SEARCH · PubMed Health

Results for “Psychosocial Intervention”

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 19 recordsLinked to original sources

PubMed2006

Effects of delayed psychosocial interventions versus early psychosocial interventions for women with early stage breast cancer.

OBJECTIVE: The importance of psychosocial counselling after a diagnosis of cancer has been acknowledged and many intervention studies have been carried out, with the aim to find out which types of intervention are most effective in enhancing quality of life in cancer patients. A factor which could be part of effective counselling could be the time of offering psychosocial counselling. The aim of this study was to research the effect of time of enrolment in a psychosocial group intervention on psychosocial adjustment. METHODS: In the present study, 67 women with early stage breast cancer were randomised in a psychosocial group intervention program starting within 4 months after surgery or in the same intervention program starting at least 3 months later. RESULTS: The main conclusion of this study is that women who started with their intervention early were less distressed at 6 months follow-up than women who were in the delayed condition. Medical and demographic variables were predictive for some psychosocial adjustment indicators, but were not associated with time of enrolment. Regardless of time of enrolment, women improved in distress, body image and recreational activities, but showed a decrease in social interaction. CONCLUSION: Though results are limited, based on these results we suggest that psychosocial counselling should be offered as soon after diagnosis or surgery for breast cancer. PRACTICE IMPLICATIONS: Women diagnosed with primary breast cancer should be able to start with psychological counselling soon after being diagnosed, to prevent them from becoming distressed at long term.

Adaptation, Psychological↗

PubMed2003

Is training in psychosocial interventions worthwhile? Report of a psychosocial intervention trainee follow-up study.

A follow-up study of psychosocial intervention (PSI) trainees from the Sheffield and Maudsley training centres was undertaken in three stages. In Stage 1, 141 students, at two PSI training centres, were sent a simple postal questionnaire to elicit career trajectory following PSI training. A response rate of 82% was achieved. The sub-group, who had been trained and who still engaged in clinical practice were identified and followed-up in more detail (n=96). The effect of PSI training in a range of domains was investigated. The impact of training may not be to equip students with formal technical skills in CBT and family work. What is more likely is that trainees acquired proficiency in: working effectively using a case management model; conveying 'therapeutic optimism'; enabling users to meet their own goals and helping them to develop better coping strategies; using 'stress vulnerability' and formal outcome measures as means of structuring this approach. The secondary aim of the study was to identify and prioritise the barriers that impede the effective implementation of PSI skills in routine service settings. For the second phase of the survey the response rate was again 82%. This group's service managers were identified and surveyed for the same information and 59% responded. The aim was to gather information about implementation issues from both the clinical and service perspectives. The results of the survey indicate that PSI training has a positive impact on the development of services for people with serious mental health problems although there are serious organisational hurdles for managers, trainees and organisations to overcome if PSI skills are to be properly implemented. Key factors that impact upon faithful implementation are related to resource issues (caseload size), organisational factors (the existence of an implementation plan and training strategy), and the extent to which the trainee's team is supportive.

Adult↗

PubMedDate not supplied

APM task force on psychosocial interventions in the general hospital inpatient setting. A review of cost-offset studies.

Several investigations of interventions with psychiatric and medical comorbidity (CM) in the medical inpatient setting have been reported. These studies include psychiatric liaison screening and interventions, psychosocial screening, and standard consultation. The studies had a variety of outcome variables: 1) altered psychiatric morbidity; 2) lag time to identification of CM; 3) lag time to referring to mental health disciplines; 4) cost offset; and 5) discharge placement. Methodological and design problems confound many of the results, in particular, the lack of random control procedures. However, similarity of findings of the frequency of CM in the inpatient setting and patient response to early detection and treatment should stimulate further research into the effects of psychiatric interventions in the acute inpatient medical setting.

Delivery of Health Care↗

PubMed1993

Psychosocial interventions for very low birthweight infants: their scope and efficacy.

With the burgeoning of infant psychiatry, and the increasing survival and development of cohorts of very low birthweight (VLBW) infants, psychiatrists are becoming increasingly involved with other professionals in designing and implementing early intervention programs. Psychosocial interventions for VLBW infants generally report positive results regardless of the orientation of the practitioners, or the stated goal of the intervention: however, they have often taken place independently of longitudinal research, and sometimes without grounding in theories of infant and family development. This paper first reviews the current state of research and findings related to infant-focussed, parent-directed, and interactional programs. Second, it addresses a number of basic questions to be considered by psychiatrists involved in consulting to neonatal intensive care units, who have to appraise, design or implement intervention programs with this group. Throughout this discussion, it is proposed that the notion of infants at developmental risk needs to be supplemented by that of caregivers at risk, and that the professional boundaries which these distinctions represent need to be overcome.

