Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.255
Filtrar
1.
Psychiatry Res ; 288: 113024, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32315874

RESUMEN

The COVID-19 pandemic will likely lead to high rates of PTSD, depression, and substance misuse among survivors, victims' families, medical workers, and other essential personnel. The mental health response to the 9/11/01 terrorist attacks, culminating in a federally-funded health program, provides a template for how providers may serve affected individuals. Drawing on the 9/11 experience, we highlight effective prevention measures, likely short and long-term treatment needs, vulnerable subgroups, and important points of divergence between 9/11 and the COVID-19 pandemic. Mental health monitoring, early identification of at-risk individuals, and treatment irrespective of financial barriers are essential for minimizing chronic distress.


Asunto(s)
Infecciones por Coronavirus/psicología , Servicios de Salud Mental , Salud Mental , Neumonía Viral/psicología , Sobrevivientes/psicología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Depresión , Personal de Salud/psicología , Humanos , Pandemias , Neumonía Viral/epidemiología , Ataques Terroristas del 11 de Septiembre/psicología , Terrorismo
2.
Am J Nurs ; 120(4): 72, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32218058
3.
Sex Reprod Health Matters ; 28(1): 1722404, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32075551

RESUMEN

In humanitarian settings, timely access to care is essential for survivors of gender-based violence (GBV). Despite the existence of GBV support services, challenges still exist in maximising benefits for survivors. This study aimed to understand the characteristics of violence against women and explore barriers and facilitators to care-seeking for GBV by women in two camps within the Dadaab refugee complex in Kenya. A mixed-methods design was used to study women accessing comprehensive GBV services between February 2016 and February 2017. Women were recruited into a cohort study (n = 209) and some purposively selected for qualitative in-depth interviews (n = 34). Survivor characteristics were descriptively analysed from baseline measures, and interview data thematically assessed. A majority of women were Muslim, of Somali origin, had been residents in the camp for more than five years, with little or no formal education, and meagre or no monthly income. From the survey, 60.3% and 66.7% of women had experienced non-partner violence or intimate partner violence in their lifetime respectively. Facilitators to accessing GBV services by survivors included awareness of GBV services and self-perceived high severity of acts of violence. Barriers included stigma by family and the community, fear of further violence from perpetrators, feelings of helplessness and insecurity, and being denied entry to service provision premises by guards. Women in the Dadaab refugee camps face violence from intimate partners, family, and other refugees. There is an urgent need to address drivers of GBV and the barriers to disclosure and access to services for all survivors of GBV.


Asunto(s)
Violencia de Género/psicología , Servicios de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud , Refugiados/psicología , Estigma Social , Sobrevivientes/psicología , Adolescente , Adulto , Estudios de Cohortes , Etiopía , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Kenia , Persona de Mediana Edad , Investigación Cualitativa , Refugiados/estadística & datos numéricos , Somalia , Sudán , Adulto Joven
4.
J Forensic Nurs ; 16(1): 6-15, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32068675

RESUMEN

BACKGROUND: Human sex trafficking is a major public health issue. The United States is the second largest market for sex-trafficked women, yet few healthcare interventions, designed for women specifically, have been identified. The purpose of this review was to present a systematic review of the literature on the characteristics and healthcare needs of women who have been trafficked for sex in the United States. METHODS: This literature review was conducted following the methodology outlined by Whittmore and Knalf and written using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Cumulative Index to Nursing & Allied Health, PsychInfo, PubMed, and Scopus databases were searched. A quality assessment tool was used to determine rigor of the studies included in this review. RESULTS: Nine publications met the inclusion criteria. Three studies specifically explored health. Four studies were composed solely of women born outside the United States, and two studies reported differences across many variables, including overall health, between women born outside the United States and women born within the United States. A lack of resources and an inadequate response by the health system resulted in care that was not optimal. CONCLUSION: There are differences between U.S.-born and non-U.S.-born victims. Evidence on the healthcare needs of U.S.-born women trafficked for sex in the United States is extremely limited. Research focusing on the health perceptions of women survivors of human sex trafficking may shed light on how they perceive health, care, and the health system and what they identify as important for key stakeholders to understand.


