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Results for “Psychosocial functioning”

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PubMed1987

Anxiety disorders: a long-term prospective and retrospective follow-up study of former inpatients suffering from an anxiety neurosis or phobia.

Psychopathological status and psychosocial functioning of 40 former inpatients suffering from an anxiety neurosis (ICD 300.0) or phobia (ICD 300.2) were followed up over a period of 6-8 years using standardized instruments. In addition, the course of illness, the utilization of medical services and the periods of work disabilities were assessed. With regard to psychopathology, in more than half of the patients course and outcome could be regarded as chronic and severe; only one third of the patients were free of marked or severe psychopathological symptoms during the 12 months preceding the reexamination. Although on the psychosocial outcome level 67% of the 40 former inpatients showed marked or severe difficulties in most social role areas, especially in the field of personal interaction, the great majority of these patients seemed to have adapted somehow to their life situations. Only 13% could be regarded as severely impaired and in continuous need of supervision and guidance. Coping difficulties with everyday demands and dissatisfaction with their social functioning and their anxiety-related restrictions were most prominent in all anxious patients. In contrast to some other long-term follow-up studies, most of which were carried out on outpatients, the results suggest a rather unfavourable course and outcome of anxiety disorders.

Adolescent↗

PubMed2007

Physical medicine rehabilitation approach to pain.

A physical medicine and rehabilitation approach to acute and chronic pain syndromes includes a wide spectrum of treatment focus. Whether assessing or treating acute or chronic pain syndromes, management should include a biopsychosocial approach. Assessment may include a focused joint and functional examination including more global areas of impairment (ie, gait, balance, and endurance) and disability. More complicated multidimensional chronic pain conditions may require the use of a more collaborative continuum of multidisciplinary and interdisciplinary treatment approaches. Regardless of the scope of care that each individual patient requires, treatment options may include active physical therapy, rational polypharmacy, CBT, and the use of passive modalities. Treatment goals generally emphasize achieving analgesia, improving psychosocial functioning, and reintegration of recreational or leisure pursuits (ie, community activities and sports). Progress in all therapies necessitates close monitoring by the health care provider and necessitates ongoing communication between members of the treatment team. Although this article focuses on diagnoses related to acute and chronic low back pain, OA, and musculoskeletal disorders, assessment and treatment recommendations may be generalized to most other pain conditions.

Humans↗

PubMedDate not supplied

Impact of illness scale: reliability, validity, and cross-cultural utility.

We report on the development of a brief (nine-item) Impact of Illness Scale (IIS), which measures the degree that an illness is perceived to restrict psychosocial functioning. The measure is shown to have high internal consistency in a variety of samples. Its construct validity is indicated by correlations with other scales measuring general functioning in samples affected by illness. There is little variation in correlations between the IIS and other measures across a number of groups from different language and cultural backgrounds. This, together with the finding that items retain their psychometric properties when used to make general ratings of mental disorders, suggests that the content of the IIS is valid. The results suggest the IIS is a reliable and valid measure of psychosocial impact of illness that may be applicable in a wide range of sociocultural settings.

Activities of Daily Living↗

PubMed1997

Prospective study of clinical and social outcome of stay in small group homes for people with mental illness.

BACKGROUND: Small group homes operating according to the principles of supported housing have, during the past five years, become a cornerstone of the housing services for the long-term mentally ill in Copenhagen. METHOD: During a 2.5-year period, 47 long-term mentally ill persons were examined at the time of entry to a group home programme. Residents' psychopathology, social integration, mastery and quality of life were measured by structured interviews, including the Present State Examination (PSE-10); and their social functioning was recorded by interview with the staff. Forty-four of the residents were re-examined at follow-up after a mean of 1.1 years using the same instruments. Data on hospitalisation were obtained through the Danish Psychiatric Case Register. RESULTS: Eighty-three per cent of the residents remained in the programme during the first year. They showed a significant improvement in subjective quality of life, PSE total score, social integration, functioning and hospitalisation index. The number of reciprocal supportive contacts in the social network increased. Lower baseline PSE total score was associated with adherence to the programme, and the improvement in quality of life during their stay was predicted by reduction in symptoms and improvement in social integration. CONCLUSIONS: A rehabilitation strategy of supplementing standard psychiatric treatment with a programme of small supportive group homes improves the quality of life, psychosocial functioning and community tenure of the long-term mentally ill.

