RESUMO
Attention-Deficit/Hyperactivity Disorder (ADHD) is often misdiagnosed or mistreated in adults because it is often thought of as a childhood problem. If a child is diagnosed and treated for the disorder, it often persists into adulthood. In adult ADHD, the symptoms may be comorbid or mimic other conditions making diagnosis and treatment difficult. Adults with ADHD require an in-depth assessment for proper diagnosis and treatment. The presentation and treatment of adults with ADHD can be complex and often requires interdisciplinary care. Mental health and non-mental health providers often overlook the disorder or feel uncomfortable treating adults with ADHD. The purpose of this manuscript is to discuss the diagnosis and management of adults with ADHD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Saúde Mental , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Comorbidade , Emoções , Família , HumanosRESUMO
Depression is a common mental disorder affecting individuals. Although many strides have been made in the area of depression, little is known about depression in special populations, especially African American men. African American men often differ in their presentation of depression and are often misdiagnosed. African American men are at greater risk for depression, but they are less likely to participate in mental health care. This article explores depression in African American by looking at environmental factors, sigma, role, and other unique to this populations, such as John Henryism. Interventions to encourage early screening and participation in care are also discussed.
Assuntos
Negro ou Afro-Americano/psicologia , Depressão/psicologia , Saúde do Homem/etnologia , Depressão/etnologia , Meio Ambiente , Humanos , Programas de Rastreamento/métodos , Serviços de Saúde Mental/estatística & dados numéricos , Estigma SocialRESUMO
OBJECTIVES: Individuals lacking access to dentists may use hospital emergency departments (EDs) or physicians (MDs) for the management of their dental problems. This study examined visits by minority and low-income individuals to physicians and hospital emergency departments for the treatment of dental problems with the goal of exploring the nature of treatment provided and patient satisfaction with the care received. METHODS: Eight focus group sessions were conducted with 53 participants drawn from low-income White, Black, and Hispanic adults who had experienced a dental problem and who had sought MD/ED care at least once during the previous 12 months. RESULTS: Toothache pain or more generalized jaw/face pain was the most frequent oral problem resulting in MD/ED visits. Pain severity was the principle reason for seeking care from MDs/EDs, with financial barriers most often mentioned as the reason for not seeking care from dentists. Expectations of MD/ED visits were generally consistent with care received; most participants limited their expectations to the provision of antibiotics or pain medication. Nearly all of the participants thought they would eventually need to see a dentist for resolution of their dental problem. CONCLUSIONS: Poor/minority individuals seek relief from oral pain through MDs/ EDs while recognizing that such care is not definitive.
Assuntos
Assistência Odontológica , Serviço Hospitalar de Emergência/estatística & dados numéricos , Grupos Minoritários , Satisfação do Paciente , Consultórios Médicos/estatística & dados numéricos , Pobreza , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Masculino , Maryland , Pessoa de Meia-IdadeRESUMO
While prostate cancer screening recommendations vary, experts agree that an individual should be provided with information and allowed to make a decision. Social factors influencing a decision to participate in prostate cancer screening among urban African-American men age 40 and over were explored. The men in this study expressed an interest in participating in prostate cancer prevention strategies that were culturally appropriate.
Assuntos
Negro ou Afro-Americano/psicologia , Tomada de Decisões , Programas de Rastreamento/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Baltimore , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/psicologia , População UrbanaRESUMO
Urban African Americans are disproportionately affected by HIV, the virus associated with AIDS. Although incidence and mortality appear to be decreasing in some populations, they continue to remain steady among inner-city African Americans. A major concern is the number of HIV-positive individuals who continue to practice high-risk behaviors. Understanding factors that increase risks is essential for the development and implementation of effective prevention initiatives. Following a constructionist epistemology, this study used ethnography to explore social and cultural factors that influence high-risk behaviors among inner-city HIV-positive African Americans. Leininger's culture care diversity and universality theory guided the study. Individual qualitative interviews were conducted with HIV-positive African Americans in the community to explore social and cultural factors that increase HIV-risky behaviors. For this study, family/kinship, economic, and education factors played a significant role in risky behaviors. Reducing HIV disparity among African Americans is dependent on designing appropriate interventions that enhance protective factors. Clinicians providing care to HIV-positive individuals can play a key role in reducing transmission by recognizing and incorporating these factors when designing effective prevention interventions.