Asunto(s)
Víctimas de Crimen , Necesidades y Demandas de Servicios de Salud , Trata de Personas , Sobrevivientes , Salud de la Mujer , Adultos Sobrevivientes de Eventos Adversos Infantiles , Actitud del Personal de Salud , Continuidad de la Atención al Paciente , Víctimas de Crimen/psicología , Cultura , Emigrantes e Inmigrantes , Femenino , Humanos , Abuso Físico , Pobreza , Sobrevivientes/psicología , Estados Unidos , Poblaciones Vulnerables
5.
BMC Public Health ; 20(1): 182, 2020 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-32020858

RESUMEN

BACKGROUND: We examined the magnitude and correlates of Ebola virus disease (EVD)-related stigma among EVD survivors in Sierra Leone since their return to their communities. In addition, we determined whether EVD-related stigma is a predictor of informal health care use among EVD survivors. METHODS: We conducted a cross-sectional study among 358 EVD survivors in five districts across all four geographic regions (Western Area, Northern Province, Eastern Province and Southern Province) of Sierra Leone. Ebola-related stigma was measured by adapting the validated HIV related stigma for people living with HIV/AIDS instrument. We also measured traditional and complementary medicine (T&CM) use (as a measure of informal healthcare use). Data were analysed using descriptive statistics and regression analysis. RESULTS: EVD survivors report higher levels of internalised stigma (0.92 ± 0.77) compared to total enacted stigma (0.71 ± 0.61). Social isolation (0.96 ± 0.88) was the highest reported enacted stigma subscale. Ebola survivors who identified as Christians [AOR = 2.51, 95%CI: 1.15-5.49, p = 0.021], who perceived their health to be fair/poor [AOR = 2.58, 95%CI: 1.39-4.77. p = 0.003] and who reside in the northern region of Sierra Leone [AOR = 2.80, 95%CI: 1.29-6.07, p = 0.009] were more likely to experience internalised stigma. Verbal abuse [AOR = 1.95, 95%CI: 1.09-3.49, p = 0.025] and healthcare neglect [AOR = 2.35, 95%CI: 1.37-4.02, p = 0.002] were independent predictors of T&CM use among EVD survivors. CONCLUSION: Our findings suggest EVD-related stigma (internalised and enacted) is prevalent among EVD survivors since their return to their communities. Religiosity, perceived health status and region were identified as independent predictors of internalised stigma. Verbal abuse and healthcare neglect predict informal healthcare use. EVD survivor-centred and community-driven anti-stigma programs are needed to promote EVD survivors' recovery and community re-integration.


Asunto(s)
Fiebre Hemorrágica Ebola/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Estigma Social , Sobrevivientes/psicología , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sierra Leona , Sobrevivientes/estadística & datos numéricos , Adulto Joven
6.
PLoS One ; 15(2): e0228875, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32050260

RESUMEN

Mutual help is common in human society, particularly during a disaster. The psychological processes underlying such social support are of interest in social and evolutionary psychology, as well as in the promotion of community resilience. However, research in terms of personality factors or support types is sporadic and has yet to address actual emergency situations. In this study, we analyzed survey data from survivors of the 2011 Tohoku earthquake and tsunami. The data included five types of social support occurring during the evacuation from a potential tsunami area: providing and receiving actual help and oral encouragement, as well as perceived support. The personality factor items included the Big Five dimensions and eight "power to live" factors, which were identified as advantageous for survival during this disaster. While none of the Big Five dimensions were associated with social support, six of the power to live factors were. Altruism, problem solving, etiquette, and self-transcendence contributed to the provision of actual help. Leadership and active well-being contributed to oral encouragement with the latter contributing also to perceived support. The findings were largely consistent with the literature in a non-emergency context. The relevance of the majority of these pro-survival personality factors to social support appeared to support the view that the propensity to cooperate in service of human survival in a disaster situation is primarily a social, rather than an individual, phenomenon, and encourages research on the mechanisms underlying how personality factors provide a benefit to both the individual and their community.


