Possible sexual dysfunction in traumatically injured clients: improving the approach at initial assessment.

AIM: To explore the perceived barriers experienced by rehabilitation case managers to discussing sexual function with clients after a traumatic injury, at the point of initial assessment. Study design: Small-scale semi-structured interviews were conducted to inform baseline measures for a service improvement proposal within the author's employing company. A qualitative phenomenological methodology was used for the interpretation of the data, with application of framework analysis. FINDINGS: Case managers within the company do not routinely ask clients about issues of sexual dysfunction at the initial assessment of rehabilitation needs. Identified inhibitors included the client's age, cultural background, the presence of other people during the assessment, embarrassment for either party, or any apparent reservations about the assessment process for the client. These echoed findings from the wider healthcare literature. Prompts to initiating conversations were also identified, including the nature of injury or the openness of the client. CONCLUSION: In their holistic assessment of clients' rehabilitation needs, and as part of the development of the therapeutic relationship, case managers are ideally situated to encourage conversations concerning issues of sexual dysfunction with clients, having the opportunity to signpost them to the most appropriate support or to facilitate referrals for treatment.

The Impact of Embarrassment to Product Purchase and Brand Influence on the Perceived Benefits and Availability of Ayurveda Products in the COVID-19 Era: an Investigation by SEM Approach.

Ayurveda as alternative medicine is widely popular across the globe. Moreover, after the onset of COVID-19, it has been looked at as a preferred option to boost immunity to prevent the infection of COVID-19. However, in developing countries, the misconceptions associated with Ayurveda lead to post-purchase embarrassment. This study proposes a model of perceived increased Availability of Ayurveda products in the market, with dependent variables such as brand influence, perceived immunity against COVID-19, post-product purchase embarrassment, and perceived safe and effective nature. The analysis is done by IBM AMOS v.22, the conceptualized hypothesis was also tested.

The effect of sexual self-schemas and sexual embarrassment of nursing students on the attitudes and beliefs of students related to sexual health.

AIM: Sexual health needs are one of the holistic care needs. Nurses need to help individuals identify and meet these needs. However, sometimes their perception of sexuality can affect their attitudes towards care. The aim of this study determine the effect of sexual self-schema and sexual embarrassment on attitudes and beliefs related to sexual health in nursing students. BACKGROUND: The sexual self-schema, which emphasizes the cognitive aspect of sexuality, is defined as cognitive generalizations that a person does for her/his own sexuality. Sexual self-schemas are known to affect individuals' feelings, beliefs and attitudes towards sexuality. Those with a positive sexual self-schema experience less embarrassment and more positive attitudes towards sexuality. Those with a negative sexual self-schema experience more sexual embarrassment. Those who experience sexual embarrassment have an avoidance of sexual interaction and talking about sexual issues. Nurses and student nurses have embarrassed to talk about sexuality with their patients. It is thought that sexual attitudes and beliefs are effective on this situation. DESIGN: This study was conducted in a cross-sectional descriptive type. Structural equality model was established to test the hypotheses of the research. In the model, the direct effects of the sexual self-schema and the sexual embarrassment on sexual attitudes and beliefs were examined. In addition, the mediating effect of sexual embarrassment between sexual schemas and sexual attitudes and beliefs is also included in the model. METHODS: The study population was the students who attended to and conducted clinical practice at the second, third and fourth study year at a Faculty of Health Sciences. For data collection, the Introductory Information Form which questioned socio-demographic characteristics of individuals, Sexual Self-Schema Scale (SSS), Sexual Embarrassment Scale (SES), and Sexual Attitudes and Beliefs Survey for Sexual Health (SABS) were used. The data were collected online with voluntary participation. RESULTS: Students' average scale scores were: SSS: 121.57 ± 21.23, SES: 12.16 ± 5.74 and SABS: 35.62 ± 7.53. It was also found that sexual self-schemas and sexual embarrassment effected sexual attitudes and beliefs. CONCLUSION: It could be recommended that these results be tested with different studies, that the course content on sexual issues be reviewed be addressed in a broader context.

Managing the experience of breathlessness with Tai Chi: A qualitative analysis from a randomized controlled trial in COPD.

