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Results for “Generalization, Psychological”

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At least 613 records · Page 34Linked to original sources

PubMed2000

The effect of testosterone on health-related quality of life in elderly males - a pilot study.

OBJECTIVE: To assess the effect of short-term testosterone supplementation on health-related quality of life in elderly males. METHOD: As part of a double-blind, placebo-controlled study, healthy males > or = 65-year-old were randomised to receive a total of four doses of 200 mg testosterone enanthanate (n = 14) or placebo (n = 8) intramuscularly every 2 weeks. Health-related quality of life (HRQOL) was assessed using the Short Form 36-item (SF-36) and Psychological General Well-Being (PGWB) scales, at baseline, week 8 and during therapy withdrawal, 6 weeks after the last dose. RESULTS: The baseline SF-36 scores were similar between the groups in seven domains; only vitality was significantly lower in the placebo group (T: 80.4, P: 65.6; P = 0.007). After the 8-week treatment period and withdrawal phase, SF-36 scores were not significantly different between the groups. The PGWB scores at baseline, on treatment and off treatment were not significantly different between the groups. Moreover, the SF-36 and PGWB scores within each group did not change significantly over time. CONCLUSION: This pilot study suggests that intramuscular testosterone, administered at a dose of 200 mg every 2 weeks, does not affect the HRQOL of elderly males.

Aged↗

PubMed2001

The impact of mastectomy, breast-conserving treatment and immediate breast reconstruction on the quality of life of Chinese women.

BACKGROUND: The psychosocial impact of breast surgery has been extensively studied in the Western population. There is a relative paucity of comparable data in Oriental women who are increasingly affected by cancer of the breast. The present study investigates the effects that different types of breast surgery have on the quality of life of Chinese women. METHODS: Forty-nine Chinese women with early breast cancer were interviewed at 6 months-2 years following their primary surgery (breast-conserving treatment (BCT, 17 patients), mastectomy (15 patients) and mastectomy with immediate breast reconstruction (17 patients)). Aspects of quality of life measured included general psychological well-being, body image, sexual functioning and social functioning. RESULTS: Patients who received BCT had significantly better body image scores compared to mastectomy patients. They were less worried about their appearance, had more freedom in the choice of clothing, felt less upset by the change in their body and felt more accepted by their partners. The three groups did not differ significantly in the other aspects of quality of life measured. CONCLUSIONS: Compared to mastectomy or mastectomy and immediate breast reconstruction, the most significant benefit of BCT is the preservation of a better body image.

Adult↗

PubMed2004

Quality of life in hereditary neuromuscular diseases.

OBJECTIVE: The aim of the study is to evaluate different aspects in the quality of life (QoL) in a group of patients affected by hereditary neuromuscular disease. MATERIAL AND METHODS: Forty-five consecutive outpatients (mean age 49.46 +/- 17.07 years, range 19-80 years) with hereditary neuromuscular disease underwent the Brooke scale and functional independent measure to assess the functional status, the Sickness Impact Profile (SIP) and Psychological General Well-Being Index (PGWBI), as a measure of the QoL. RESULTS AND CONCLUSIONS: All patients had a poor QoL assessment with SIP. The higher disability level was not related to a worse QoL perception with the exception of the physical area. Females and patients above 49 years showed the worst QoL profile. The discomfort linked to the emotional and affective sphere, assessed with PGWBI, appeared low in the study sample. Therefore psychosocial aspects and economical and environmental factors may influence the QoL.

Adult↗

PubMed2000

Rehabilitation of patients with chronic obstructive pulmonary disease. Exercise twice a week is not sufficient!