Asunto(s)
Sobrevivientes/psicología , Adulto , Desastres/estadística & datos numéricos , Terremotos/estadística & datos numéricos , Femenino , Humanos , Masculino , Personalidad/fisiología , Apoyo Social , Encuestas y Cuestionarios , Tsunamis/estadística & datos numéricos , Adulto Joven
7.
Forensic Sci Int ; 306: 110062, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31786514

RESUMEN

The renowned work of Clyde Snow and the development of the Equipo Argentino de Anthropología Forense (EAAF) team has inspired the use of forensic anthropological and archaeological skills in human rights interventions around the world. Whether for medico-legal intervention and acquisition of evidence or humanitarian repatriation and identification of human remains, forensic expertise has garnered attention in the global arena. Arguably fulfilling evidentiary and psychosocial needs, there has been growing interest in this post-conflict redress. However, as part of the critique of these interventions, scholars and practitioners have pointed out - primarily in medico-legal investigations - a lack of sensitization of local communities regarding forensic work, increasing the potential for re-traumatization, unrealistic expectations, or an unintentional increase in political tensions. Research regarding forensic intervention and human remains have permeated social sciences, peace and conflict studies, and science and technology studies, revealing both intentional and unintentional impacts of forensic sciences after mass violence. In an effort to mitigate negative impacts of medico-legal or humanitarian interventions, the research described here sought to sensitize communities in Uganda about forensic methods. Findings from this study suggest that sensitization is necessary and desired, and that a multi-step approach can assist in managing expectations.


Asunto(s)
Conflictos Armados , Antropología Forense/organización & administración , Sobrevivientes/psicología , Altruismo , Arqueología , Recursos Audiovisuales , Entierro , Relaciones Comunidad-Institución , Grupos Focales , Antropología Forense/educación , Derechos Humanos , Humanos , Población Rural , Uganda
8.
J Surg Res ; 245: 516-522, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31450039

RESUMEN

BACKGROUND: A necrotizing soft-tissue infection (NSTI) is a rare but severe infection with a high mortality rate of 12%-20%. Diagnosing is challenging and often delayed. Treatment consists of surgical debridement of all necrotic tissue and administration of antibiotics. Despite adequate treatment, survivors are often left with extensive wounds, resulting in mutilating scars and functional deficits. Both the disease and the subsequent scars can negatively influence the health-related quality of life (HRQoL). The present study was performed to contribute to the knowledge about HRQoL in patients after NSTI. METHODS: We retrospectively identified patients treated for NSTI in a tertiary center in the Netherlands. Patient and treatment characteristics were collected and patients were asked to fill in a Short Form 36 questionnaire. RESULTS: Forty-six patients with a diagnosis of NSTI were identified. Twenty-eight (61%) were male and mean age was 57 y. Thirty-nine patients (80%) survived. Thirty-one (84%) of the survivors returned the questionnaire after a median follow-up of 4.1 y (interquartile range [IQR], 2.4-5.9 y). Statistically significantly decreased scores when compared to the Dutch reference values were observed for the Short Form 36 domains, physical functioning, role-physical functioning, general health, and the combined Physical Component Score. No differences were observed for the other five domains or for the Mental Component Score. CONCLUSIONS: This study confirms that NSTI negatively affects HRQoL as reported by the patient, especially on the physical domains. To learn more about HRQoL in patients after NSTI, studies in larger groups with a more disease-specific questionnaire should be performed. LEVEL OF EVIDENCE: Level 3, prognostic and epidemiological.


Asunto(s)
Fascitis Necrotizante/cirugía , Gangrena de Fournier/cirugía , Gangrena Gaseosa/cirugía , Calidad de Vida , Infecciones de los Tejidos Blandos/cirugía , Adulto , Desbridamiento/efectos adversos , Fascitis Necrotizante/complicaciones , Fascitis Necrotizante/psicología , Femenino , Gangrena de Fournier/complicaciones , Gangrena de Fournier/psicología , Gangrena Gaseosa/complicaciones , Gangrena Gaseosa/psicología , Humanos , Masculino , Persona de Mediana Edad , Terapia de Presión Negativa para Heridas/efectos adversos , Países Bajos , Periodo Posoperatorio , Estudios Retrospectivos , Infecciones de los Tejidos Blandos/complicaciones , Infecciones de los Tejidos Blandos/psicología , Encuestas y Cuestionarios/estadística & datos numéricos , Sobrevivientes/psicología , Sobrevivientes/estadística & datos numéricos
9.
Disasters ; 44(1): 85-102, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31231844

RESUMEN

After the Great East Japan Earthquake and Tsunami, volunteers participated in the recovery of lost photographs. This effort-which we call the Picturescue Movement-subsequently began to organise photograph restoration gatherings. We conducted field research during the gatherings in Noda, one of the tsunami-stricken areas. We have also carried out research on restoration gatherings in the city of Rikuzentakata. A comparison of findings across these two localities identifies two approaches to photograph restoration gatherings: 'aiming' and 'staying'. The aiming approach, employed in Rikuzentakata, emphasises returning photographs to their owners quickly, whereas the latter approach, used in Noda, is one in which volunteers stay with survivors for some time and encourage them to recall the past at their own pace. We conclude that the staying approach is more likely than the aiming approach to promote disaster recovery among survivors.


