SEARCH · PubMed Health

Results for “Psychosocial functioning”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

PubMed1999

Do aftercare services reduce inpatient psychiatric readmissions?

OBJECTIVE: To determine whether aftercare services reduce the likelihood that children and adolescents will be readmitted to inpatient psychiatric facilities. DATA SOURCES/STUDY SETTING: Analyses of data from the Fort Bragg Demonstration. Data were based on 204 sample individuals (children and adolescents), all of whom were discharged from inpatient facilities during the study period. STUDY DESIGN: These analyses use hazard modeling to examine the impact of aftercare services on the likelihood of readmission. Comparisons of individuals for whom the timing of aftercare services differ are adjusted for a wide range of individual characteristics, including client demographics, diagnosis, symptomatology, and psychosocial functioning. DATA COLLECTION/EXTRACTION METHODS: Detailed data on psychopathology, symptomatology, and psychosocial functioning were collected on individuals included in these analyses. This information was taken from structured diagnostic interviews and behavior checklists, including the Child Behavior Checklist and Diagnostic Interview Schedule for Children, completed by the child and his or her caretaker. Information on the use of mental health services was taken from insurance claims and a management information system, and was used to identify the period from discharge to readmission and to describe the client's use of outpatient therapy, case management, intermediate (or stepdown) services, and residential treatment centers during this period. PRINCIPAL FINDINGS/CONCLUSIONS: Using Cox models that allow for censoring and that include the use of aftercare services as time-varying covariates, we find that aftercare services generally do not influence the likelihood of inpatient readmission. For the lower middle class families included in this study, the estimated effect of aftercare is not statistically significant and has limited practical significance. When we look at specific forms of aftercare, we find that outpatient therapy has the largest effect and that stepdown services in intermediate settings have the smallest. We also identify family and individual characteristics that influence the likelihood of readmission.

Adolescent↗

PubMed2002

Neuropsychological and psychiatric outcomes following coronary surgery or angioplasty: a comparative study.

BACKGROUND: Medical outcomes following coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) are similar, but few studies have compared neuropsychological outcomes after these procedures. METHODS: A retrospective study compared detailed neurocognitive and psychosocial functioning in 32 patients (CABG, n = 16; PTCA, n = 16) aged 61 +/- 6 years, 9-15 months after coronary revascularisation. Subjects were tested for executive functioning, speed of processing/attention and learning/memory, significant psychopathology (General Health Questionnaire, GHQ) and psychosocial functioning (Short Form (SF)-36 health survey). In the prospective study, 55 patients completed GHQ and SF-36 surveys, the day prior to and 6 months following PTCA. RESULTS: There were no significant differences between the CABG and PTCA groups for neuropsychological or psychosocial end-points (P > 0.20). Executive functioning in both groups, however, was worse than for healthy population controls (P < 0.01). The PTCA patients were significantly more likely than CABG patients to have psychiatric abnormality (GHQ Score >4; P < 0.01). After PTCA, however, there was a significant improvement in the GHQ and SF-36 scores (P < 0.05). CONCLUSIONS: Although executive function is often impaired after coronary revascularisation, neuropsychological status appears equivalent after CABG or PTCA. Psychiatric pathology is common in patients undergoing PTCA, but improves after this intervention.

Journal Article↗

PubMed2005

Child health-related quality of life and household food security.

OBJECTIVE: To examine the association of household food insecurity with child self- or proxy-reported health-related quality of life (HRQOL). DESIGN: Cross-sectional telephone survey from January 1, 2000, through June 30, 2000. PARTICIPANTS: Three hundred ninety-nine children who live in 36 counties of the Delta region of Arkansas, Louisiana, and Mississippi. MAIN OUTCOME MEASURES: Household food insecurity status was measured using the US Household Food Security Scale. Child HRQOL was measured by the Pediatric Quality of Life Inventory, QL version 4.0. Analysis Summary statistics, linear and logistic regressions, incorporating survey weights, performed with SUDAAN version 8. RESULTS: Household food insecurity was significantly associated with total child HRQOL (P<.05) and physical function (P<.05), adjusted for child age, ethnicity, gender, and family income. Children aged 3 through 8 years in food insecure households were reported by parents to have lower physical function (P = .001), while children aged 12 through 17 years reported lower psychosocial function (P = .007). Black males in food insecure households reported lower physical function (P<.05) and lower total HRQOL (P<.05). CONCLUSIONS: Children who live in food insecure households have poorer HRQOL. The effect on physical or psychosocial function may differ by age, ethnicity, and gender. Food security should be considered an important risk factor for child health.