Adult↗

PubMed2002

Intervention to improve psychological functioning for newly diagnosed patients with cancer.

PURPOSE/OBJECTIVES: To test the effects of a computer-based nursing intervention designed to provide patients and family caregivers with concrete, objective information on symptom management; provide education about disease and treatment; coordinate medical resources; and provide emotional support and counseling. DESIGN: Two-site, randomized clinical trial. SETTINGS: A large, urban, midwestern, tertiary-cancer center and a community-based cancer center in a medium-sized midwestern city. SAMPLE: 109 patients newly diagnosed with breast, colon, or lung cancer who were receiving chemotherapy; 54 received standard care, and 55 participated in the intervention group. METHODS: Outcome data were collected via structured telephone interviews at three time points: baseline, midway through the intervention, and one month postintervention. The intervention consisting of nine visits, five in person and four by telephone, was conducted over 18 weeks by advanced practice oncology nurses. MAIN RESEARCH VARIABLES: Psychosocial functioning, anxiety, and depression. FINDINGS: Patients who received the intervention had significantly less depression between baseline and the midway point, as well as less anxiety and greater improvement in the role-emotional and mental health subscales of the Medical Outcomes Study 36 Short Form. CONCLUSIONS: Cancer-care nursing interventions can decrease psychosocial morbidity and improve quality of life for newly diagnosed patients with cancer undergoing treatment. Additional research is needed to understand who benefited most from the intervention. IMPLICATIONS FOR NURSING: This nurse-directed intervention resulted in improved mental health for patients; however, physical subscales were not changed. Further work is needed to determine why depression and mental health were affected yet physical health and symptoms did not differ between groups. Results support the important role of nurses in addressing mental health issues in patients and families experiencing cancer.

Adult↗

PubMed1997

Being a stroke patient: a review of the literature.

The purpose of this paper is to review the research literature on the patient's experience of stroke. Four qualitative studies on how patients experience stroke were identified. The findings of these studies show that the stroke patient often has clear goals for himself in relation to functional abilities, against which he measures all success and forward progress in his rehabilitation. Even though the stroke patient accepts a lower level of functional ability, he is not willing to accept the rehabilitation professionals' prediction of his ultimate functional level if it is lower than his own goal. Furthermore, stroke patients see recovery as a return to the existence they had lived before the stroke, which is different from the health care providers' view. To the health care provider, recovery is measured in terms of isolated and discrete return of movement, whereas in the eyes of the patients, recovery is a return to previously valued activities. Further, studies on psychosocial function after stroke were reviewed. Recent studies show that the psychological impact of the stroke experience is immense and that stroke patients experience stress on a variety of levels. Also, depression exists in a large portion of the stroke population. The impact of stroke also influences the patient's social existence, as studies have shown that stroke patients do manifest diminished social function. However, the reviewed studies are not without limitations. Further studies, with a qualitative design, are needed to throw light on the patient's experience of being ill with stroke, and the process of his recovery.

Aphasia↗

PubMed2005

Early psychological consequences of the March 11, 2004, terrorist attacks in Madrid, Spain.

On March 11, 2004, Al-Qaeda set off 10 bombs on several train routes in Madrid. 192 people were killed and 2,000 wounded. In this study, 1,179 questionnaires were administered Week 2 after the attacks to residents 18 years and over from the affected geographical areas. The questionnaire included items about sociodemographic variables and exposure to the attacks. Psychological effects were assessed as presence of acute stress and depressive symptomatology and functional impairment. 46.7% of the sample presented symptomatology of acute stress and 49.6% depressive symptoms. Among the symptoms of acute stress, the most frequent were re-experiencing (72.5%) and dissociative symptoms (71.8%). The chief predicting variables in symptomatology were being female, over 65 yr. old, and a habitual train user. The large number of affected people was refined with an item analysis and the consideration of severity of interference in psychosocial functioning.

Adolescent↗

PubMed2002

Behavioural problems in children and parenting stress associated with primary nocturnal enuresis in Hong Kong.

