ABSTRACT
Successful management of chronic kidney disease (CKD) typically involves consideration of several lifestyle changes and treatments that could improve patients' health outcomes. The complexity of behavioral changes and treatment decisions that must be made by patients, with the support of their treatment team, could diminish their motivation to address CKD and lead to poorer treatment outcomes. Hence, motivational enhancement, in the context of patient education and shared decision-making with the treatment team, is a critical issue in CKD patient care. This article describes how motivational interviewing can be used with patients to enhance their motivation to address CKD and participate in treatment.
Subject(s)
Kidney Failure, Chronic/therapy , Motivational Interviewing , Decision Making , Disease Management , Humans , Life Style , Patient-Centered Care , Professional-Patient RelationsABSTRACT
OBJECTIVE: We examined rates of overweight and obesity in a sample of Operation Enduring Freedom/Operation Iraqi Freedom Veterans setting up routine care within 1 Veterans Affairs medical center and examined associations between weight and measures of symptoms of posttraumatic stress disorder (PTSD) and depression. METHODS: Retrospective chart reviews were conducted to collect data on weight and symptoms of PTSD and depression. RESULTS: Mean body mass index (=27 kg/m2, SD = 4.47) was within the overweight range. Veterans had rates of overweight that were higher than those of national samples of individuals in the same age group, but had lower rates of obesity. Measures of symptoms of PTSD and depression were not associated with weight. CONCLUSIONS: A high proportion of individuals in this group of Operation Enduring Freedom/Operation Iraqi Freedom Veterans is overweight with rates consistent with the larger active duty population. Overweight was not associated with psychological distress. These data raise concerns for long-term problems with weight in this group of Veterans.
Subject(s)
Afghan Campaign 2001- , Depression/epidemiology , Iraq War, 2003-2011 , Overweight/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Veterans/statistics & numerical data , Adult , Female , Humans , Male , Middle Aged , Obesity/epidemiology , Retrospective Studies , United States/epidemiology , Veterans/psychology , Young AdultABSTRACT
Careers in academic health centers (AHCs) come with a unique set of challenges and rewards. Building a stable and rewarding career as a psychologist in an AHC requires the efforts of a whole team of players and coaches. This paper outlines the characteristics of AHCs and the general skills psychologists need to thrive in this type of setting. Advice specific to each stage of career development (early, mid, and late) is offered, highlighting the themes of coaching and teamwork that are critical to success in an AHC.
Subject(s)
Academic Medical Centers , Career Mobility , Clinical Competence , Psychology , Humans , United StatesABSTRACT
Sickle cell disease is characterized by acute pain crises. Pain, chronic medical problems, utilization and coping were compared in younger vs older patients using questionnaires and medical record review. Groups reported similar pain intensity and medical conditions. The pattern of utilization differed such that older patients attended outpatient clinic, and younger patients went to the Emergency Department. Younger patients were more likely to cope by ignoring pain, or by using heat, cold or massage. Older patients were more likely to pray and hope. We conclude that age plays an important role in the utilization and coping of sickle cell patients.