Adolescent↗

PubMed2002

Separating the apples and oranges in the fruit cocktail: the mixed results of psychosocial interventions on cancer survival.

In past reviews of the literature on psychosocial interventions for cancer patients, different reviewers have reached disparate conclusions about the ability of a psychosocial intervention to have an impact on cancer survival. This article highlights some of the basis for differences of opinion, including the range of psychosocial interventions provided to patients and the challenges inherent in conducting research studies of this type. Social workers who work with cancer patients at vulnerable times need to understand what the current evidence shows can be gained from participation in a psychosocial intervention. Several key questions have been identified that can provide the basis for future rigorous studies. The role of the social worker in participating and shaping research on the relationship of psychosocial intervention and cancer survival is also discussed.

Humans↗

PubMed2003

The effectiveness of psychosocial interventions delivered by general practitioners.

BACKGROUND: Many patients visit their general practitioner (GP) because of problems that are psychosocial in origin. However, for many of these problems there is no evidence-based treatment available in primary care, and these patients place time-consuming demands on their GP. Therefore, GPs could benefit from tools to help these patients more effectively and efficiently. In this light, it is important to assess whether structured psychosocial interventions might be an appropriate tool for GPs. Previous reviews have shown that psychosocial interventions in primary care seem more effective that usual care. However, these interventions were mostly performed by health professionals other than the GP. OBJECTIVES: To present a systematic review of the literature addressing the effectiveness of psychosocial interventions by general practitioners by assessing the clinical outcomes and the methodological quality of selected studies. SEARCH STRATEGY: The literature search was conducted using the CCDAN Trials Register, the Cochrane Library and reference lists of relevant studies for citation tracking. Also, personal communication with experts took place. SELECTION CRITERIA: Randomised controlled trials, controlled clinical trials and controlled patient preference trials addressing the effectiveness of psychosocial interventions by GPs for any problem or disorder. Studies published before January 2002 were eligible for entry. DATA COLLECTION AND ANALYSIS: Methodological quality was independently be assessed by two reviewers using the Maastricht-Amsterdam Criteria List and the CCDAN Quality Rating Scale. The qualitative and quantitative characteristics of selected trials were independently extracted by two reviewers using a standardised data extraction form. Levels of evidence were used to determine the strength of the evidence available. Results from studies that reported similar interventions and outcome measures were meta-analysed. MAIN RESULTS: Eight studies were included in the review. Selected studies addressed different psychosocial interventions for four distinct disorders or health complaints. There is good evidence that problem-solving treatment by general practitioners is effective for major depression. The evidence concerning the remaining interventions for other health complaints (reattribution or cognitive behavioural group therapy for somatisation, counselling for smoking cessation, behavioural interventions to reduce alcohol reduction) is either limited or conflicting. REVIEWER'S CONCLUSIONS: In general, there is little available evidence on the use of psychosocial interventions by general practitioners. Of the psychosocial interventions reviewed, problem-solving treatment for depression seems the most promising tool for GPs, although a stronger evidence-base is required and the effectiveness in routine practice remains to be demonstrated. More research is required to improve the evidence-base on this subject.

Alcohol Drinking↗

PubMed2001

Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer.

PURPOSE: To determine whether making patient-reported cancer needs, quality-of-life (QOL), and psychosocial information available to the health care team, allowing coordinated specifically targeted psychosocial interventions, resulted in reduced cancer needs, improved QOL, and increased satisfaction with care received. METHODS: Self-reported cancer needs, QOL, and psychosocial information was collected from 450 people with cancer, using standardized questionnaires via a touch-screen computer. For a randomly chosen two thirds, this information was made available to the health care team who coordinated targeted psychosocial interventions. Information from the remaining one third was not seen. Patients were assessed 2 and 6 months after randomization for changes in their cancer needs, QOL, and psychosocial functioning and satisfaction with overall care received. RESULTS: There were no significant differences between the two arms with respect to changes in cancer needs, QOL, or psychosocial functioning between the baseline and follow-up assessments, nor with respect to satisfaction with care. However, for the subgroup of patients who were moderately or severely depressed at baseline, there was a significant reduction in depression for the intervention arm relative to the control arm at the 6-month assessment (P =.001). CONCLUSION: Making patient-reported cancer needs, QOL, and psychosocial data available to the health care team at a single consultation together with coordinated psychosocial interventions does not seem to reduce cancer needs nor improve QOL, psychosocial functioning, or satisfaction with the care received. However, identification of patients with moderate or severe levels of depression may be valuable in reducing subsequent levels of depression.

