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Results for “Psychosocial functioning”

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PubMed1998

Qualitative analysis of three case management programs.

Most investigations of case management service programs for people with severe mental illness lack detail about the specialized interventions employed, their key differences, and the changes they undergo over time. Qualitative data are presented which describe and compare three service approaches, and their relationship to quantitative outcomes from a cost-effectiveness study of the three models. The organization and functioning of the PACT Adaptation Model were most conductive to enhancing client psychosocial functioning and significantly reducing intensive mental health service costs. Outcomes for the Clinical Team and Intensive Broker Models were less consonant with the qualitative findings.

Adult↗

PubMed2002

The impact of a family empowerment intervention on juvenile offender heavy drinking: a latent growth model analysis.

We report the results of a growth model analysis of the impact of a Family Empowerment Intervention (FEI) on the heavy drinking over a 36-month follow-up period among youths processed at the Hillsborough County Juvenile Assessment Center. Families involved in the project were randomly assigned to either receive an Extended Services Intervention (ESI) or the FEI. Families in the ESI group received monthly phone contacts and, if indicated, referral information; FEI families received three one-hour, home-based meetings per week for approximately 10 weeks from a clinician-trained paraprofessional. By seeking to improve family functioning by empowering parents, it was hypothesized that target youths' behavior and psychosocial functioning would improve. Although the difference between FEI and ESI was not significant, the reported frequency of getting very high or drunk on alcohol declined more over time for FEI completers than FEI noncompleters. The results provide support for the impact of the FEI services.

Adolescent↗

PubMed1992

Relationship of scores on two personality measures: creativity and self-image.

This study investigated the relationship between self-image and creativity in late adolescence. The multidimensional Offer Self-image Questionnaire was used to assess self-image while the How Do You Think Inventory was used to measure creativity. The results were similar to investigations indicating superior socioemotional functioning among gifted adolescents. More creatively scoring subjects (n = 65) exhibited better psychosocial functioning on six of the eleven self-image dimensions measured than the less creatively scoring subjects (n = 69). Concomitant with their more heightened self-assurance was subjects' expressed greater confidence in social competence. The findings are contrary to the profile that depicts creative individuals as socially and emotionally deficient.

Adolescent↗

PubMed1990

A prospective comparison of neuropsychologic function in HIV-seropositive and seronegative methadone-maintained patients.

A prospective longitudinal study of neuropsychological and psychosocial functioning in a methadone-maintained population was initiated to test the hypothesis that cognitive impairments may be present early in the course of HIV infection, before the onset of other physical symptoms. A total of 220 methadone-clinic patients without evidence of HIV-related illnesses were given baseline psychological screening tests, as well as serological testing for HIV antibodies. At baseline, 83 (38%) had antibodies to HIV and 137 (62%) did not. On initial testing, controlling for race/ethnicity, age, sex and drug use, the seropositives were more cognitively impaired than the seronegatives. The differences were statistically significant for three subtests on univariate analysis: finger tapping (dominant), digit span (forward) and similarities. Ninety-one patients whose current serological status was known were given follow-up neuropsychological and psychosocial assessments after a mean interval of 7.4 months from baseline testing. At follow-up, seropositives continued to be more cognitively impaired than seronegatives, but there was no deterioration in the performance of the initial seropositives over the time interval.

Adaptation, Psychological↗

PubMed1998

[Complications in the treatment of angle class II division 1 malocclusion].

OBJECTIVE: This article describes a retrospective inventory of various categories of complications which occurred in a sample consecutively treated patients with Class II division 1 malocclusion. DESIGN: Retrospective, descriptive study. METHODS: Treatment was performed with a headgear-activator and a edgewise appliance. All patients originate from one orthodontic specialist office and were between 10 and 14 years of age during treatment. From the group of 600 patients 100 (n = 100) were randomly selected for the study. A standard form was used for the inventory of the complications. The complications were divided into 5 categories: dental, skeletal, functional, psychosocial and multiple (two or more complications). RESULTS: In the group of 100 patients no complications were found in 48 patients (48%); 52 patients showed complications (52%). From these 52 patients 29 showed one complication, 19 had 2 complications, 4 showed 3 complications. In total 79 complications occurred divided as follows: dental complications 23 (29.1%); skeletal complications 19 (24.1%); functional complications 15 (19.0%); psychosocial complications 22 (27.8%). CONCLUSION: Complications occur very frequently in the treatment of Angle Class II division 1 malocclusions. These complications may occur in various combinations and may compromise the treatment result in a variable way.

Adolescent↗

PubMed2006

A review of quality of life and psychosocial issues in scoliosis.

