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The influence of perceived control over causes and responses to health threats: a vignette study.

OBJECTIVES: To test the hypothesis that a disease caused by controllable, compared with uncontrollable, factors is more likely to result in negative emotions and less likelihood of disclosure to significant others. DESIGN AND METHODS: A between-participants design in which students (N=108) imagined they had just been diagnosed with either HIV or hypertension and where the cause for each was described as either controllable or uncontrollable. Anticipated emotional and behavioural responses by self and others were assessed by questionnaire. RESULTS: When the vignette represented a more controllable cause, participants thought they would have more negative feelings and that they would be less likely to disclose information about the disease to their family or an acquaintance than when the vignette represented a less controllable cause. The type of disease, but not the cause, influenced anticipated responses by others. CONCLUSIONS: Although greater perceived control over future outcomes is often psychologically adaptive, these findings suggest that the perception that the onset of a disease was controllable may be maladaptive, resulting in more negative feelings and a greater reluctance to disclose the diagnosis to others. In the light of the increasing use of medical technologies aimed at primary prevention of disease, together with a cultural shift toward individual responsibility for health, there is a need for greater understanding of how the perceived controllability of the cause of a disease affects subsequent adjustment.

Journal Article↗

Psychological adjustment of children with recently diagnosed diabetes mellitus.

Children with recent onset of insulin-dependent diabetes mellitus (IDDM) were compared with a sample of children with a recent acute medical problem. No differences were found in terms of self-esteem, locus of control, behavioral symptoms, or social functioning. A separate assessment of adjustment to diabetes was strongly correlated with each of these general personality, behavioral symptom, and social functioning measures. Sociodemographic factors such as age, gender, and social class did not predict the level of adjustment to diabetes. This study suggests that onset of diabetes does not necessarily lead to major disruptions of psychological adaptation. It also affirms the view that early adjustment to diabetes is embedded in a context of overall personality development and adaptation.

Acute Disease↗

Leisure after stroke.

Leisure activities and satisfaction derived from leisure activities were investigated together with feelings of stigma and of depression in 51 first-stroke married/cohabitating hemiplegics (males (n: 39) mean age 54 +/- 9; females (n: 12) mean age 50 +/- 12). Leisure goals appeared to mirror traditional gender roles; males having more outdoor and straining leisure activities. For the majority, number and frequency of active leisure participation decreased after stroke and they became passively discontented. This was the case for outdoor and indoor activities as well as for activities characterized by social interaction and entertainment. Mutual and non-mutual partnership of leisure activities occurred for those investigated within a year after stroke. Dissatisfaction also followed increased, passive, time together with spouse. Stigmatism was common (about 50 per cent) during the first year post-stroke, while depression was most common (65 per cent) between 7 and 12 months after stroke. The findings are discussed in terms of physical (disease-related) resources, geographical circumstances and psychological adaptation in its temporal context.

Attitude to Health↗

Advocating for the woman with breast cancer.

Health care workers and breast cancer survivors have an important role to play as advocates for breast cancer patients. At the most basic level, advocates must ensure that the patient has access to medical care. In addition they must help to ensure that the quality of care is optimal, enhancing the likelihood of survival, rehabilitation, and psychological adaptation. This article describes important advocacy issues for women with breast cancer, including informational needs, patient-physician communication, choice of primary surgical treatment, reconstructive surgery, adjuvant therapy, psychosocial issues, and employment and insurance problems.

Breast Neoplasms↗

Roles of cognitive characteristics in tinnitus patients.

To investigate the cognitive characteristics that affect the emotional and functional distress caused by tinnitus and to decide and test the model to explain their relations, 167 patients with tinnitus, who visited Samsung Medical Center, Seoul, Korea between March 2001 and May 2002 were recruited. To examine their features related to tinnitus, the following scales were administered; Tinnitus-related basic questionnaire including dysfunctional beliefs, Tinnitus Handicap Inventory, State-Trait Anxiety Inventory, Anxious Thought and Tendencies, Self-Consciousness Scale, and modified 'catastrophic thought' from Coping Strategies Questionnaire. The results showed that the duration of experiencing tinnitus was 4.7 +/-7.1 yr, those who complained of hearing one sound were the most common (45.5%), and hearing sounds similarly described to whistling were the most common (22.5%). Also, there were significant correlations among tinnitus features, cognitive characteristics, and distresses from tinnitus. As a result of testing the model, Normed fit index, Incremental fit index, Tucker-Lewis index, and Comparative fit index were over .90, indicating that it is a good model, and Root mean square error of approximation showed a reasonable fit. Also, the direct effects of the trait or severity of tinnitus on distress did not appear to be significant, thus it appeared to be affecting indirectly through the cognitive characteristics. This result shows that cognitive interventions can be important for the psychological adaptations of tinnitus patients.