Several studies of chronic obstructive pulmonary disease (COPD) have shown that pulmonary rehabilitation, consisting of at least three training sessions a week, improves exercise performance and health status. This study investigates feasibility, effect and economic aspects of a rehabilitation programme consisting of two sessions a week for 8 weeks. Twenty-four patients with moderate COPD were randomized to rehabilitation and 21 to placebo. Patients were assigned to an 8-week programme of exercise plus education (Exercise group) or conventional community care (Placebo group). The rehabilitation program was carried out in a hospital outpatient setting and consisted of 16 h exercise and 13.5 h of education. The exercise group received physiotherapy and education twice a week. Seven patients did not complete the programme. The characteristics of the 38 COPD-patients at baseline were the following: (mean +/- SD) forced expiratory volume in 1 sec (FEV1) 1.1+/-0.4 1 (47% of predicted), 6-min walking distance (6MWD) 413+/-75 m, score of St. George's Respiratory Questionnaire (SGRQ) 44+/-21. Health-status, assessed by SGRQ and The Psychological General Well-being (PGWB) Index, did not improve. Rehabilitation resulted in an insignificant improvement in the 6MWD [29 m (95% confidence interval: -8 -66 m)]. We conclude that a rehabilitation program consisting of exercise and education twice a week for 8 weeks had no effect on exercise performance and well being in patients with moderate COPD.

Ambulatory Care↗

PubMed2002

[Effects of sociomedical risk factors on the progression of ovarian cancer].

INTRODUCTION: The potential prognostic influence of sociomedical risk factors probably on ovarian cancer patient prognosis has yet not been intensively investigated. This study was to determine whether the general psychologic constitution has an influence on patient survival after primäry surgery and in how far it correlates to sociobiologic factors. METHOD: 695 long-term followed ovarian carcinoma patients were studied. The median follow-up was 4.8 years with a range of 63 days to 18.7 years. Tumor-associated death was recorded in 219 patients. The prognostic influence of sociomedical risk factor was determined by age and stage corrected survival analysis. RESULTS: The variables "genetic or hereditary risk", "hormone replacement therapy" and "use of tobacco or alcohol" had no significant influence on survival. However, the variables "psychic disorders" and "parity" were found to be of strong prognostic influence, alone and in combination. Patients showing psychic disorders had a clearly worse prognosis (p < 0,001), as well as those of higher parity (p < 0,001). DISCUSSION: This newly described link between patients' psychological constitution and course of disease suggests psychotherapeutic support to be helpful for ovarian carcinoma patients. Risk factors, furthermore, may have an opposite effect on both cancer incidence and prognosis. The latter is discussed on the background of an ovarian carcinogenesis threshold model.

Female↗

PubMed1980

[The concept of "drive" in German psychiatry (author's transl)].

Subject of this paper is the attempt to five a survey of the concept of "drive". Some approaches to a better understanding of drive are described: a general psychological way, a phenomenological-psychopathological way, a psychoanalytical way and a neurophysiological-neuropsychological way. The problem is discussed to seize the phenomenon of drive as a whole in contrast to the postulated numerous drives. Some clinical aspects are outlined. Finally, the suggestion is discussed to leave global characteristics as "drive" and better try--also in a clinical point of view--an exact recording in men of the drives as single phenomenons.

Drive↗

PubMed1998

Preoperative left-ventricular ejection fraction does not influence the improvement in quality of life after coronary artery bypass surgery.

Coronary artery bypass grafting (CABG) is an established treatment for angina pectoris which conveys relief of chest pain and improved physical performance. However, increased survival has only been observed in selected subgroups of patients with advanced coronary artery disease, particularly in the presence of depressed left-ventricular ejection fraction (LVEF). It is therefore of interest to study whether the outcome in terms of quality of life (QoL) is also more favorable in candidates with depressed LVEF. All patients who underwent CABG without concomitant valve surgery in western Sweden between 6.1988 and 6.1991 (n = 2121) were sent questionnaires on QoL involving 3 different instruments, the Physical Activity Score, the Nottingham Health Profile, and the Psychological General Well-being Index. They were submitted before surgery and 3 times in the 2 years thereafter. QoL was improved on all postoperative occasions. The degree of improvement was not associated with preoperative LVEF for any of the instruments. The postoperative Physical Activity Score was associated with preoperative LVEF. The other instruments showed no such association with LVEF. The improvement in QoL during 2 years after CABG is not dependent on the LVEF determined prior to operation. Self-estimated physical abilities are postoperatively associated with preoperative LVEF whereas health-related QoL and general well-being are not.