Adaptation, Psychological↗

PubMed1997

To randomise or not to randomise: methodological pitfalls of the RCT design in psychosocial intervention studies.

We are seeing evidence of more studies investigating the effectiveness of psychosocial interventions of cancer patients, predominantly within groups. As roles within cancer and palliative care diversify, specially trained nurses and other health care workers are taking a more active role within psychosocial intervention studies. Frequently, these studies are randomised controlled trials (RCTs). Often, the results of these psychosocial RCTs have been laid open to general criticisms of design, implementation and reporting. The following paper focuses specifically on the general and experimenter problems in conducting RCTs within psychosocial interventions. It highlights the limitations and inherent problems seen with RCTs of psychosocial interventions so that health care workers are aware of these before considering undertaking psychosocial RCTs with cancer patients.

Bias↗

PubMed2004

Psychosocial interventions for people with a milder dementing illness: a systematic review.

INTRODUCTION: Over the last three decades, interest has grown in the use of psychosocial interventions for people with dementia. Empirical studies and systematic reviews have been undertaken on a range of such interventions to examine their effectiveness. However, little account has been taken of the appropriateness of psychosocial interventions for people in different stages of the illness. This raises important questions about the degree to which the research evidence can be generalized for people in the milder and the more severe stages of dementia. This systematic review was undertaken therefore to investigate the effectiveness of psychosocial interventions for people with a milder dementing illness. METHODS: A comprehensive search was undertaken using all the major health care databases, as well as various grey literature sources. For studies to be included in the review, they must have investigated the effect of one or more psychosocial intervention on people with a milder dementing illness, employing a controlled trial design, and measuring outcomes such as cognitive ability, communication, functional performance and well-being. Identified studies were critically appraised, and where suitable for inclusion, data were extracted. RESULTS: Four studies met the final inclusion criteria for the review, and covered three psychosocial interventions: reality orientation, procedural memory stimulation and counselling. No evidence was found for the effectiveness of counselling and procedural memory stimulation on the outcome measures used. However, some evidence was found that reality orientation is effective in improving cognitive ability, with a demonstrable long-term gain using follow-up data. CONCLUSIONS: The review provides some evidence for the use of reality orientation for people in the milder stages of dementia. However, due to the small sample sizes in all the included studies, more research is needed into the effectiveness of psychosocial interventions for this client group. Implications for nursing practice are discussed, and recommendations for future research are set out.

Cognitive Behavioral Therapy↗

PubMed2005

Psychosocial interventions for conversion disorder.

BACKGROUND: Conversion disorder is an alteration or loss of physical functioning suggestive of a physical disorder that is thought to be due to a psychological stressor or conflict. The fact that many theories about the cause of conversion disorder focus on psychological and social factors would suggest that a psychosocial intervention might be of most benefit. OBJECTIVES: To investigate the efficacy of psychosocial interventions on people diagnosed with conversion disorder compared with standard care, a biological intervention or another psychosocial intervention. SEARCH STRATEGY: We searched the Cochrane Depression, Anxiety and Neurosis Group Trials Register (May 2004), various databases on OVID (February 2004), handsearched reference lists and textbooks on conversion disorder and contacted relevant authors. SELECTION CRITERIA: We included all randomised controlled trials that compared psychosocial interventions for conversion disorder with standard care or other interventions (biological or psychosocial). DATA COLLECTION AND ANALYSIS: We reliably selected, quality assessed and extracted data from the studies. For dichotomous outcomes we calculated a relative risk with its associated 95% confidence interval and a number needed to treat. For continuous data we calculated a weighted mean difference. MAIN RESULTS: The search identified 260 references, 217 were clearly not relevant to this review and excluded on the basis of their titles and abstracts, 40 more were excluded after reading the full papers (the reasons are given in the excluded studies tables) and only three studies (total n =119) met the inclusion criteria. One study was concerned with paradoxical injunction therapy and the other two studied the value of hypnosis. The three studies had different interventions and control groups so the results could not be combined. All of the studies were of poor methodological quality and it is therefore difficult to place much value on the results of the studies. We were unable to include some data because of poor reporting. AUTHORS' CONCLUSIONS: Randomised studies are possible in this field. The use of psychosocial interventions for conversion disorder requires more research and it is not possible to draw any conclusions about their potential benefits or harms from the included studies.