Asunto(s)
Desastres , Fotograbar , Sistemas de Socorro/organización & administración , Sobrevivientes/psicología , Tsunamis , Humanos , Japón
10.
BMC Psychol ; 7(1): 84, 2019 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-31856892

RESUMEN

BACKGROUND: The 1994 Genocide against the Tutsi was a major traumatic event affecting nearly all Rwandans. Significant psychological sequels continue to occur in the population 25 years after, with a high prevalence of posttraumatic stress disorder (PTSD) found in women. Three groups are typically designated with regard to the Genocide against the Tutsi: those who were targeted and categorized as genocide "survivors," those who were in the country during the genocide and were the "non-targeted" group, and those who were outside of the country, referred to as the "1959 returnees." Each group experienced various traumatic events during and in the aftermath of the genocide. Offspring of the designated groups, currently exhibit symptoms of PTSD disregarding of being born in the years following the genocide. A number of studies have described the prevalence of PTSD in the general adult population. There is a lack of research comparing the prevalence of PTSD in women and their offspring among these three target groups, therefore, this study aimed to bridge the gap. METHODS: We conducted a comparative cross-sectional study with a sample of 432 mothers and 432 children in three categories: genocide survivors, in country non-targeted and 1959 returnees. Participant ages for children were between 14 to 22 years and for mothers, between the ages of 32 to 87 years. The UCLA-PTSD DSM-5, PTSD Check list-5 and Life events Checklist-5 were translated from English to Kinyarwanda and were used to assess exposure to trauma and the prevalence of PTSD symptoms in Rwandan mothers and their offspring. RESULTS: Key Results yield a PTSD rate of 18.8, 6.2, 5.2% within survivors, in country non-targeted, and returnees respectively with an average PTSD rate of 43.8% for parents, and 16.5% for offspring. CONCLUSION: PTSD among the mothers' groups and their offspring have been found, specifically in the offspring of genocide survivors. Considering these adolescents were not born at the time of the 1994 Genocide against the Tutsi, the results suggest future studies should explore the precipitating factors contributing to the PTSD symptoms within this specific group.


Asunto(s)
Genocidio , Madres/psicología , Trastornos por Estrés Postraumático/epidemiología , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres , Prevalencia , Rwanda , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-31847437

RESUMEN

BACKGROUND: This study aims to examine the impact of individual-level and community-based factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. METHODS: Sub-samples of survivors of stroke (2011: n = 413, 2013: n = 395, 2015: n = 441) recruited by the China Health and Retirement Longitudinal Study (CHARLS) were included in the analysis. Zero-inflated Poisson and multi-level logistic regression models were used to explore factors associated with social participation. RESULTS: More than half of individuals (55.0%) had no social participation and 23.4% participated in multiple social activities. The most popular social activities that individuals participated in were interacting with friends (32.6%) and going to a community club to play table games (22.7%). Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with the participation of going to a community club to play table games. CONCLUSION: Stroke survivors are at high risk of limited social participation. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation.


Asunto(s)
Conducta Social , Participación Social , Accidente Cerebrovascular/psicología , Sobrevivientes/psicología , Anciano , China , Depresión , Ejercicio Físico , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad
12.
BMC Health Serv Res ; 19(1): 990, 2019 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-31870375