Adolescent↗

PubMed2003

Psychosocial aspects of functional gastrointestinal disorders.

Psychosocial factors, such as stress, abuse history, psychiatric disturbance, coping style, and learned illness behaviors, play an important role in functional GI disorders in terms of symptom experience and clinical outcome. These psychosocial factors are influenced by and influence GI symptoms in a bidirectional manner as mediated through the brain-gut axis (CNS and ENS pathways). Entering the patient encounter using a biopsychosocial approach and a care (versus cure) style can help avoid excessive diagnostic testing, and elicit crucial information about potential abuse history or psychiatric symptoms that can help guide therapy. Finally, for patients with severe, refractory symptoms, multicomponent treatment involving psychologic therapy, such as CBT, relaxation, or hypnotherapy, can be beneficial.

Attitude to Health↗

PubMed1994

Psychosocial stressors among depressed adolescent mothers.

This study sought to determine whether depressed adolescent mothers experience more psychosocial stressors than do nondepressed mothers and which stressors best predict maternal depression. Subjects consisted of 154 adolescent mothers 14 to 21 years of age who were recruited 1 to 3 days postpartum. The Beck Depression Inventory was used to assess severity of depression, and the Problem Oriented Screening Instrument for Teenagers was administered to assess mothers' level of psychosocial functioning. Depressed mothers consistently reported more problems in most areas of psychosocial functioning. Additionally, the best predictors of maternal depression were mental health status, family relations, and social skills.

Adolescent↗

PubMedDate not supplied

Long-term physical functioning and psychosocial adjustment in survivors of sudden cardiac death.

OBJECTIVE: To identify and describe a range of functional health outcomes in a sample of sudden cardiac death survivors. DESIGN: Cross-sectional survey. SETTING: Northern California tertiary medical center. SUBJECTS: Sixty-one sudden cardiac death survivors at least 6 months but not more than 4 years after cardiac arrest. Subjects were excluded if they had uncontrolled congestive heart failure, unstable angina, other debilitating cardiac or concomitant illness, or evident cognitive deficits. METHODS: Chart reviews, patient interviews, and a standardized questionnaire. RESULTS: Survivors reported significantly poorer physical functioning than normal subjects (p < 0.001), although none were limited in self-care. Mental Health Index Scores and subscale scores for psychologic well-being were within established norms. However, mean scores for the psychologic distress subscale were elevated (p < 0.001). Initial work return was 72%. Of the 37 (61%) survivors who were sexually active before their arrests, 78% resumed coitus. Twenty-five survivors reported mild to moderately severe impairments in memory or other cognitive skills. Poor physical functioning was associated with illness severity, change in work status, and increased anxiety. Psychologic distress was associated with change in work status and poor physical functioning, but not illness severity. CONCLUSIONS: Despite significant decreases in physical functioning and reports of mild to moderately severe cognitive impairments, only a minority of sudden cardiac death survivors are severely psychologically distressed. Illness severity is a strong predictor of physical functioning, but its contribution to psychologic distress is indirect, acting largely through the aegis of poor physical functioning and loss of prearrest work status.

Activities of Daily Living↗

PubMed1999

Behavioral and psychosocial profiles of alcohol-exposed children.

BACKGROUND: It is widely known that prenatal alcohol exposure is related to cognitive and behavioral deficits throughout childhood and adolescence. Much research has focused on understanding and quantifying the cognitive profile of children with fetal alcohol syndrome (FAS) with relatively less empirical research on behavioral or psychosocial adjustment. The primary purpose of this study was to examine the behavioral and psychosocial profile of children exposed to heavy amounts of alcohol prenatally. METHOD: Two groups of subjects were evaluated: an alcohol-exposed group (ALC) and a nonexposed control group (NC) each made up of 32 subjects matched for age, gender, and ethnicity. The alcohol-exposed group consisted of children heavily exposed to alcohol in utero, including 19 children diagnosed with FAS. The Personality Inventory for Children (PIC) was completed by the caretaker of each child. Four validity/screening scales and 12 clinical scales were scored for all subjects. RESULTS: Analyses revealed significant group differences on four validity/screening scales and 12 substantive scales. Within the ALC group, the profile of children without FAS was similar to that of children with FAS, with the exception that their profiles were consistent with less cognitive impairment. CONCLUSIONS: These findings indicate that in addition to previously reported cognitive impairments, heavy prenatal alcohol exposure is related to significant impairments in psychosocial functioning. Even children without alcohol-related physical anomalies suffer from impaired psychosocial functioning. Because impairments of this nature can interfere with functioning across multiple domains, effective early intervention programs should be considered for families of alcohol-exposed children. Furthermore, given the similarities of alcohol-exposed children with and without FAS, it is imperative to obtain prenatal alcohol exposure histories on all children experiencing cognitive or psychosocial deficits.