Aged↗

PubMed2006

Are people with high and low mental rotation abilities differently susceptible to the alignment effect?

We investigated whether the alignment effect (Levine et al, 1982 Journal of Experimental Psychology: General 111 157-175) is influenced by mental rotation abilities. In two experiments, groups of undergraduate students with high and low performance in mental rotation tasks were required to study either schematic (experiment 1) or more complex (experiment 2) maps, and to perform a number of pointing tasks adopting a perspective which could be aligned, misaligned (45 degrees, 135 degrees), or counteraligned (180 degrees) with the perspective assumed during learning. Cognitive styles in spatial representation have also been considered. Results of experiment 1 show that people with low performance in mental rotation tasks prefer to adopt a representation of space focused more on landmarks. Their performance in the pointing tasks depends on the alignment conditions, with more errors in the counteraligned condition followed by the two misaligned and aligned ones. In contrast to this, high-ability mental rotators prefer survey and route spatial representations and are affected only by the aligned and non-aligned conditions. In the second experiment, practice was studied as a function of mental rotation and alignment. The group high in mental rotation ability was found to be free from the alignment effect in the pointing tasks performed after the final of four learning phases.

Cognition↗

PubMed2001

Different methods for evaluating daytime tiredness in snoring men.

Many snorers complain of daytime tiredness and reduced mental energy. In 42 middle-aged snoring men, the results of sections relating to mental energy in 2 quality-of-life instruments, energy in the Nottingham Health Profile (NHP) and vitality in the Psychological General Well-Being (PGWB) questionnaire, were compared with those of population samples. The snorers were significantly more tired than the population samples (p < 0.001). The scores for the NHP and PGWB were then correlated with a visual analogue scale (VAS) of drowsiness. The correlation coefficient between NHP (energy) and the corresponding VAS value was r = 0.52 (p < 0.001). The correlation coefficient between PGWB (vitality) and the VAS value for drowsiness was r = -0.56 (p <0.001). When nasal breathing was improved with the use of the Nozovent nostril dilator at night for 1 month, NHP (energy) and the VAS value for drowsiness improved significantly (p < 0.001). A single VAS value for drowsiness is a good instrument for evaluating daytime tiredness and for measuring the clinical effect of treatment in snorers.

Adult↗

PubMed1993

Factors affecting group therapy outcome for adult sexual abuse survivors.

Adult female sexual abuse survivors (N = 148) participated in year-long therapy groups. Demographic, abuse history, initial symptomatology, and group process variables were examined in relationship to group completion and improvement over time. Survivors who had previously been psychiatrically hospitalized were less likely to complete group treatment. Among group completers, significant pretreatment-posttreatment changes were found on measures of locus of control, sexual problems, self-esteem, trauma-related symptomatology (TSC-33), and general psychological distress (SCL-90-R). Greater changes on the SCL-90-R were found among Caucasian women, women with more initial trauma-related symptomatology, women whose abuse included intercourse, members of groups with similar abuse histories, and women with previous psychotherapy experience.

Adolescent↗

PubMed1985

The effect of previous experience on preference of approach for effective counseling.

Students in a general psychology class viewed four videotapes of initial vocational-educational and initial personal concern counseling sessions. The sessions were presented from a client-centered approach and from a behavioral approach, and employed the same client and counselor. After viewing the tapes, the students were asked to indicate which approach they thought would be more effective in helping a client. Results showed that students who had previously experienced counseling preferred a behavioral approach for both the vocational-educational concern and the personal concern. Students with no experience of counseling did not exhibit a preference.