STUDY DESIGN: Recent literature regarding the psychological impact of scoliosis was reviewed. OBJECTIVE: To determine the impact of scoliosis on health-related quality of life (HRQL), psychosocial functioning, and body image to improve patient outcomes. SUMMARY OF BACKGROUND DATA: Adolescents and adults with adolescent idiopathic scoliosis have been known to score lower than healthy controls on HRQL measures. However, HRQL instruments may not adequately capture psychological distress experienced by patients. METHODS: Research papers concerning HRQL and psychosocial factors in patients with scoliosis were reviewed. RESULTS: Studies of psychosocial health and body image have revealed that functioning in these domains may affect compliance behavior and satisfaction with treatment outcomes among adolescent patients. Psychosocial and body image disturbance is less marked in patients with good social or family functioning, or patients who exercise regularly or are psychologically healthy. Adults with scoliosis generally display fewer psychological problems than adolescents. However, adults with scoliosis may experience psychosocial limitations due to poor physical health or body image disturbance. Support group membership can improve psychosocial health in adults with scoliosis. CONCLUSIONS: Adolescent patients with scoliosis may experience psychosocial difficulties, especially while undergoing treatment for scoliosis. Interventions aimed at managing psychosocial or body image disturbances may help to ameliorate the potentially negative impact of scoliosis on these facets of life.

Adolescent↗

PubMed2004

Burden of relatives and predictors of burden. Baseline results from the Munich 5-year-follow-up study on relatives of first hospitalized patients with schizophrenia or depression.

In the present study, part of the Munich 5-year follow-up study on key relatives of first-hospitalized schizophrenic and depressive patients, baseline results with respect to relatives' burden and predictors of burden are presented. Basing on a transactional stress model the following hypothesis was tested: the impact of the patients' illness on their relatives' stress outcome is moderated by the psychosocial resources of the relatives. Stress outcome was measured in terms of objective and subjective burden, well-being, self-rated symptoms and global satisfaction with life. Potential moderating variables included age and gender, generalized stress response and illness-related coping strategies, beliefs of control,perceived social support,personality factors, expressed emotion and life stressors. A total of 83 relatives, whose ill family members had been hospitalized in the Department of Psychiatry of the Ludwig-Maximilians-University of Munich for the first time, participated in the study. Findings did not entirely support the hypothesis. On the one hand, relatives' stress outcome was independent of the objective stressors (severity of the illness, kind of symptoms, level of psychosocial functioning at admission). On the other hand, burden was significantly associated with several psychosocial resources and dispositions of the relatives. Multivariate linear regression analyses indicated that expressed emotion, emotion-focused coping strategies and generalized negative stress response are the most relevant predictors of burden. It is argued that a multidimensional approach in burden assessment is necessary and has relevant implications for improving family intervention strategies.

Adaptation, Psychological↗

PubMed1987

Cancer patients' quality of life over the disease course: lessons from the real world.

We examined the correlates of the Quality of Life Index (QLI) in three samples of cancer patients: newly diagnosed (N = 397), recipients of chemotherapy (N = 194), and terminal (N = 2046). The relative importance of physical, emotional, social, and disease symptom characteristics in predicting the QLI was compared across samples. Despite differences in data collection approaches (telephone, personal interview, or paper and pencil) and differences in patient characteristics, the QLI was a robust construct with its central organizing principle being physical functioning. In all samples, functioning, symptoms, depression, and social support were significant predictors of the QLI, while age and cancer type were only minimally related. The QLI significantly differentiated between patients at different disease phases and measured more than physiological functioning. However analyses suggested that the dominant factor constraining the range of human psychosocial functioning was physical condition.

Aged↗

PubMed2004

The impact of parental cancer on children and the family: a review of the literature.

OBJECTIVE: Children of cancer patients may go through a distressing time. The aim of this review was to survey present knowledge on the impact of parental cancer on children and the family. DESIGN: Studies published between January 1980 and March 2004 addressing emotional, social, behavioural, cognitive and physical functioning of children of a parent diagnosed with cancer, as well as the association with child, parental and familial variables were reviewed. RESULTS: Fifty-two studies were found. Emotional problems in school-aged children (11 years) were reported in several qualitative studies, but in only one quantitative study. Quantitative and qualitative studies reported anxiety and depression in adolescents (12 years), in particular in adolescent daughters of ill mothers. Quantitative studies generally showed no behavioural and social problems in school-aged children and adolescents. One quantitative study found physical complaints in school-aged children. However, qualitative studies revealed behavioural problems in school-aged children and also described restrictions in cognitive and physical functioning in children of all ages. The most consistent variables related to child functioning appeared to be parental psychological functioning, marital satisfaction and family communication. Intervention studies directed to the needs of children and their families reported positive effects. CONCLUSION: While quantitative studies reported especially disturbed emotional functioning, qualitative studies reported problems in all domains of child functioning. Well-designed studies are needed to gain more insight into the psychosocial functioning of children of cancer patients in order to develop tailored care.