Adolescent↗

PubMed2004

Elderly participants of social and rehabilitative day centres.

As it develops, an ageing society has increased need of services that can promote the health and well-being of the elderly. Community-based day programmes are one kind of service intended to support elderly people with restricted function in their daily lives. There are several different forms of day programmes for the elderly in Sweden, but guidelines are vague about their aim and implementation and little is known about the persons using them. The aim of this study was to identify characteristics of the elderly people living in their own home who participated in social day centres in comparison with participants who attended a rehabilitative day centre. The focus was on perceived functioning and competence in daily life. Twelve social day centre participants and 12 rehabilitative day centre participants answered two questionnaires, the sickness impact profile (SIP) and occupational self-assessment (OSA). The results show that the majority of participants from both centres were elderly persons living alone who experienced severely restricted physical function. This demonstrates that the day centres serve the needs of a specific group of elderly people, namely, those with highly restricted functioning living on their own. A significant difference between the groups was that those who attended the social day centre perceived better psychosocial function than the group attending the rehabilitative centre. The fact that the social centre group had better psychosocial function than the other group, but yet had severely restricted physical function indicates that it is preferably the psychosocial well-being of elderly persons with restricted functioning that is possible to influence. This result implies that these centres serve as an important meeting place for elderly persons who would otherwise be isolated in their homes because of their physical restrictions. To fulfil this challenge, the day centres might need to accommodate a wider range of persons with restricted functioning.

Activities of Daily Living↗

PubMed2004

Fatigue in patients with chronic obstructive pulmonary disease.

BACKGROUND: Fatigue is a frequently occurring symptom in patients with chronic obstructive pulmonary disease (COPD). Despite this, relatively few studies have objectively assessed patients' perceptions of fatigue and the impact of perceived fatigue on their everyday lives. OBJECTIVE: The purpose of this study was to describe the prevalence, duration and severity of fatigue among patients with COPD and the impact of perceived fatigue on cognitive, physical and psychosocial functioning in comparison with controls. METHOD: The Fatigue Impact Scale, including physical, psychosocial and cognitive dimension and structured questions about the frequency, duration, and severity of fatigue was mailed to 44 outpatients with COPD and 88 randomly selected age- and sex-matched controls. In total 36 patients and 37 controls completed the questionnaire. RESULTS: Almost half of the patients (47.2%), reported fatigue every day during the preceding month compared with 13.5% of the control group (P < 0.001). The duration of fatigue was more than 6 hours in 52.7% of the patients and 44.4% reported that fatigue was either the worst or one of the worst symptoms they had, compared with 18.9% (P < 0.001) and 10.8% (P < 0.01) in the control group. The patients reported a significantly greater impact of fatigue on cognitive, physical and psychosocial functioning compared with the control group (P < 0.001). CONCLUSION: These findings indicate that fatigue is a highly prevalent symptom, which impacts on patients' functional condition and needs to be professionally assessed and managed.

Aged↗

PubMed2006

Comparative validity of seven scoring systems for the instrumental activities of daily living scale in rural elders.

Lawton and Brody's eight-item Instrumental Activities of Daily Living (IADL) scale is used often with elderly patients but scored in several different ways. We scored the IADL with seven popular procedures ranging from relatively simple to complex (Guttman scores, summed and Rasch scores from dichotomous, trichotomous, and polytomous items) in a sample of rural elders (N = 231). We compared the IADL scales' prediction of concurrent cognitive functioning, depressive symptoms, psychosocial functioning, and health care use (medications, outpatient visits, inpatient days). Validity coefficients ranged from small to large among outcome variables but were highly consistent across IADL scoring procedures. Consequently, researchers and clinicians may prefer to use simpler IADL scoring procedures with this population.

Activities of Daily Living↗

PubMed1988

Efficacy of cardiac rehabilitation services. With emphasis on patients after myocardial infarction.