Adult↗

PubMed2000

Impact of age on improvement in health-related quality of life 5 years after coronary artery bypass grafting.

The aim of this study was to describe the relief of symptoms and improvement in other aspects of health-related quality of life 5 years after coronary artery by-pass grafting in relation to age. Patients in western Sweden were approached with an inquiry prior to surgery and 5 years after the operation. Health-related quality of life was estimated with 3 different instruments: Physical Activity Score (PAS), Nottingham Health Profile (NHP), Psychological General Well-Being Index (PGWB). Prior to surgery patients were approached either in the ward or by post and 5 years after surgery they were approached by post. A total of 1719 patients were available for the survey, of whom 876 (51%) responded to the survey both prior to and after 5 years. Among the 876 respondents 287 were <60 years, 331 were 60-67 years and 258 were >67 years. In terms of physical activity, chest pain and dyspnoea, a similar improvement was observed regardless of age. In terms of health-related quality of life questionnaires, there was an inverse association between age and improvement when using PAS and a similar trend was observed with NHP and PGWB. In conclusion, 5 years after coronary artery bypass grafting relief of symptoms and improvement in physical activity was not associated with age, whereas improvement in other aspects of health-related quality of life tended to be less marked in elderly people. Overall age seemed to have a small impact on the improved well-being 5 years after coronary surgery. However, due to the limited response rate the results may not be applicable to a non-selected coronary artery bypass grafting population.

Age Factors↗

PubMed1998

An evaluation of multidisciplinary intervention governed by functional independence measure (FIMSM) in incontinent stroke patients.

Patients with acute hemispheric stroke and ensuring urinary incontinence were randomly allocated to a ward using conventional methods of rehabilitation (n = 13) or to a ward practicing rehabilitation governed by Functional Independence Measure (FIM) (n = 21). All patients were assessed on admission and on discharge using the Katz activities of daily living (ADL) index, the psychological general well-being index, item G of the FIM index (FIM-G), and a mobility score. Patients admitted to the ward utilizing FIM were additionally evaluated using the total FIM on admission, repeatedly during the rehabilitation period and on discharge. An individual rehabilitation programme based on the latest FIM score was used throughout rehabilitation. There were no differences on admission between groups regarding clinical and demographic characteristics, ADL, mobility and mood. Twenty patients in the intervention group regained continence before discharge compared to 3 (p < 0.01) in the control group. There was also a greater improvement in well-being in the intervention group compared to the control group (p < 0.01). This study has indicated that rehabilitation governed by the use of FIM reduced urinary incontinence and enhanced well-being better than conventional methods of rehabilitation. The results warrant a larger study to further investigate rehabilitation of incontinent stroke patients using FIM.

Activities of Daily Living↗

PubMed2001

Validation of the inflammatory bowel disease questionnaire in Swedish patients with ulcerative colitis.

BACKGROUND: The Inflammatory Bowel Disease Questionnaire (IBDQ) is a disease-specific health-related quality of life (HRQOL) questionnaire including four dimensions and a sum score. The aim of this study was to assess the internal and external validity, reliability, and sensitivity of a Swedish version of the IBDQ. METHODS: Three hundred consecutive patients with ulcerative colitis completed the IBDQ and three other health-related quality of life questionnaires (the Rating Form of IBD Patient Concerns (RFIPC), the Short Form-36 (SF-36) and the Psychological General Well-Being (PGWB) index). Disease activity was evaluated using a 1-week symptom diary, blood tests and rigid sigmoidoscopy. One hundred and fourteen patients filled in the questionnaire a second time, of whom 75 had been in stable remission for over 6 months and 39 had a significant clinical change in disease activity. RESULTS: Factor analysis of the 32 IBDQ items did not support the four dimensional scores. The dimensional scores had sufficient convergent validity, but low discriminative validity and homogeneity. The homogeneity was also low for the sum score. The inter-dimensional correlations were high. The concurrent validity was supported by correlations between the dimensional scores and other measures of disease activity and HRQOL. Patients in relapse scored significantly less on the sum score and the four dimensions compared to patients in remission. The test-retest correlations for the dimensional scores were 0.40-0.76. Patients with a change in disease activity during the 6-month follow-up period had a significant change in IBDQ scores not found in those who remained in remission. CONCLUSIONS: The Swedish version of the IBDQ had external validity and was shown to be a reliable and sensitive measure of HRQOL in ulcerative colitis, though there are some concerns regarding the internal validity. The use of a sum score was not supported and the questionnaire may benefit from a redivision of items into dimensions with better homogeneity and discriminative validity.