Anti-Anxiety Agents↗

PubMed2006

A review of evidence-based psychosocial interventions for bipolar disorder.

Various forms of psychosocial intervention have been found efficacious as adjunctive treatments for bipolar disorder, including family-focused therapy, interpersonal and social rhythm therapy, cognitive-behavioral therapy, and individual or group psychoeducation. When used in conjunction with pharmacotherapy, these interventions may prolong time to relapse, reduce symptom severity, and increase medication adherence. Family-focused therapy seeks to reduce the high levels of stress and conflict in the families of bipolar patients, thereby improving the patient's illness course. Interpersonal and social rhythm therapy focuses on stabilizing the daily and nightly routines of bipolar patients and resolving key interpersonal problems. Cognitive-behavioral therapy assists patients in modifying dysfunctional cognitions and behaviors that may aggravate the course of bipolar disorder. Group psychoeducation provides a supportive, interactive setting in which patients learn about their disorder and how to cope with it. This article discusses each of these interventions and summarizes the evidence for their efficacy in randomized trials. Recommendations for implementing psychosocial interventions in clinical practice are also given.

Bipolar Disorder↗

PubMed2003

A review of psychosocial interventions in infertility.

Counselling has been strongly recommended by numerous governmental, medical and community associations to help infertile people. The purpose of this review was to determine whether psychosocial interventions improved well-being and pregnancy rates, and to identify the kinds of interventions that were most effective. A systematic search identified all published and unpublished papers in any language and any source that (1) described a psychosocial intervention and (2) evaluated its effect on at least one outcome measure in an infertile population. A total of 380 studies met the first criteria but only 6.6% (n=25) of these were independent evaluation studies. Analysis of these studies showed that psychosocial interventions were more effective in reducing negative affect than in changing interpersonal functioning (e.g., marital and social functioning). Pregnancy rates were unlikely to be affected by psychosocial interventions. It was also found that group interventions which had emphasised education and skills training (e.g., relaxation training) were significantly more effective in producing positive change across a range of outcomes than counselling interventions which emphasised emotional expression and support and/or discussion about thoughts and feelings related to infertility. Men and women were found to benefit equally from psychosocial interventions. Directions for future research on the evaluation of psychosocial interventions are discussed.

Counseling↗

PubMed2005

What works for adolescents with AN? A systematic review of psychosocial interventions.

OBJECTIVE: To determine the effectiveness of psychosocial interventions for adolescents with AN. METHODS: An extensive and systematic literature search was conducted for randomised controlled trials (RCTs) addressing the effectiveness of psychosocial interventions for teenagers (11-18 years) with AN. RESULTS: Eight RCTs were located meeting the review's inclusion criteria, the majority of which focused on some form of family-related intervention. DISCUSSION: Unfortunately, a lack of robust primary research on which to base the review meant that clear recommendations could not be made. More good quality research, examining a range of interventions, and involving larger samples, is required before a similar systematic review is executed.

Adolescent↗

PubMed2004

Does psychosocial intervention improve survival in cancer? A meta-analysis.

BACKGROUND: There is growing evidence that positive psychosocial intervention improves the wellbeing of cancer patients. Two meta-analyses conducted to date confirmed a significant small-to-moderate effect on quality of life. Previous randomized trials reported that psychosocial intervention also improved survival. However, more recent trials failed to detect a difference in survival. A systematic review of randomized trials that have examined the effectiveness of psychosocial intervention in cancer patients in terms of survival prolongation was conducted. METHODS: Randomized trials published between 1966 and June 2002 were identified through the databases of MEDLINE, EMBASE, CancerLit, CINAHL, Cochrane Library and reference lists of relevant articles. Relevant data were abstracted. The results of randomized trials were pooled using meta-analyses to estimate the effect of treatment on overall survival at one and four years in all cancer patients and also in breast cancer patients with metastases. RESULTS: Eight trials, which involved a total of 1062 patients (all cancer histologies), were identified. One- and four-year overall survival rates were obtained from eight trials and six trials, respectively. There was no statistically significant difference in the overall survival rates at one and four years [P = 0.6; RR 0.94 (95% CI 0.72, 1.22)] and [P = 0.5; RR 0.93 (95% CI 0.77, 1.13)], respectively. Four trials examined 511 metastatic breast cancer patients. Again, there was no statistically significant difference in the overall survival rates at one and four years [P = 0.3; RR 0.87 (95% CI 0.67, 1.14)] and [P = 0.3; RR 0.91 (95% CI 0.76, 1.10)], respectively. CONCLUSIONS: Psychosocial intervention does not prolong survival in cancer. This meta-analysis can not rule out small effect sizes because of the small number of trials and small trial sizes.