Anxiety Disorders↗

A rooming-in program for mothers and newborns.

This report describes a rooming-in program based on allocation of resources to patients in accord with their health needs. It outlines the advantages of having the healthy infant kept with the mother continually during the puerperium. This promotes easier psychological adaptation of mother and infant, reduces the incidence of cross-infection in the hospital, encourages breast-feeding, and paves the way for providing the newborn with regular checkups at peripheral health centers. The report also points out the need to instill a strong instructional component into the roomin-in program. The basic elements of the overall program are maternal training based on indivisual instruction, group discussion sessions accompanied with instructional slides, and participation by the mother in the care of her infant under supervision of the midwifery team. The adoption of a program of this nature does not imply an increase in existing human and material resources, but rather a rationalization of the distribution of present resources and the added contribution of the mother's active participation in helping to care for her child.

Equipment and Supplies, Hospital↗

[Pathogenesis and clinical morphology of congenital disorders of sex differentiation].

Bisexual structure of genitalia presents difficulties for clinical diagnosis. Therefore, knowledge of pathogenesis and clinical morphology of congenital disturbances of sexual differentiation helps to establish earlier hermaphroditism variant, appropriate surgery for complete social-psychological adaptation of this group of patients.

Disorders of Sex Development↗

[The development of mixed emotional and behavioral disorders in children raised in foster care institutions].

The aim of the work was to evaluate the changes brought by time in the psychoemotional state of neglected and abandoned children (exhibiting disturbed social relations), which were displayed in childrens' behavior. The longitudinal research has been carried out by the epidemiological case-control scheme. Two groups of children were examined. During the first test the study group was formed by 70 (44 boys and 26 girls) neglected and abandoned children drew up from foster care institutions. The control group was adequate in age and sex to the study group. It included 70 (44 boys and 26 girls) children from traditional families. The second test was carried out two was years later. It was applied to the same groups of children, only this time 50 (32 boys and 18 girls) children from the study and from the control group were tested. Mixed psychoemotional and behavioral disorders were evaluated by experts (teachers from foster care institutions, nurseries and schools) who applied the scale of indicators. The results gave evidence of psychoemotional problems in the neglected and abandoned children growing up in foster care institutions: they were nervous, exhibited aggression, difficulties in their education emerge. The behavior and emotions shape themselves in frustration and depression. These disorders tend to grow and become more serious in the course of time, social behavior deviations and social health development disorders emerged. The psychoemotional health development of neglected and abandoned children evoked difficulties in their psychological adaptation.

Affective Symptoms↗

[Measures for psychological prophylaxis of the psychogenic adaptation disorders among flying personnel].

Adaptation disorders lie behind 70 to 80% of morbidity among and medical disqualification of flyers. Mental health is the hallmark of the psychoprophylaxis system defining its structural and methodical principles, and purpose. Counteraction to the psych dependent adaptation disorders requires consolidation of efforts of the services responsible for flyers professional health and flight safety; emphasis on motivation and social well-being of flyers is imperative.

Adaptation, Psychological↗

[Significance of modernization of the social rehabilitation system within promotion of the nursing care].

A specially elaborated system-module approach, that contributes to shaping, in medical students, the moral principles for their occupational activity, is suggested. A continuous humanistic-training system embracing the educational and pedagogic processes is elaborated; the system is a principally new type of orientation of medical personnel aimed at the medical-and-psychological adaptation and rehabilitation of elderly population.

Aged↗

Psychosocial issues in genital herpes management.

Genital herpes leads to considerable distress in many patients at the time of diagnosis. Most people with recurrences adapt psychologically over time, but some fail to do so, and show continuing psychological morbidity. It is not clear why some people adjust and others do not. Antiviral medication may help to promote adjustment but the evidence is inconclusive. Little is known about the behavioural adjustments that people make, or how they deal with their sexual relationships. Many people fail to disclose to some or all of their sexual partners, particularly casual partners. There are little hard data on the most effective ways to help people adjust to the diagnosis and to help them to reduce the risk of transmission, although what people are told (and the practical advice they are offered) may be important. This article, the first of two papers in this issue to consider the impact of genital herpes, outlines the problems facing people with genital herpes; the second article gives practical guidance for clinicians supporting people with herpes.

Antiviral Agents↗

[Reconstructive surgery in laryngostenosis in children].