Colitis, Ulcerative↗

PubMed2004

Effect of an oats-containing gluten-free diet on symptoms and quality of life in coeliac disease. A randomized study.

BACKGROUND: Evidence suggests the acceptability of oats in a gluten-free diet in coeliac disease. We investigated the impact of an oats-containing diet on quality of life and gastrointestinal symptoms. METHODS: Thirty-nine coeliac disease patients on a gluten-free diet were randomized to take either 50 g of oats-containing gluten-free products daily or to continue without oats for 1 year. Quality of life was assessed using the Psychological General Well-Being questionnaire and gastrointestinal symptoms using the Gastrointestinal Symptom Rating Scale. Small-bowel mucosal villous architecture, CD3+, alphabeta+, gammadelta+ intraepithelial lymphocytes, serum endomysial and tissue transglutaminase antibodies were investigated. RESULTS: Twenty-three subjects were randomized to the oats-containing diet and 16 to the traditional gluten-free diet. All adhered strictly to their respective diet. Quality of life did not differ between the groups. In general, there were more gastrointestinal symptoms in the oats-consuming group. Patients taking oats suffered significantly more often from diarrhoea, but there was a simultaneous trend towards a more severe average constipation symptom score. The villous structure did not differ between the groups, but the density of intraepithelial lymphocytes was slightly but significantly higher in the oats group. The severity of symptoms was not dependent on the degree of inflammation. Antibody levels did not increase during the study period. CONCLUSION: The oats-containing gluten-free diet caused more intestinal symptoms than the traditional diet. Mucosal integrity was not disturbed, but more inflammation was evident in the oats group. Oats provide an alternative in the gluten-free diet, but coeliac patients should be aware of the possible increase in intestinal symptoms.

Adult↗

PubMed2004

Does the 'test-and-treat' strategy work in primary health care for management of uninvestigated dyspepsia? A prospective two-year follow-up study of 1552 patients.

BACKGROUND: Although the 'test-and-treat' strategy is suggested as first-line therapy for uninvestigated dyspepsia, no large-scale studies in a real-life setting are available. METHODS: 1552 dyspeptic patients aged between 25 and 60 with no alarm symptoms were recruited to the study. After screening with a 13C-urea breath test, they were randomized into three treatment arms: Helicobacter pylori-positive either to eradication therapy with OAM (omeprazole, amoxycillin and metronidazole) (Hp+/erad) or omeprazole 20 mg daily (Hp+/ome) for 10 days, whereas H. pylori-negative patients (Hp-/ome) were treated with 20 mg omeprazole for 10 days. Gastrointestinal symptoms were registered at baseline at 1 and 2 years on the Gastrointestinal Symptom Rating Scale (GSRS) and quality of life with the Psychological General Well-Being index (PGWB). Additional visits, referrals for and number of endoscopies and their findings were registered during the 2 years' follow-up. RESULTS: Of the 1552 patients, 583 were H. pylori-positive (37.6%), and 288 of these were randomized for omeprazole and 295 to OAM. The Hp-/ome group had fewer general practitioner (GP) contacts (P<0.0001) than the H. pylori-positive groups. Eradication therapy significantly improved general well-being and reduced upper gastrointestinal symptoms: abdominal pain (P=0.0001), heartburn (P=0.0061), acid regurgitation (P=0.003), hunger pain (P=0.009), especially in Hp+/erad. Peptic ulcer was found in 6.2%, 1.0%, 0.2% in Hp+/ome, Hp-+/erad and Hp-/ome, respectively (P=0.0007). Only 3 patients (1.0%) developed peptic ulcers in Hp-+/erad, all eradication failures. CONCLUSIONS: In uninvestigated dyspepsia, a negative test result for H. pylori reduces the number of GP contacts and endoscopy referrals compared to H. pylori-positive regardless of eradication therapy. Applied in real life, the test-and-treat strategy failed to reduce the number of endoscopies, but significantly reduced peptic ulcer disease and improved dyspeptic symptoms and quality of life.