During the 1970s, emphasis increased in clinical practice on early ambulation and exercise-based rehabilitation after myocardial infarction and other cardiac illnesses or procedures. This shift was based on the belief that exercise and improved conditioning would improve prognosis. We examine the evidence supporting this assertion. Most of the reports on cardiac rehabilitation are about patients who have coronary artery disease and a history of myocardial infarction. The review, therefore, is focused primarily on the patient who has had a myocardial infarction. Effects of cardiac rehabilitation, emphasizing exercise treatment and conditioning, are reviewed with regard to patient outcomes, including changes in functional (work) capacity, psychosocial functioning and health-related knowledge, risk factor modification, morbidity and mortality, and cardiac function. The safety of cardiac exercise programs is reviewed, and the use of telemetry monitoring is considered. We also discuss the role of cardiac rehabilitation in categories of patients other than those with myocardial infarction and the application of newer approaches to rehabilitation such as programs based in the patient's home.

Aged↗

PubMedDate not supplied

Psychosocial impairment and recurrence of major depression.

Major depressive disorder is often marked by multiple recurrences. Unfortunately, it is difficult to predict specifically which patients will suffer a recurrence. This study examined whether psychosocial impairment is a risk factor for recurrence. A total of 290 subjects with unipolar major depressive disorder according to Research Diagnostic Criteria (RDC) were prospectively followed for up to 15 years as part of the Collaborative Depression Study (CDS), a multicenter longitudinal observational study of the mood disorders. Follow-up data on course of illness and psychosocial functioning were collected with the Longitudinal Interval Follow-up Evaluation (LIFE). The association of psychosocial impairment with recurrence of major depression was examined with mixed-effects logistic regression. The mean (SD) score for psychosocial functioning during recovery from an episode of major depression was 9.0 (2.7), with a possible range of 4 (no impairment) to 20 (severe impairment). For euthymic subjects who recovered from an episode of major depression, elevated psychosocial impairment was significantly associated with subsequent recurrence of major depression, with an odds ratio of 1.12 (95% confidence interval [CI], 1.06 to 1.19). The odds ratio of 1.12 indicates that for each 1-point increase in the functional impairment score, the risk of recurrence increases by about 12%. In patients who have recovered from an episode of major depression, the presence of psychosocial impairment may help identify who is at increased risk of recurrence.

Adolescent↗

PubMed1990

Functional and psychosocial consequences of disease and experience of pain and exertion in a group of rheumatic patients considered for active training. Result of a survey in Bollnäs Medical District. I.

The purpose of this study was to select and describe a group of RA patients within a defined area who had, on clinical grounds, been considered for active training. The material consisted of 69 patients with classical or definite RA. It comprised half of the RA patients known to the clinic. The patients were assessed by means of a questionnaire, functional tests with rating of activity-induced pain, a cycling-test with rating of perceived exertion, and an interview by a psychologist. Subjective disease consequences were pain and stiffness. 38% of the patients never or seldom exercised. 72% wished to increase their activity but were prevented by pain. The functional tests indicated slow performance and considerable pain in activities of daily life. The interview disclosed above all, a low degree of self-confidence. Generalized pain and functional impairment correlated slightly with psychosocial factors. The results of the study indicate the need for active training as one strategy to alleviate pain and to maintain functional capacity in RA patients.

Adaptation, Psychological↗

PubMed2006

Responsiveness of the coronary revascularisation outcome questionnaire compared with the SF-36 and Seattle Angina Questionnaire.

We describe a comparison of the responsiveness of three validated instruments when used with patients undergoing coronary bypass surgery (CABG) and angioplasty (PTCA). Patients were randomly selected to receive the Coronary Revascularisation Outcome Questionnaire (CROQ), and either the Seattle Angina Questionnaire (SAQ), or the SF-36 before and 3 months after coronary revascularisation. At total of 199 patients (127 CABG, 72 PTCA) completed the CROQ; 55/72 CABG and 34/38 PTCA patients also completed the SAQ or SF-36, respectively. Effect sizes and standardised response means were calculated as change over the 3-month period for scales measuring similar constructs on each instrument. We used bootstrap estimation to derive 95% confidence intervals for differences in the responsiveness indices. For CABG, the CROQ demonstrated significantly greater change in psychosocial functioning than the SF-36, but less than the SAQ. For PTCA, the CROQ showed greater change for symptoms than the SAQ, but the SAQ was more responsive in terms of physical functioning; and the CROQ showed significantly greater change than the SF-36 for psychosocial functioning. There were no other significant differences between similar scales on the three instruments. In conclusion, the CROQ was as responsive as the disease-specific SAQ and more responsive than the generic SF-36.

