Psychological well-being in patients undergoing stem cell transplantation

The aim of the study is to determine the psychological well-being of patients who underwent stem cell transplantation. This cross-sectional study was conducted with 100 patients. Data were collected face-to-face using an introductory information form and the Brief Symptom Inventory.When the results of the patients were examined, the interpersonal sensitivity of the sub-dimensions of the scale was found to be 5.0 ± 4.06, depression 7.60 ± 5.37, and anxiety disorder 7.90 ± 5.34. There was a significant difference between the diagnosistime of the patients and all sub-factors of the scale, except phobic anxiety. It was found that the psychological state of the patients was directly related to the time of first diagnosis. As a result, the importance of following the psychological processof the patients during the treatment process was revealed when planning nursing care.

Results of the Nursing Outcomes Classification/NOC for patients with obsessive-compulsive disorder.

OBJECTIVE: To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessive-compulsive disorder (OCD) in outpatient follow-up. METHOD: Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. RESULTS: Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. CONCLUSION: The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.

Results of the Nursing Outcomes Classification/NOC for patients with obsessive-compulsive disorder / Resultados de la Nursing Outcomes Classification/NOC para pacientes con trastorno obsesivo-compulsivo / Resultados da Nursing Outcomes Classification/NOC para pacientes com transtorno obsessivo-compulsivo

ABSTRACT Objective: To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessive-compulsive disorder (OCD) in outpatient follow-up. Method: Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. Results: Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. Conclusion: The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.

RESUMEN Objetivo: Evaluar la aplicación de resultados e indicadores de enfermería seleccionados en la Nursing Outcomes Classification (NOC) para examinar a los pacientes con Trastorno Obsesivo-Compulsivo (TOC) en seguimiento ambulatorio. Método: Investigación de resultados. Primeramente, se realizó un acuerdo entre enfermeros expertos en salud mental (SM) y en proceso de enfermería para seleccionar los resultados e indicadores de la NOC, seguido de la elaboración de sus definiciones conceptuales y operativas. Después, se construyó un instrumento con las informaciones recolectadas, y lo aplicaron a un grupo piloto con seis pacientes, que recibían atención en el ambulatorio de SM. Se aplicó el instrumento a los pacientes con TOC, sometidos a Terapia Cognitivo-Conductual en Grupo (TCCG). Estudio aprobado por el Comité de Ética en Investigación de la institución. Resultados: Se seleccionaron cuatro resultados y 17 indicadores NOC. Se observó una modificación significativa de los puntajes de nueve indicadores después de la TCCG. Conclusión: El estudio apuntó la viabilidad de evaluación de los síntomas de pacientes con TOC por medio de los resultados e indicadores de la NOC en el ámbito ambulatorio.

RESUMO Objetivo: Analisar a aplicação de resultados e indicadores de enfermagem selecionados na Nursing Outcomes Classification (NOC) para avaliar pacientes com Transtorno Obsessivo-Compulsivo (TOC) em acompanhamento ambulatorial. Método: Pesquisa de resultados. Primeiro, realizou-se consenso entre enfermeiros especialistas em saúde mental (SM) e em processo de enfermagem para seleção de resultados e indicadores da NOC, seguido da elaboração das suas definições conceituais e operacionais. Depois, construiu-se um instrumento com estes, que foi testado em grupo piloto de seis pacientes atendidos em ambulatório de SM. O instrumento foi aplicado aos pacientes com TOC submetidos a Terapia Cognitivo-Comportamental em Grupo (TCCG). Estudo aprovado pelo Comitê de Ética em Pesquisa da instituição. Resultados: Foram selecionados quatro resultados e 17 indicadores NOC. Observou-se modificação significativa dos escores de nove indicadores após a TCCG. Conclusão: O estudo apontou viabilidade de avaliação dos sintomas de pacientes com TOC através dos resultados e indicadores da NOC em cenário ambulatorial.

PANDAS: What nurses need to know.

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) describes a disorder that develops in children who abruptly develop neurologic abnormalities following a streptococcal infection. The authors discuss what is known about this poorly understood disorder and how nurses can educate and support patients and their families.

Culturally Sensitive OCD Research: Lessons from the U.S.-Mexico Border.