UNLABELLED: The aim of this study was to investigate the behavioural problems and parenting stress of enuretic children in the local Chinese community. The study recruited 89 children with primary nocturnal enuresis (PNE) from the paediatric clinics of 9 regional hospitals in Hong Kong, and 131 age- and gender-matched control children without PNE from the Student Health Centres. After adequate instruction, the parents completed the Child Behaviour Checklist (CBCL) and Parenting Stress Index (PSI). A trained interviewer interviewed the parents and children and rated the children on the Global Assessment of Functioning (GAF). The PNE group had worse overall scores in both the Problem and Competence scales of CBCL; in particular, they had more attention problems and aggressive behaviours, and lower social competence and school performance than the control group. Their parents demonstrated more parenting stress as shown by higher PSI scores. CONCLUSION: In the local Chinese population, PNE was associated with more childhood behavioural problems and greater parenting stress. Attention to the psychosocial functioning of the child and parents may be important in the management of enuresis.

Adolescent↗

PubMed2006

Major depression in the transition to adulthood: the impact of active and past depression on young adult functioning.

This study examined the association between active and past major depression and deficits in young adult functioning using data from a longitudinal community study (N = 354). Three groups were compared: (1) participants with a 1-year diagnosis of major depression at age 26 (active group); (2) those who experienced major depression during the transition to adulthood, ages 18-25, but did not have active depression at age 26 (past group); and (3) individuals not meeting diagnostic criteria for depression during the transition period. Results highlight serious deficits in psychosocial functioning at age 26 linked to both active and past depression. Although participants with active depression experienced the greatest number of problems, those with past depression evidenced similar deficits across many important domains of functioning. The significant impairments characterizing those with past depression indicate the need for continued monitoring to decrease the risk of recurrence and the establishment of a chronic course of illness.

Adaptation, Psychological↗

PubMed1986

A pilot home-based geriatric health screening project in primary care.

Regular multidimensional screening of the elderly for undetected health problems has the potential for delaying functional deterioration and improving the quality of life, but has not been evaluated rigorously. This pilot study examined the amount and type of unmet health care need discovered by home-based screening of 100 family practice patients aged 75 and over. Although 96 per cent of patients had some health problems, only 71 per cent had problems that needed further intervention. Of these, the majority were problems in the area of psychosocial function, independence, and lifestyle. Age, sex, and frequency of attendance at the practice in the previous year were not found to be useful markers for targeting screening efforts. Although it is potentially beneficial for detecting unmet need, home-based screening is resource-intensive and requires further examination in randomized trials in the North American context.

Aged↗

PubMed1993

Older patients with COPD: benefits of exercise training.

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and functional disability in older adults. In its advanced stages, it is characterized by progressive breathlessness and serious exercise curtailment. Aerobic exercise training (EXT) is recommended for patients who remain breathless despite optimal pharmacologic treatment. Although the physiologic rationale for EXT in COPD patients remains controversial, it is generally accepted that even older incapacitated COPD sufferers who participate in an individualized training program show significant reductions in breathlessness, increased exercise capacity, and enhanced psychosocial function. An 8-week outpatient program that is carefully regulated and includes an educational component is recommended.

Aged↗

PubMed2003

The psychosocial and psychiatric side of cystic fibrosis in adolescents and adults.

Increasing numbers of cystic fibrosis (CF) patients are surviving into adulthood. An understanding of the psychiatric and psychosocial aspects of CF in adults and adolescents is therefore more important than ever. There is a large body of evidence indicating that the psychological and psychosocial functioning of people with CF is similar to that of well people, until the disease becomes severe. However, there is also evidence that patients do suffer an increased likelihood of psychiatric problems, such as depression, and of scoring poorly on physical functioning measures of quality of life. Studies have found conflicting evidence as to any association between degree of respiratory impairment and psychological functioning. Coping styles seem to have a large effect upon the quality of life of CF patients. People with cystic fibrosis can have problems with sexuality, platonic relationships and independence. Families of patients also suffer problems, which can affect the patients themselves. Non-compliance is a complicated problem with many patients. New treatments for people with CF are emerging, such as lobe transplants from live donors and gene therapy, with possible new psychosocial problems resulting. Furthermore, older studies are becoming increasingly inapplicable as treatment and prognosis changes. Therefore, more research is needed in this field.