Adaptation, Psychological↗

PubMed2003

Long-term treatment goals: enhancing healthy outcomes.

The long-term management of schizophrenia with a goal of functional rehabilitation remains an enormous challenge to clinicians despite improvements in drug therapy, psychosocial treatments, and family and community interventions. The goals of long-term therapy are to preserve the gains made during acute treatment, prevent symptom exacerbation, enhance psychosocial functioning, and improve quality of life. Schizophrenia is an illness that disrupts broad areas of mental function, including thought, cognition, affect, and motor performance. The new antipsychotics should aid physicians in meeting higher treatment goals for persons with schizophrenia. These agents combine high efficacy with improved tolerability, mainly through a low liability for extrapyramidal symptoms and probably improve cognitive affect. Recent studies have demonstrated efficacy of these new antipsychotics in improving psychopathology and symptoms and in preventing relapse during long-term use. These drugs are likely to provide physicians with an increasingly viable option in the long-term treatment and rehabilitation of patients with schizophrenia.

Antipsychotic Agents↗

PubMed1984

Psychosocial problems among adults with epilepsy.

The psychosocial functioning of adults with epilepsy was evaluated by the administration of the Washington Psychosocial Seizure Inventory, which was given to five groups of patients across the United States. In four of the five samples, the results were indistinguishable from one another, with similar psychosocial problems suggested despite substantially different patient characteristics and referral sources. Emotional, interpersonal, vocational, and financial concerns were most commonly found, as well as difficulties in dealing with seizures. Persons in the fifth sample were selected somewhat differently; they had fewer vocational and financial problems, but were otherwise similar. The results have implications for the study of psychosocial problems in epilepsy and for the establishment of treatment programs.

Adolescent↗

PubMedDate not supplied

Cadaveric renal transplant failure: the short-term sequelae.

Quality of life was evaluated in 103 patients initially when each was placed on the waiting list for a cadaveric transplant. Patients who were not transplanted were reassessed six months after being placed on the waiting list. Patients who received a transplant were reassessed six months after the surgery. Cadaveric transplantation was performed in sixty-three patients by the time of follow-up. The mortality rate of 12.7 percent in transplanted patients after six months was more than twice that in patients who remained on the waiting list without a transplant, but this difference was not statistically significant. There was a graft failure rate of 23.6 percent among transplanted patients who survived six months. Graft failures were associated with some deterioration in subsequent physical activity (F = 5.4, p less than 0.03) but not in psychosocial functioning. Successful cadaveric transplants were associated with a marked and significant improvement in psychosocial well-being (F = 10.5, p less than 0.002) after six months even though physical activity did not increase. These findings suggest that 1) a successful cadaveric transplant is associated with an improved quality of life, 2) the graft failure rate of 23 percent with cadaveric transplantation is still appreciable but 3) graft failure is not necessarily associated in the short term with deterioration in psychosocial well-being.

Adolescent↗

PubMed2003

The development and validation of a neuropathy- and foot ulcer-specific quality of life instrument.

OBJECTIVE: The purpose of this study was to develop a questionnaire that measures patients' perceptions of the impact of diabetic peripheral neuropathy and foot ulcers on their quality of life and to assess the psychometric properties of this instrument in a sample of patients with varying severity and symptomatology of diabetic peripheral neuropathy. RESEARCH DESIGN AND METHODS: The neuropathy- and foot ulcer-specific quality of life instrument (NeuroQoL), generated from interviews with patients with (n = 47) and without (n = 15) diabetic peripheral neuropathy, was administered to 418 consecutive patients with diabetic peripheral neuropathy (35% with foot ulcer history) attending either U.K. (n = 290) or U.S. (n = 128) diabetes centers. Psychometric tests of NeuroQoL included factor analyses and internal consistency of scales; a series of multivariate analyses were performed to establish its criterion, construct, and incremental validity. Results were compared with those obtained using the Short Form (SF)-12 measure of health-related functioning. RESULTS: Factor analyses of NeuroQoL revealed three physical symptom measures and two psychosocial functioning measures with good reliability (alpha = 0.86-0.95). NeuroQoL was more strongly associated with measures of neuropathic severity than SF-12, more fully mediated the relationship of diabetic peripheral neuropathy with overall quality of life, and significantly increased explained variance in overall quality of life over SF-12. CONCLUSIONS: NeuroQoL reliably captures the key dimensions of the patients' experience of diabetic peripheral neuropathy and is a valid tool for studying the impact of neuropathy and foot ulceration on quality of life.