Adult↗

PubMed2003

Functional impairment in children and adolescents with obsessive-compulsive disorder.

Although obsessive-compulsive disorder (OCD) is a chronic and oftentimes debilitating disorder, the specific impact of this illness on the psychosocial functioning of affected youngsters has not been systematically described. A total of 151 clinic-referred youngsters (mean age 11.8 years, 57% male, 83% Caucasian) with primary Diagnostic and Statistical Manual of Mental Disorders (fourth edition) OCD and a primary caretaker completed a checklist designed to assess the impact of OCD on school, social, and family functioning. The two most common OCD-related problems were concentrating on schoolwork and doing homework. Consistent with the heterogeneous nature of OCD, subjects exhibited a broad range of specific impairments. However, almost 90% of youngsters reported at least one significant OCD-related dysfunction, and close to half reported significant OCD-related problems at school, home, and socially. Parents were more likely to report significant impairments in home and school functioning than children. However, few systematic gender or age effects were noted. Impairment ratings were significantly correlated with clinician-generated measures of OCD severity. These results provide the most specific description to date of the adverse impact of OCD on child psychosocial functioning. Given the adverse developmental consequences of psychosocial dysfunction, treatment studies need to carefully track and address OCD-specific functional impairments in affected youngsters.

Adolescent↗

PubMed1984

Quality of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease.

Measures of quality of life were obtained on 985 patients with mild hypoxemia and chronic obstructive pulmonary disease (COPD). A subsample of 100 patients were also given extensive neuropsychological and personality tests. Mildly hypoxemic COPD patients showed impairment in quality-of-life activities. They showed less impairment in physical function, compared with previous studies on COPD patients with hypoxemia, but about equal impairment in psychosocial function and dysphoric mood. Nonrelated health changes in life do not seem to account for these findings. Degree of self-reported tension-anxiety was the single greatest predictor of both physical and psychosocial measures of quality of life. Level of exercise completed, forced expiratory volume in 1 s, and neuropsychological status were significantly related to physical limitations, but not psychosocial functioning. The Pao2 was not significantly related to quality-of-life measures in this patient group.

Adult↗

PubMedDate not supplied

Psychosocial outcome in patients with moderate to severe head injury: 2-year follow-up.

Psychosocial outcome and recovery of a group of 31 consecutive adult patients with moderate to severe head injuries were prospectively investigated over a 2-year period. A friend control group was used for comparison purposes. We conclude that moderate and severe head injuries have a significant long-term impact on psychosocial functioning. More specifically, although there is an increase over time in the number of subjects who resume former levels of activity, many moderate to severely head-injured people remain unable to work, support themselves financially, live independently and participate in pre-injury leisure activities at least up to 2 years post-injury. Initially, self-perceived limitations in everyday functioning are widespread, with physical functioning being of primary concern. Over time, there is improvement in both physical and psychosocial areas. However, in spite of improvement, difficulties in psychosocial functioning become dominant later due to greater improvement in the physical area. This study gives no evidence of general increase in emotional distress with increasing time since injury.

Activities of Daily Living↗

PubMed2004

Use of information about maternal distress and negative life events to facilitate identification of psychosocial problems in children.

BACKGROUND: Despite the availability of effective screening measures, primary care physicians fail to identify and manage many children with psychosocial problems. Physicians often have information about significant negative events in a child's life. The present study evaluated the potential utility of using information about negative life events to facilitate physician identification of children with psychosocial problems. METHODS: Negative life events, maternal distress and child psychosocial functioning measures were completed by 185 mothers of children, aged 4-12 years. Family physicians provided data about the children's psychosocial functioning. RESULTS: Mothers identified 15.1% (n = 28) of the children as having psychosocial problems. Physicians correctly identified 21% (n = 6) of these at-risk children. Physician use of negative life events would have led to the identification of 39.2% (n = 11) at-risk children. Information about maternal distress and negative life events would have resulted in an additional 18% (n = 5) of children identified by the physicians. Information about maternal distress alone would have resulted in an identification rate of 53.5% (n = 15). CONCLUSIONS: Using information about negative events in a child's life, physicians could improve their rate of identification of children with psychosocial problems. Children who have had more than two negative events in their lives are at increased risk for psychosocial problems.

Adult↗