This paper explores culturally-related concerns that arose during a multi-year study of obsessive-compulsive disorder (OCD) along the U.S.-Mexico border and describes adaptations made to better connect the research process to study participants. The purpose of this exploration is two-fold: (1) to offer suggestions for culturally sensitive borderland mental health research; and (2) to enhance dialog focused on culture, mental health research and the U.S.-Mexico border. Systematic coding of the written record of weekly research team meetings identified six recurring cultural concerns: emotionally charged and poorly understood terminology; differing meanings of ethnicity and acculturation; quality of life-regional variation and uncertainty; overlap of research and care; hopeful but hesitant; and fatalism. We conclude that diligence in the initial planning phase of a study is only part of the challenge in doing culturally sensitive research. Equally important is an ongoing process of evaluation to make explicit cultural concerns that arise during research, as well as a readiness to implement culturally sensitive research adaptations.

[Nursing Experience With Reconstructing Self-Control Using Rational-Emotive Behavior Therapy on a Patient With Schizophrenia and Obsessive-Compulsive Symptoms].

This case report describes a nursing experience caring for a patient with schizophrenia and obsessive-compulsive symptoms. This patient suffered from symptoms of being controlled, obsessive thoughts, and compulsive behaviors. In addition, the patient showed no interest in implementing strategies for dealing with anxiety, no motivation for changing this suffering, and an inability to receive a higher level of rehabilitative job training in daycare. These problems impeded this patient's reintegration into the community. Therefore, the authors employed a five-dimension assessment (physical, emotional, cognitive, social, and spiritual) in order to address the two major nursing problems. The period of nursing care was from October 21, 2016 to January 10, 2017. The two nursing problems addressed included: 1) altered thought processes and 2) ineffective coping. The author provided potentially helpful nursing processes based on the theory of Rational-Emotive Behavior Therapy in order to help the patient cope with symptoms, including being controlled and obsessive-compulsive behaviors. Meanwhile, a relaxation technique was applied to reduce the patient's feelings of discomfort during the nursing processes. As a result, the patient's coping skills to deal with symptoms of being controlled, obsession, and compulsion were improved through refutation of irrational beliefs. In addition to showing rational emotions and appropriate behavior to handle pressures, the patient was also able to apply the relaxation technique to relieve the discomfort from anxiety and pain as needed. This case report suggests that nurses may implement the irrational beliefs refutation training regimen under Rational-Emotive Behavior Therapy for similar cases at the beginning of nursing-patients relationships. Furthermore, providing relaxation techniques in the nursing process may assist patients to deal with stressful life events. The results of this nursing experience are expected to help nursing colleagues apply the above theory and skills with schizophrenia patients with obsessive-compulsive symptoms.

Quality of life and burden in caregivers of youth with obsessive-compulsive disorder presenting for intensive treatment.

BACKGROUND: Pediatric obsessive-compulsive disorder (OCD) is associated with deleterious familial effects; caregivers are often enmeshed in the disorder and can experience considerable burden and decreased quality of life (QoL). Consequently, this study examined burden and QoL in caregivers of youth with OCD enrolled in an intensive outpatient or partial hospitalization program. METHOD: The relationships between caregiver QoL and burden and the following variables were investigated: OCD symptom severity, functioning (youth functional impairment, general family functioning), family (family accommodation, parental relationship satisfaction, positive aspects of caregiving), and comorbid psychopathology (caregiver anxiety and depressive symptoms, youth internalizing and externalizing behaviors). Seventy-two child and caregiver dyads completed clinician- and self-rated questionnaires. RESULTS: Components of caregiver QoL correlated with caregiver-rated functional impairment, family accommodation, youth externalizing behaviors, and caregiver psychopathology. Aspects of caregiver burden correlated with child OCD symptom severity, functional impairment related to OCD, as well as caregiver and child comorbid psychopathology. Caregiver depressive symptoms predicted caregiver QoL, and caregiver depressive symptoms and child externalizing symptoms both predicted caregiver burden. Caregiver burden did not mediate the relationship between obsessive-compulsive symptom severity and caregiver QoL. CONCLUSION: Ultimately, elucidating factors associated with increased caregiver burden and poorer QoL is pertinent for identifying at-risk families and developing targeted interventions.