Activities of Daily Living↗

PubMed2005

The development of the Indian vision function questionnaire: field testing and psychometric evaluation.

OBJECTIVE: To develop and evaluate the acceptability, reliability, validity, and responsiveness of the Indian vision function questionnaire (IND-VFQ). METHODS: Problem statements from previous qualitative studies were reduced to a 45 item interviewer administered questionnaire representing three a priori domains (general functioning, psychosocial impact, and visual symptoms) which was evaluated in patients with cataract (n = 420), glaucoma (n = 120), diabetic retinopathy, or age related macular degeneration (n = 120) and normal controls (n = 120). Standard methods were used for item reduction and to evaluate psychometric properties. RESULTS: Psychometric item reduction produced a 33 item questionnaire. Psychometric evaluation showed that two of the three scales (psychosocial impact and visual symptoms) had good acceptability, and that all three scales showed high internal consistency (alpha >0.80; item-total correlations 0.54-0.86) and test-retest reliability (>0.89). All three scales showed moderate evidence of convergent and discriminant validity. Responsiveness, assessed in cataract patients (n = 120) before and after surgery, was good for all three scales (effect sizes >1). CONCLUSIONS: The IND-VFQ33 is a psychometrically sound measure of vision function addressing a gap in patient defined measures of vision function developed in populations living in low income countries.

Activities of Daily Living↗

PubMed2005

Anatomical outcome and quality of life following posterior vaginal wall prolapse repair using collagen xenograft.

The aim of this study was to evaluate quality of life, sexual function, and anatomical outcome after posterior vaginal wall prolapse repair using a collagen xenograft. Thirty-three patients were evaluated preoperatively and at 6 and 12 months follow-up (FU). Quality of life and sexual function were assessed using a self-reported questionnaire. Prolapse staging was performed using the pelvic organ prolapse quantification system (POPQ). Preoperatively 3 patients had stage I, 26 patients stage II, and 4 patients stage III prolapse of the posterior vaginal wall. Prolapse of the posterior vaginal wall > or = stage II was observed in 7 patients (21%) at the 6-month FU and in 13 patients (39%) at the 12-month FU. Mean point Bp was reduced from -1.1 preoperatively to -2.5 at 6 months FU (p < 0.01) and -1.8 at 12 months FU (p < 0.01). Previous abdominal surgery was associated with a less favorable anatomical outcome (odds ratio: 2.0, 95% confidence interval: 1.5-3.8). There were no significant changes in sexual function or dyspareunia during the 1-year FU. Preoperatively 76% of the patients reported a negative impact on quality of life as a result of genital prolapse. There was a significant improvement in several variables associated with quality of life at 6 and 12 months FU. Posterior vaginal wall prolapse repair using a collagen xenograft was associated with an unsatisfying anatomical outcome at 1-year FU although several quality of life-associated variables affecting psychosocial function were improved. Improvement was not restricted to postoperative restoration of vaginal topography, and previous surgery had a negative effect on anatomical outcome.

Adult↗

PubMed2005

Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up.

OBJECTIVE: The relationship between cognition and outcome in people with schizophrenia has been established in studies that, for the most part, examined chronic patients and were cross-sectional in design. The purpose of this study was to analyze the relationships between neurocognitive variables assessed at illness onset and functional outcome in a longitudinal design. An additional area of interest was whether the severity of negative symptoms would predict outcome independently from neurocognitive variables or whether there would be an overlap in their predictive power. METHOD: The authors administered a comprehensive cognitive battery and clinical assessments to 99 subjects who were in their first episode of illness and analyzed the relationship of cognition and symptom severity at intake with community outcome after an average follow-up period of 7 years. RESULTS: Verbal memory, processing speed and attention, and the severity of negative symptoms at intake were related to subsequent outcome. Global psychosocial functioning was predicted by negative symptoms and attention. Verbal memory was the significant predictor of the degree of impairment in recreational activities. Impairment in relationships was predicted by negative symptoms and memory, whereas attention and negative symptoms were predictive of work performance. There was an overlap in the variance in outcome explained by cognitive variables and negative symptoms. CONCLUSIONS: Verbal memory and processing speed and attention are potential targets for psychosocial interventions to improve outcome. Results from cross-sectional or chronic patient studies do not necessarily correspond to the findings of this prospective first-episode study in which cognition appears to explain less of the variance in outcome.

