included descriptive statistics, correlational techniques, and path analyses. RESULTS: The women reported low levels of uncertainty, moderate levels of distress, and high levels of social support. Prayer was the most frequently used prenatal coping strategy, whereas avoidance was used least often. Women who reported higher levels of uncertainty also reported less social support (r = -.45, p < .01), less psychological well-being (r = -.48, p < .01), less positive interpretation (r = -.30, p < .01), and more use of avoidance (r = .43, p < .01). The modified path analysis showed good fit with the data. Avoidance significantly mediated the effects of uncertainty on psychological well-being (z = -2.74, p < .01). Social support had a significant direct effect on preparation for motherhood (beta = .43, z = 3.94, p < .001). DISCUSSION: Avoidance mediated the effect of uncertainty on psychological well-being for the high-risk pregnant women in this sample. The results of the study may help perinatal nurses to better understand how high-risk pregnancy affects these women.

Adaptation, Psychological↗