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder.

OBJECTIVE: Familial aspects of pediatric obsessive-compulsive disorder (OCD), including accommodation and treatment, have received notable and warranted attention. However, individual perspectives of its repercussions on family functioning, including emotional and occupational parental burden, have not been closely examined. The present study details this topic using a large multicenter sample. METHOD: Participants included 354 youth affected with OCD and their mothers and fathers ascertained through OCD programs in Boston, Massachusetts (n = 180) and Vancouver, British Columbia (n = 174). The validated OCD Family Functioning Scale and standard OCD measurements were completed. Descriptive, between-site, and cross-perspective comparative analyses were followed by regression model testing to predict family impairment. RESULTS: Family functioning was negatively affected from youth, mother, and father perspectives. Impairment was reportedly more extensive at the time of worst OCD severity and was greater from maternal versus paternal viewpoints. Most frequently affected family tasks and implicated OCD symptoms included morning and bedtime routines and intrusive thoughts. Emotional repercussions in all members included stress and anxiety, followed by frustration or anger in youth and sadness in parents. Nearly half of mothers and one third of fathers reported daily occupational impairment. Compared with youth self-report, parents perceived fewer social and academic effects on their child. Family accommodation most consistently predicted family impairment, especially from parent perspectives. OCD and compulsion severity, contamination and religious obsessions, and comorbidities also predicted various perspectives of family subdomain impairment. CONCLUSION: This study quantitatively details the pervasive burden that pediatric OCD places on families, as reported from complementary relative perspectives. Further attention to this topic is warranted in clinical and research realms.

Examining the effects of accommodation and caregiver burden on relationship satisfaction in caregivers of individuals with OCD.

Obsessive-compulsive disorder (OCD) is a debilitating condition that does not always respond well to treatment. People with OCD often require a great deal of assistance from caregivers or family members, which is referred to as family accommodations. Caregivers may experience a great deal of stress, depression, and other problems as a result of caring for their loved one with OCD. They may have decreased relationship satisfaction due to the accommodations required by their family member. The present study examines the experience family members have of caring for someone with OCD and how it relates to caregiver burden, relationship satisfaction, and level of family accommodations. Participants for this study included 50 caregivers of individuals with OCD. Analyses were primarily correlational in nature. Results found that high relationship satisfaction was correlated with caregiver burden and OCD severity.

Is It PANS, CANS, or PANDAS? Neuropsychiatric Pediatric Disorders That Are Not Black and White--Implications for the School Nurse.

The terms pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), pediatric acute-onset neuropsychiatric syndrome (PANS), and childhood acute neuropsychiatric symptoms (CANS) have all been used to describe certain acute onset neuropsychiatric pediatric disorders. Additionally, controversy is ongoing concerning the diagnosis and etiology of the disorders. The school nurse, as a member of a multidisciplinary team, benefits from an awareness of these disorders, the resulting impact on school performance, and the recommended treatment. The school nurse assists the team through the development of an Individualized Healthcare Plan to help the student to achieve success in school.

Development of a functional analytical nurse observation chart (FANOC).

BACKGROUND: There has been little evaluation or development of nurse observation charts on psychiatric in-patient units since they were first introduced. AIM: We aimed to develop a new nursing chart that adds a functional and contextual assessment of the observed behaviour. We describe its initial evaluation in an in-patient setting. METHOD: A member of the staff coded a participant's behaviour as either an instance of an individual's daily life problem; or an improvement; or a non-clinically relevant behaviour. We evaluated the charts in 14 in-patients and compared the coding of the behaviour against that of one of the investigators. RESULTS: After brief training the inter-rater agreement resulted in Kappa = 0.496 with p < .001. Removal of a rating of neutral behaviours resulted in a higher Kappa = 0.546 with p < .001. CONCLUSIONS: The inter-rater reliability was only moderate for the Functional Analytical Nurse Observation Charts. Frequent training and support from management and therapy staff is required to maintain a psychologically informed environment and observation in an in-patient setting. An area for further research is to explore the impact that a FANOC has on staff satisfaction and an individual's experience of care, and whether it can assist in determining mediators of change before an improvement in symptoms.