Adult↗

PubMed2006

Psychological factors as a predictor of treatment response in patients with heartburn: a pooled analysis of clinical trials.

OBJECTIVE: A pooled analysis, using data from three prospective, randomized, double-blind, placebo-controlled, clinical studies, was undertaken to determine the relationship between well-being and subsequent clinical response to acid suppressant therapy in 1887 adult patients with reflux symptoms (with/without endoscopically verified erosive esophagitis). MATERIAL AND METHODS: Well-being was assessed at study entry using the Psychological General Well-Being (PGWB) Index. Patients were assessed for complete relief of heartburn (absence of symptoms in the preceding 7 days) after 4 weeks' treatment (omeprazole 10 or 20 mg once daily; ranitidine 150 mg twice daily). RESULTS: Multiple logistic regression analysis identified baseline PGWB Index total score and anxiety score as independent prognostic indicators of treatment response in endoscopy-positive patients (n=1333). Thus, the likelihood of achieving complete heartburn relief was impaired by high baseline levels of anxiety or a low total well-being score. In the endoscopy-negative group, high levels of depression and low vitality scores affected treatment response adversely. Furthermore, age (for endoscopy-positive patients only) and body mass index (for endoscopy-negative patients only) showed an association with treatment outcome. Gender seemed to have no prognostic value on treatment outcome. CONCLUSIONS: Patient well-being may be a useful prognostic indicator in patients presenting with reflux symptoms, with a high level of anxiety predicating against a response to acid suppressant therapy, particularly in those with normal endoscopic findings.

Adolescent↗

PubMed2006

Evaluation of the Inflammatory Bowel Disease Questionnaire in Swedish patients with Crohn's disease.

OBJECTIVE: Health-related quality of life (HRQoL) is an important measure of inflammatory bowel disease (IBD) health outcome. The Inflammatory Bowel Disease Questionnaire (IBDQ) comprising 32 items grouped into four dimensions is a widely used IBD-specific HRQoL instrument. The purpose of this study was to evaluate the validity, reliability and responsiveness of the Swedish translation of the IBDQ in patients with Crohn's disease (CD). MATERIAL AND METHODS: Four hundred and forty-eight patients with CD completed the IBDQ and three other HRQoL questionnaires (Rating Form of IBD Patient Concerns; Short Form-36; and the Psychological General Well-Being Index) in connection with their regular visit at the outpatient clinic. Disease activity was assessed by the physician on a 4-point Likert scale. Thirty-two patients who were stable in remission completed the questionnaires a second time, 4 weeks later. A total of 418 patients repeated all measurements after 6 months. RESULTS: The dimensional scores were highly correlated with other measures of corresponding aspects of HRQoL and were significantly better in remission than in relapse. High test-retest correlations indicated good reliability. Responsiveness was confirmed in patients whose disease activity changed over time. However, high correlations between the dimensions, poor correlations between items within each dimension, and factor analysis all indicated that the original grouping of the items is not valid for Swedish CD patients. CONCLUSIONS: Although the Swedish IBDQ has good external validity, reliability and responsiveness for patients with CD, our results did not support the original grouping of the items.

Adult↗