Aged↗

PubMed1999

[Interaction between breast cancer, psychosocial stress and the immune response].

Awareness of the interactive relation between psychosocial stressors, neuroendocrine and immunological processes, and tumour progression in patients with breast cancer appears to be important for clinicians. However, it is not established yet how the available knowledge can be applied therapeutically. Hormonal factors play a part in the carcinogenesis of breast cancer. Growth of the breast tumour is influenced by endocrine hormones. Antioestrogen therapy is effective in the treatment of breast cancer. Several components of the immune system are related to the course of disease in breast cancer patients. Psychosocial stressors influence neuroendocrine (corticotrophin-releasing hormone (CRH), cortisol, oestrogen) and immunological functions. Psychosocial stressors may be linked to recurrence or survival. Certain coping mechanisms (even those of a negative nature) and the social network of the patient may have prognostic values. Since recurrence of the disease is still possible many years after curative surgery, multifactorial effects on the course of disease are likely.

Adaptation, Psychological↗

PubMed2001

Exercise and multiple sclerosis: physiological, psychological, and quality of life issues.

The case for the benefits of physical activity has been well documented in healthy individuals, and the potential for reducing the risk of mental and physical ill health is substantial. Yet, individuals with multiple sclerosis (MS) have long been advised to avoid participation in exercise in order to minimise the risk of exacerbations and symptoms of fatigue. There is, however, increasing interest in how acute and chronic exercise affect physiological and psychological functioning in MS. Much of the research has examined physiological tolerance to exercise and focused on responses in terms of heart rate, blood pressure, cardiorespiratory fitness, muscle function, and symptom stability. Little research has focused on understanding how exercise affects psychosocial functioning and brings about changes in depression, affect, mood, well-being, and quality of life. This paper provides a summary of the research exploring the efficacy of physical activity for people with MS. In addition, the key issues that face clinical practice are examined, and considerations for research are discussed.

Autonomic Nervous System↗

PubMed1995

Practical functional assessment of elderly persons: a primary-care approach.

OBJECTIVE: To describe simple, practical measures of physical and psychosocial function to detect problems and enhance the care of elderly patients. DESIGN: We reviewed pertinent articles and current standard textbooks of geriatrics; the most useful findings are summarized, and tools that can be used for functional assessment of the geriatric population are presented. RESULTS: Care of elderly patients necessitates a comprehensive review of key areas of function. Using only clinical judgment, physicians may overlook important clinical deficits common in older patients. Because of their length and complexity, many of the standard geriatric assessment tools are impractical for use by primary-care physicians. Certain simplified or condensed versions--such as the Functional Reach Test and the "Get Up and Go" Test--are efficient substitutes. In this article, we describe methods for practical identification of functional impairments, assessment of cognition and mood, evaluation of hearing and vision, and detection of problems with continence, nutrition, and social needs. Instruments for assessment of caregiver burden are also outlined. CONCLUSION: Use of the assessment tools presented herein can assist primary-care physicians in comprehensive evaluation of function in older patients.

Aged↗

PubMed2001

Effectiveness of home treatment in children and adolescents with externalizing psychiatric disorders.

OBJECTIVE: The study examines effectiveness of home treatment in children and adolescents with severe externalizing behavior disorders. METHODS: Fifty patients with ICD-10 diagnosis F90, F91, or F92 aged 5-16 years were treated in a home treatment setting for 3.5 months. Assessments were made using multiple informants (patients, parents, therapists, supervisors, and clinicians not involved in the treatment) to evaluate psychiatric symptoms, various aspects of psychosocial functioning, and global treatment outcome. RESULTS AND CONCLUSIONS: Findings showed a significant decrease in psychiatric symptoms and improvement in psychosocial adjustment. Positive treatment effects were seen in almost every area of social functioning. The child's compliance and the therapist's professionalism were found to be the most important predictors of treatment outcome. Findings suggest that extent of achieved home treatment effects in externalizing disorders is similar to that in internalizing disorders.

Adolescent↗

PubMed1988

Late effects of antileukemic treatment.

Increasing numbers of childhood ALL survivors have increased the need to assess the physical and psychosocial functioning of this group in a careful manner. This article reviews data on the frequency and types of second malignancies, structural and functional changes in the central nervous system, endocrine effects on growth and reproduction, and psychosocial aspects of development. Most long-term survivors of ALL do not have serious or life-threatening medical problems; however, medical and psychosocial problems may not be insignificant and may require coordinated management over prolonged periods.

Antineoplastic Agents↗