PURPOSE: Chronic obstructive pulmonary disease (COPD) is associated with dyspnea, decreased physical activity, and reduced quality-of-life. While pulmonary rehabilitation is helpful, maintenance of physical activity afterwards is problematic. We sought to explore qualitatively the multi-dimensional, biopsychosocial experience of patients with COPD who participated in Tai Chi (TC) vs. group walking to facilitate physical activity after pulmonary rehabilitation). METHODS: We analyzed semi-structured qualitative exit interviews (N = 81) from a randomized controlled trial comparing 6-months TC with a time-matched group walking intervention and usual care control (UC). Transcripts were reviewed by at least 2 independent reviewers utilizing a social constructivist framework and theoretical sampling approach. An in-depth analysis of an exemplar subset was performed to thematic saturation and captured emergent themes within and between groups. RESULTS: Focused analysis was conducted on 54 transcripts (N = 21 TC, N = 16 Walking, N = 17 UC). Participants were characterized by mean age 68.5 (±8.3) years, GOLD Stage = 3.0 (IQR 2.0-3.0), baseline FEV1 percent predicted 48.8% (±16.4), and 48.2% female. We identified predominant themes of breathlessness, and associated fear and embarrassment that limited physical activity across all groups. In both TC and walking, participants reported improvements in energy and endurance. Those in TC additionally shared improvements in breathing, mobility, and capacity for daily activities facilitated by body and breath awareness, emotional control and regulation of breathing, and an adaptive reframing of breathlessness. CONCLUSION: TC promoted physical and mental wellbeing by diminishing fear and embarrassment associated with breathlessness. Results highlight the multimodal characteristics of TC that may facilitate continued physical activity and improvement in quality of life.

Stress and Illness: A Role for Specific Emotions.

Research on stress and disease has often afforded an important role to emotion, typically conceptualized in broad categories (e.g., negative emotions), viewed as playing a causal role (e.g., anger contributing to pathophysiology of cardiovascular disease), and measured using self-report inventories. In this article, I argue for the value of evaluating specific emotions, considering bidirectional causal influences, and assessing actual emotional responding when considering the role that emotions play in the stress-disease relationship. In terms of specificity, specific emotions (e.g., anger, sadness, and embarrassment) can be linked with particular health outcomes (e.g., cardiovascular disease and musculoskeletal disease). In terms of bidirectionality, the influences of emotions on disease as well as the influences of disease on emotional functioning can be considered. In terms of assessing actual emotional responding, emotions can be studied in vivo under controlled conditions that allow behavioral, physiological, and subjective responses to be measured during different kinds of emotional functioning (e.g., responding to emotional stimuli, interacting with relationship partners, and downregulating emotional responses). With these considerations in mind, I review early theories and empirical studies in psychosomatic medicine that considered the role of specific emotions and emotion-related behaviors. Studies from our laboratory are presented that illustrate a) differences in patterns of autonomic nervous system responding associated with specific emotions, b) relationships between specific emotions and particular health outcomes in the context of social relationships, c) age as a moderator of the relationship between specific emotions and well-being, d) bidirectional influences (emotions influencing disease and disease influencing emotional functioning), and e) impact of changes in emotional functioning in individuals with neurodegenerative diseases on the health of familial caregivers.

CO2 laser treatment for pearly penile papules - personal experience.

Pearly penile papules (PPP) are physiological lesions in the epithelium of the corona of the glans penis which extend to its neck. These lesions may also appear on both sides of the frenulum. Although they are not pathological, the lesions frequently cause concern or embarrassment/discomfort in patients. They are the most common reason for seeing a dermatologist. There are several methods of treatment for PPP such as cryosurgery, electrocoagulation, treatment with CO2, Er:YAG, or pulsed dye lasers. This paper describes the authors' experience in removing PPP with a CO2 laser.

Identifying key components for a psychological intervention for people with vitiligo - a quantitative and qualitative study in the United Kingdom using web-based questionnaires of people with vitiligo and healthcare professionals.

BACKGROUND: Psychological interventions are recommended as part of routine management of vitiligo. However, the development and effectiveness of such interventions have been rarely addressed. This study aimed to identify key components for a psychological intervention for people with vitiligo. This is the first time perspectives of people with vitiligo, and healthcare professionals (HCPs) have been directly explored to inform intervention content and delivery. OBJECTIVES: To identify 1. which psychological difficulties are highlighted that can be targeted by an intervention; 2. what is important in terms of intervention content and delivery. METHODS: Web-based questionnaires containing both quantitative and qualitative items were completed by people with vitiligo and HCPs. Questionnaires collected data from people with vitiligo on demographics, clinical features, psychological difficulties and priority areas for psychological interventions, including ideas on delivery and content. HCPs questionnaires collected data on psychological difficulties reported, use of psychological interventions and suitability within health services. Quantitative data were analysed using descriptive statistics, and qualitative data utilized thematic framework analysis. RESULTS: A total of 100 people with vitiligo (66% female, 92% Caucasian) and 39 HCPs (54% dermatologists) participated. Key areas of difficulty were the impact of vitiligo, coping, issues with appearance/body image and the sun, and medical interactions. Vitiligo on sensitive sites was associated with more psychological impact. Interventions directed at increasing acceptance, confidence and self-esteem, as well as managing embarrassment, were important. These issues could be managed through interventions such as cognitive behavioural therapy, mindfulness and acceptance and commitment therapy. Both people with vitiligo and HCPs favoured individual interventions. CONCLUSION: Vitiligo has significant impact, requiring ongoing psychosocial support. There is a strong need for a psychoeducational intervention with focus on acceptance and managing social impact. The results of this study are the first steps to informing the development of a patient-centred psychological intervention.