RESUMEN

BACKGROUND: Sexual violence is a global public health issue. It is a form of gender-based violence commonly experienced by women accessing mental health services. The biomedical model has been the dominant model of care in acute psychiatric units, however, there has been a global movement towards more gender-sensitive and trauma-informed models. To date, only a small amount of research has focused on evaluating these models of care and health professionals' experiences of providing this care. The aim of this study is to gain an in-depth understanding of healthcare professionals' perceptions of how Gender Sensitive Care (GSC) is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence. METHODS: This study used case study methodology and the Normalisation Process Theory (NPT) conceptual framework. NPT is a practical framework that can be used to evaluate the implementation of complex models of care in health settings. It included semi-structured interviews with 40 health professionals, document and policy reviews, and observations from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic and content analysis. RESULTS: Themes were developed under the four NPT core constructs; 1) Understanding GSC in acute psychiatric units: "Without the corridors there's not a lot we can do", 2) Engagement and Commitment to GSC in acute psychiatric units: "There are a few of us who have that gender sensitive lens", 3) Organising, relating and involvement in GSC: "It's band aid stuff", 4) Monitoring and Evaluation of GSC in acute psychiatric units: "We are not perfect, we have to receive that feedback". DISCUSSION: Many health professionals held a simplistic understanding of GSC and avoided the responsibility of implementing it. Additionally, the competing demands of the biomedical model and a lack of appraisal has resulted in an inconsistent enactment of GSC. CONCLUSIONS: Health professionals in this study enacted GSC to varying levels. Our findings suggest the need to address each NPT construct comprehensively to adequately implement GSC.


Asunto(s)
Actitud del Personal de Salud , Personal de Salud/psicología , Servicios de Salud Mental/organización & administración , Servicio de Psiquiatría en Hospital/organización & administración , Delitos Sexuales/psicología , Sobrevivientes/psicología , Adulto , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Sobrevivientes/estadística & datos numéricos , Victoria , Adulto Joven
13.
Nurs Clin North Am ; 54(4): 569-584, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31703782

RESUMEN

Human trafficking is the intentional exploitation of vulnerable individuals for the personal gain of the exploiter and is now recognized as an emerging public health care priority. Health care providers are well positioned to identify and assist trafficked individuals as well as those who may be at risk for exploitation. Trauma informed care is essential to identify victims and evaluate the impact of traumatic stress while highlighting survivors' strengths and supporting their resiliency. Human trafficking demographics, including mental and physical health problems, health considerations, risk factors, screening, implications for practice, and national resources, are reviewed.


Asunto(s)
Prestación de Atención de Salud , Medicina Basada en la Evidencia , Trata de Personas/estadística & datos numéricos , Sobrevivientes/psicología , Adulto , Niño , Personal de Salud , Trata de Personas/psicología , Humanos , Servicios de Salud Mental , Salud Pública
14.
Artículo en Inglés | MEDLINE | ID: mdl-31590225

RESUMEN

Suicide often imparts highly stressful ramifications to those left behind. Previous research on suicide survivors (SUSs) has demonstrated their being at high risk for developing anxiety and depression, including pathological complicated grief (CG). Self-disclosure (S-D)--the tendency to share one's personal feelings--has been found to be an important component of dealing with grief. In this study, we examined the effect of S-D on CG in an 18-month longitudinal design following one hundred fifty-six SUSs. We found that SUSs suffering from pathological CG at Time 1 (T1) were lower in S-D at T1 and T2 and higher in depression at T2. We also found that SUSs with lower S-D at T1 had higher CG at T2. Using a structural equation model, we found that S-D at T1 contributed significantly (and negatively) to CG at T1, above and beyond the natural fading of CG over time. Our findings emphasize that while CG is highly prevalent among SUSs, S-D has a beneficial effect which can serve as a protective factor against CG for this group. Implications regarding possible interventions with SUSs were discussed.


Asunto(s)
Depresión/psicología , Pesar , Autorrevelación , Suicidio/psicología , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
15.
Medicine (Baltimore) ; 98(39): e17307, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31574859