[Consultations with a nurse specialized in cognitive behavioural therapies]. / Une consultation infirmière spécialisée en therapies comportementales et cognitives.

Cognitive behavioural therapies (CBT), which have been proven to be effective, are tools which are simple to use and implement. In Sainte Anne hospital, consultations with a nurse specialised in CBT were first set up in 2011.The nurse specialised in CBT sees the patients on a one-to-one basis and often plays, within the multidisciplinary team, the role of care coordinator.

Pediatric obsessive-compulsive disorder: a review for nursing professionals.

TOPIC: Pediatric obsessive-compulsive disorder (OCD). PURPOSE: OCD is a neuropsychiatric disorder characterized by the presence of obsessions and/or compulsions. Given that most children with OCD will initially be seen by nursing professionals in environments such as pediatrician offices, hospitals, and schools, increasing awareness of this disorder among nurses will likely facilitate early detection, accurate diagnosis, and appropriate treatment. SOURCES: Psyc-INFO, PubMed, Google Scholar. CONCLUSION: This article provides an overview of pediatric OCD, including information about clinical presentation, suspected etiology, epidemiology, assessment, and evidence-based treatment options.

Dimensional analysis of burden in family caregivers of patients with obsessive-compulsive disorder.

AIMS: Obsessive-compulsive disorder (OCD) also generates emotional burden in the patient's family members, but no study has evaluated the specific dimensions of burden. The objectives were to evaluate the dimensions of the Zarit Burden Interview (ZBI) and possible correlates. METHODS: This was a cross-sectional study involving 47 patients and 47 caregivers, using a sociodemographic questionnaire; the ZBI; the Self Reporting Questionnaire; the Family Accommodation Scale; and the Yale-Brown Obsessive-Compulsive Scale. The ZBI factor analysis was conducted using Varimax Rotation. RESULTS: Six factors were identified, explaining 74.2% of the total variance: factor 1, interference in the caregiver's personal life (36.6% of the variance); factor 2, perception of patient's dependence (10.8%); factor 3, feelings of irritation or intolerance (9.2%); factor 4, guilt (7.2%); factor 5, insecurity (5.6%); and factor 6, embarrassment (4.8%). The six ZBI factors were associated with greater OCD severity and with greater accommodation to the patient's symptoms, and factors 1, 2, 5 and 6 with caregiver's psychological morbidity. Caregiver's sex (female) was associated with factors 5 and 6, relationship with the patient (being a parent or son/daughter) with factor 5, higher educational level with factor 6, living with the patient with factor 3, worse self-evaluation of health with factors 1, 5 and 6, and occupational status (not working) with factors 1, 2, 5 and 6. CONCLUSION: The dimensions of burden identified indicate the most affected aspects of a caregiver's life and could guide the planning of more specific interventions. Thus, the caregiver could participate more effectively in the OCD patient's treatment, with a lower impact on his/her life.

Perceived burden and quality of life of caregivers in obsessive-compulsive disorder.

AIM: The study aimed to examine the family burden and quality of life (QOL) of caregivers of patients with obsessive-compulsive disorder (OCD). METHODS: A cross-sectional assessment of 50 patients with OCD and their caregivers was carried out. The severity of OCD was assessed using the Yale-Brown Obsessive Compulsive Scale. The caregivers were assessed using the Family Burden Interview Schedule and the World Health Organization Quality of Life BREF version (WHOQOL-BREF). RESULTS: Fifty-six percent of caregivers reported a high objective burden. Severity of illness correlated with burden and impaired QOL of caregivers. Age of patient, longer duration of illness and longer duration of treatment were predictive of poorer QOL of caregivers in the physical health domain. Greater objective burden, disruption of family leisure and interaction due to OCD led to significantly poorer QOL in all domains in caregivers. Higher financial burden, perception of poorer mental health, and higher subjective burden were predictive of poorer physical, general health and general and psychological QOL, respectively. CONCLUSIONS: The study provides important insights into the QOL and perceived burden of caregivers of OCD patients. It highlights the need for improving the quality of care not only for patients but also for primary caregivers.