Adaptation, Psychological↗

PubMedDate not supplied

Characteristics of patients who made gains at a geriatric day hospital.

The charts of patients who attended a geriatric day hospital (DH) over a 16-month period were reviewed retrospectively (n = 112). Home visits were conducted on consenting patients who made gains (either functional, psychosocial or medical) according to the chart review; they (and/or their caregivers) were questioned about what gains were made at the DH and whether these gains were still present. Initial gains (n = 77, or 69%) were gains identified by chart review, and confirmed by patients at the home visit (when a home visit was possible). Patients who had home visits performed (n = 58) were further classified as to if they had persistent gains or not. Measurements of mood, function, cognition, mobility, balance, and medications were also collected. Patients were defined as having had persistent gains if they relayed gains were still present and, when a gain was measurable (e.g., mobility), there had to be objective evidence of persistent improvement. Backwards elimination modeling using logistic regression analyses was conducted to look for characteristics of patients who made initial gains and had persistent gains. In gender-adjusted analyses, people with cardiac conditions (p = 0.006) or depression (p = 0.047) were most likely to make initial gains whereas those with dementia were less likely to make initial gains (p = 0.005). There were no statistically significant associations (p < 0.05) found between any of the variables examined and the likelihood of having persistent gains. This study suggests that certain types of patients may be more likely to benefit, at least initially, from a DH program.

Aged↗

PubMedDate not supplied

Profile of administrators of schools of nursing, Part II: Mentoring relationships and influence activities.

Part two of a two-part study was conducted to obtain data on the influence activities and mentoring relationships of administrators of schools of nursing. The deans and directors of the American Association of Colleges of Nursing member schools were mailed a questionnaire that included sections on the above topics incorporated from Vance's questionnaire and a scale for rating mentoring functions. A response rate of 73.5 per cent was obtained. A majority of the subjects had entry-level preparation at the baccalaureate level and had obtained a doctorate. Despite a majority of the subjects reporting involvement in mentoring relationships, the percentage of those having a mentor while in the dean or director position was only 27 per cent. The positions of the mentors were most often supervisors from the academic area. A Student's t test determined that psychosocial functions of a mentoring relationship were more important than career functions, although both functions had a relatively high mean score. The subjects also reported involvement in a variety of professional activities of influence, such as publishing, presenting, consulting, and conducting research. The suggestion was made that perhaps multiple mentors and other avenues may be needed to prepare for the scholarly, professional, and administrative expectations of the role.

Administrative Personnel↗

PubMed1999

Fatigue after stroke.

OBJECTIVE: To determine the frequency and outcome of fatigue, its impact on functioning, and its relationship with depression in patients 3 to 13 months poststroke. DESIGN: Survey. SETTING: Community. PARTICIPANTS: Eighty-eight individuals from a pool of 181 consecutive patients previously admitted to an acute stroke service who were willing and able to complete the self-report questionnaires, and 56 elderly controls living independently in the community. MAIN OUTCOME MEASURES: Fatigue Impact Scale (a self-report measure of the presence and severity of fatigue and its impact on cognitive, physical, and psychosocial functions) and the Geriatric Depression Scale. RESULTS: The frequency of self-reported fatigue problems was greater in the stroke group (68%) than in the control group (36%, p < .001) and was not related to time poststroke, stroke severity, or lesion location. Forty percent of the stroke group reported that fatigue was either their worst or one of their worst symptoms. Patients attributed more functional limitations to their fatigue than did control subjects with fatigue. Although the presence of fatigue was independent of depression, the impact of fatigue on functional abilities was strongly influenced by depression. CONCLUSION: Fatigue can contribute to functional impairment up to 13 months after stroke, and its recognition and treatment are important for maximizing recovery.

Activities of Daily Living↗