Assuntos
Negro ou Afro-Americano/etnologia , Infecções por HIV/etnologia , Assunção de Riscos , Comportamento Sexual/etnologia , População Urbana , Negro ou Afro-Americano/estatística & dados numéricos , Antropologia Cultural , Causas de Morte , Relações Comunidade-Instituição , Diversidade Cultural , Escolaridade , Família/psicologia , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Incidência , Masculino , Motivação , Pesquisa Metodológica em Enfermagem , Teoria de Enfermagem , Pesquisa Qualitativa , Autoimagem , Grupos de Autoajuda , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Enfermagem Transcultural , População Urbana/estatística & dados numéricosRESUMO
African-American men are suffering disproportionately from most illnesses. Seemingly, action is needed if health disparities that disproportionately affect African-American men as compared to their White and female counterparts are to be reduced or eliminated. An important step in decreasing common health disparities evidenced among African-American men is to understand social factors that act as motivators and barriers to seeking care for most of this vulnerable population. Following a constructionist epistemology, this study used ethnography to explore social structure factors that motivate urban African-American men to seek care. Leininger's Culture Care Diversity and Universality Theory guided this study. Qualitative interviews were conducted with urban African-American men and other individuals in the community to explore understanding, attitudes, and beliefs about health. Critical issues examined included social factors associated with health seeking behaviors. Themes that emerged from these data indicated that critical social factors include: 1) Kinship/significant others; 2) accessibility of resources; 3) ethnohealth belief; and 4) accepting caring environment. The data also indicated a relationship between these social factors and health seeking behaviors of urban African-American men.
Assuntos
Negro ou Afro-Americano , Comportamentos Relacionados com a Saúde/etnologia , Homens , Adulto , Cultura , Empatia , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Homens/psicologia , New England , Relações Profissional-Paciente , Apoio Social , População UrbanaRESUMO
BACKGROUND: African Americans (AAs) have low rates of colorectal cancer (CRC) screening. To the authors' knowledge, factors that influence their participation, especially individuals with a family history of CRC ("family history"), are not well understood. METHODS: A secondary analysis of the 2002 Maryland Cancer Survey data examined predictors of risk-appropriate, timely CRC screening ("screening") in AAs with a family history and in individuals without a family history. Predictors that were evaluated included age, sex, family history, mammogram or prostate-specific antigen (PSA) screening, body mass index, activity, fruit/vegetable consumption, alcohol, smoking, perceived risk of cancer, education, employment, insurance, access to a healthcare provider, and healthcare provider recommendation of fecal occult blood test (FOBT) and/or sigmoidoscopy/colonoscopy. RESULTS: In individuals without a family history of CRC (N = 492), recommendation for FOBT (odds ratio [OR] of 11.90; 95% confidence interval [95% CI], 6.84-20.71) and sigmoidoscopy/colonscopy (OR of 7.06; 95% CI, 4.11-12.14), moderate/vigorous activity (OR of 1.74; 95% CI, 1.06-2.28), and PSA screening history (OR of 2.68; 95% CI, 1.01-7.81) were found to be predictive of screening. In individuals with a family history (N = 88), recommendation for sigmoidoscopy/colonscopy (OR of 24.3; 95%, CI 5.30-111.34) and vigorous activity (OR of 5.21; 95% CI, 1.09-24.88) were found to be predictive of screening. However, family history did not predict screening when the analysis was controlled for age, education, and insurance. AAs who had a family history were less likely to screen compared with their white counterparts (N = 293) and compared with AAs who were at average risk for CRC (P < .05). CONCLUSIONS: Regardless of family history, healthcare provider recommendation and activity level were important predictors of screening. Lower screening rates were observed in AAs who had a family history compared with individuals who did not. The authors believe that, for AAs who have a family history, further examination of barriers and facilitators to CRC screening within the cultural context is warranted.
Assuntos
Negro ou Afro-Americano/etnologia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Saúde da Família , Comportamentos Relacionados com a Saúde/etnologia , Hereditariedade , Adulto , Distribuição por Idade , Idoso , Neoplasias Colorretais/etnologia , Neoplasias Colorretais/genética , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
African American men are disproportionately affected by most illnesses and associated complications. These men are also less likely to participate in primary and secondary prevention interventions. Little is known about reaching them. The purpose of this study(1) was to explore factors associated with effectively reaching African American men. Ethnographic methods were used. Key and general informants from an urban Northeastern community were recruited for this study. The data revealed 3 major themes as essential to reaching African American men: a trusted and respected community member providing the outreach, a perceived safe and caring environment during outreach, and a perceived benefit from participating in the outreach. The findings from this study provided a foundation for designing community interventions that will increase participation among African American men. Future research efforts should focus on operationalizing these findings in the community.