Methods of laryngoplasty with usage of costal cartilage autotransplant and segmental laryngeal resection were applied in 33 patients with laryngostenosis of various etiology. Decannulation of the patients during the first 4 months after beginning of the treatment was made in 75% patients with one-stage laryngoplasty. A new method of stenting in reconstructive operations on the larynx is proposed. The endolumen technique of silicon stent fixation isolated from tracheostome cannula is thought an optimal method of stenting. Surgery is optimal early after verification of the diagnosis. Early operations make it possible to optimize prognosis of one-stage treatment as they reduce the number of complications after long-term carrying of tracheostomic cannula as well as provide better socio-psychological adaptation of the patients.

Adolescent↗

[Treatment compliance and subjective well-being among post-stroke patients].

The quality of life (QOL) and the factors that influenced it were studied in patients suffering from stroke. QOL was studied at 2 separate levels: 1) compliance with the advice of a physician, 2) subjective well-being. A patient with high QOL was defined as a person with both high compliance to the advice of a physician and high subjective well-being. Subjects were selected from persons who participated in rehabilitation at health centers and welfare centers, and members of a stroke patient. The following results were obtained. 1) When compared to results obtained from other research for the general population, subjective well-being in stroke patients was lower among men and those 69 years of age or under. Compliance with advice of a physician was higher for either sex and all age groups in the interviewees than in the general population. 2) Factors which were related to compliance differed from those related to subjective well-being. Compliance with the advice of a physician was higher among those interviewees having the shortest time elapsing since the occurrence of stroke, high social support and low psychological adaptation to the stroke experience. Among social support network members, relatives figured prominently among factors related to compliance. Among interviewees, subjective well-being decreased with depression, high degree of impairment in activity of daily living, and when three years or greater had elapsed since the stroke. Among these factors the relationship between depression and subjective well-being was the strongest.

Aged↗

[The efficacy of the hypnosuggestive psychotherapy of myocardial infarct patients].

The efficacy of the short-term psychotherapy was studied in 90 patients with myocardial infarction using the rating scale and the psychological Mini-Mult test. The hypnosuggestive therapy improved the mental status of the patients by reducing affective disorders. It promoted the formation of adequate psychological reaction to the illness and successful psychological adaptation, exerted a favourable effect on angina pectoris, cardialgia and moderate arterial hypertension.

Adult↗

Hartmann's "Ego Psychology and the Problem of Adaptation".

Hartmann's monograph is an argument for the problem-solving value of all aspects of the mind and for the subordination of intelligence to the organism's larger, primarily social purposes. Hartmann proposed that, in psychoanalytic treatment, intelligent reflection serves one's largest purposes by taking respectful account of non-rational but adaptive ways of appraising reality, with a view toward making the best use of non-rational as well as rational propensities. He regarded it as the kind of thinking that the sociologist, Karl Mannheim, had recommended to government planners faced with immensely complicated, incompletely masterable forces. Hartmann's view of the role of the intellect in analytic treatment suggests that therapists should maintain both their demand for intelligent reflection and their hopefulness about other kinds of work that may be going on sub rosa.

Adaptation, Psychological↗

[Xerostomia and hyposalivation: clinical aspects].

In stomatology, salivary function and dysfunction are seldom discussed in their biological and psychological aspects; too often, the terms are mistakenly used as synonyms. The importance of identifying these conditions not only involves direct therapeutic implications, as it can additionally influence global and systemic buccal conditions, as well as modify tissue response and psychological adaptation to dental, periodontal and prothesis therapy as currently performed in daily practice. The physiopathogenesis, etiology, the local and general clinical repercussions, as well as those on behavior, the methods of clinical evaluation and treatment/handling of hyposalivation and xerostoma, are presented and discussed.

Humans↗

[Results of the use of relaxation therapy in hypertension].

To assess the efficiency of relaxation therapy (RT) as part of the treatment for essential hypertension (EH), 100 male EH patients, aged 20 to 55 years, were repeatedly examined at 12 months' intervals, using clinical, psychological and psychophysiologic tests. The patients were divided into 2 groups: the main group received RT as autotraining (AT) or using biologic feedback devices, and the control group was not exposed to mental influences. Patients from the main group showed a more marked resting BP drop as well as a smaller and shorter hypertensive response to emotional stress, improved psychosocial status and psychologic adaptation, and better working capacity. A comparative five-year follow-up study of 90 patients was carried out to assess the value of RT for secondary EH prevention. The use of AT is associated with a slower progress of the disease, as compared to the controls, as evidenced by lower BP values, more limited growth of left-ventricular hypertrophy, and lesser neurotization as well as shorter EH-related temporary disability periods.

Adult↗