Adolescent↗

PubMedDate not supplied

A comparison of two intensities of psychosocial intervention for alcohol dependent patients treated with acamprosate.

AIMS: To compare two levels of psychosocial intervention in combination with acamprosate medication for the treatment of alcohol dependence. METHODS: Patients (n = 70) were prescribed acamprosate and randomized to Minimal Psychosocial Intervention (MPI) or Extended Psychosocial Intervention (EPI). MPI patients met a psychiatrist for 20-30 min sessions on four occasions during a 6 month period. EPI patients were offered 10-15 sessions with a psychiatric nurse in addition to the visits to the psychiatrist. EPI patients were trained to use behavioural and cognitive coping skills to deal with high-risk situations in line with a manual developed for relapse prevention. Patients were assessed four times during the 24-week study by self-report and laboratory tests. RESULTS: Patients on average reported a decline in days with heavy drinking and in cumulative number of drinking days. No significant differences between patients in MPI and EPI were found with respect to heavy drinking, cumulative number of drinking days, number of days to first drink, or biomarkers of alcohol consumption. Higher age and lower level of education were significant predictors of treatment success. CONCLUSIONS: Adding more intensive individual treatments appears to add no extra improvement beyond that obtained by prescribing acamprosate and offering an infrequent consultation with a physician.

Acamprosate↗

PubMed1998

[Does psychosocial intervention in cancer patients affect survival and psychological well-being?].

We have critically reviewed the scientific literature examining the effect of psychosocial interventions on survival and well-being among adult cancer patients. Only studies using randomization and including a control-group not receiving psychosocial intervention were reviewed. Six studies examined the effect on prognosis. In four of these studies survival increased significantly in the intervention group as compared to the control group. All of these studies, however, have methodological flaws, leaving a possible prognostic effect to be clarified in larger, well-controlled future studies. The effect of psychosocial intervention on various psychosocial variables (such as anxiety and depression) was evaluated in 20 studies. Differences in patient populations, intervention strategies, and outcomes decrease the comparability of the results, and the majority of these studies suffer from methodological flaws as well. A positive effect on anxiety and depression immediately following the intervention is, however, reported in the majority of these studies. It is thus possible that the level of anxiety and depression may be decreased by integrating psychosocial intervention in the overall treatment of cancer.

Adult↗

PubMed2004

Who participates in psychosocial interventions for caregivers of patients with dementia?

OBJECTIVE: The purpose of the present study is to evaluate if the participants in psychosocial interventions for dementia caregivers are representative of the whole population of dementia patients or if some socioeconomic groups are over- or underrepresented. DESIGN: The demographic and socioeconomic characteristics of the 128 participants of a randomized controlled study on the effects of caregiver education were compared with those of all the elderly residents of the City of Zurich (n = 64,856, elderly group), of all demented patients entering a City of Zurich nursing home in a 6-month period (n = 218, NH entry group) and of all demented inhabitants evaluated during a 20-month follow-up at a community memory clinic (n = 187, memory group). METHODS: Data on income and wealth were derived from official tax records. The characteristics of the different groups were compared by chi2 or t tests. RESULTS: As expected in a study on caregiver education, the demented patients were younger, more often male and married than all other study groups (p < 0.01). The participants in the psychosocial intervention had significantly (p < 0.01) higher education than all other groups; this effect is caused in part by the higher proportion of males. The NH entry group was less well educated than the elderly group (p < 0.05). The intervention group had a higher income and was wealthier than the three other groups (p < 0.01), but there was no significant difference with respect to the wealth of the memory group. The 25% poorest of the elderly group made up only about 10% of the participants in the intervention group. However, the 25% richest of the elderly group made up 42% of the intervention group. The method of recruitment for the psychosocial intervention (by media, referral of physicians and by a memory clinic) was not significantly related to any of the demographic or socioeconomic parameters. CONCLUSION: The lower socioeconomic strata are clearly underrepresented in psychosocial interventions.

Aged↗

PubMed1992

Measuring the effectiveness of psychosocial interventions in pregnancy.

Questions about the effectiveness of psychosocial interventions in pregnancy are important in any overall evaluation of antenatal care. This article reviews the evidence as to the positive benefit on a range of pregnancy outcomes provided by 35 published and unpublished randomized controlled trials of psychosocial interventions.

Female↗