RESUMEN

To investigate the cognitive and psychological outcomes of pediatric allogeneic HSCT survivors in China.A total of 135 3 to 18 years old children and adolescents who underwent allo-HSCT and survived at least 3 months post-HSCT were recruited and completed the assessments. Cognitive and psychological functions were assessed via age-appropriate standardized measures. Clinical information was extracted from the medical records.Forty one 3 to 6 years old children completed Psychological Questionnaires for 3 to 6 years Children. The scores of 21(51.2%) children in cognitive development dimension, 18(43.9%) in motor development dimension, 16(39.0%) in language development and social development dimension, 15(36.6%) in emotion and will dimension and 14(34.1%) in living habits dimension were less than the standard. Fifty six 8 to 16 years old children and adolescents completed the Depression Self-rating Scale for Children and 9 (16.1%) of these met the criteria of depression. Sixty nine 7 to 16 years old children and adolescents completed the screening for Child Anxiety Related Disorders and 7 (10.1%) of these met the criteria of anxiety, especially social phobia and school phobia. Eighty nine 6 to 18 years old children and adolescents completed the Symptom Checklist-90 and 43.8% to 77.5% of these experienced mild symptoms like obsession-compulsion (77.5%), hostility (64%), and interpersonal sensitivity (60.7%). Children treated with total body irradiation (TBI) showed more cognitive impairments like motor deficits than those without TBI. Also older children and adolescents had more symptoms like psychoticism.These findings demonstrated cognitive and psychological late effects of pediatric allo-HSCT survivors in a single center in China and highlighted that the survivors conditioned with TBI had more cognitive impairments and older children and adolescents had more symptoms. Early intervention in these children and adolescents might minimize the cognitive losses and psychological effects.


Asunto(s)
Ansiedad , Disfunción Cognitiva , Depresión , Trasplante de Células Madre Hematopoyéticas , Complicaciones Posoperatorias , Calidad de Vida , Adolescente , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/prevención & control , Niño , Preescolar , China/epidemiología , Cognición , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Disfunción Cognitiva/prevención & control , Depresión/diagnóstico , Depresión/etiología , Depresión/prevención & control , Intervención Médica Temprana/métodos , Femenino , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Masculino , Destreza Motora , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/prevención & control , Técnicas Psicológicas , Sobrevivientes/psicología
16.
Dis Colon Rectum ; 62(11): 1294-1304, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31567919

RESUMEN

BACKGROUND: Despite the increasing number of younger individuals diagnosed with colon and rectal cancer, research on the long-term disease-specific health-related quality of life of younger (<50 years) survivors of colon and rectal cancer is scarce. OBJECTIVE: Our study aimed to compare disease-specific functional deficits and symptoms of survivors of colon and rectal cancer 5 to 16 years postdiagnosis, stratified by age at diagnosis and by sex. DESIGN: This is a cross-sectional study. SETTING: We used data from the population-based CAncEr Survivorship-A multi-Regional study in collaboration with 5 population-based German cancer registries. PATIENTS: Survivors of colon and rectal cancer were included in the study. MAIN OUTCOME MEASURES: Respondents completed the disease-specific European Organization for Research and Treatment of Cancer Quality of Life colorectal cancer module. Age at diagnosis categories were <50, 50 to 59, 60 to 69, and ≥70 years. Least square mean health-related quality of life scores, derived from linear regression, were adjusted for sex, education, time since diagnosis, cancer site, cancer stage, and treatment, where appropriate. RESULTS: The sample comprised 697 survivors of colon cancer and 479 survivors of rectal cancer. In general, survivors of colon and rectal cancer diagnosed at <50 years of age reported lower functioning and higher symptom burden in comparison with survivors diagnosed at an older age. When stratified by sex, female survivors of colon cancer tended to report more concerns with hair loss but fewer sexual problems when compared with male survivors of colon cancer of the same age. Female survivors of rectal cancer in all age groups tended to report lower levels of sexual interest than male survivors of rectal cancer of the same age. LIMITATIONS: This was a cross-sectional study with findings that could be biased toward healthier long-term survivors. The generalizability of results is limited to survivors diagnosed before 2005. CONCLUSIONS: Our results suggest that supportive care for survivors of colon and rectal cancer to improve their self-management of symptoms should be adapted according to cancer type, age at diagnosis, and sex. See Video Abstract at http://links.lww.com/DCR/B29. LA EDAD AL DIAGNÓSTICO Y EL GÉNERO ESTÁN ASOCIADOS CON DÉFICITS A LARGO PLAZO EN LA CALIDAD DE VIDA RELACIONADA CON LA SALUD ESPECíFICA DE LA ENFERMEDAD DE LOS SOBREVIVIENTES DE CÁNCER DE COLON Y RECTO: UN ESTUDIO BASADO EN LA POBLACIÓN:: A pesar del creciente número de individuos jóvenes diagnosticados con cáncer de colon y recto, la investigación sobre la calidad de vida relacionada con la salud específica de la enfermedad a largo plazo de los sobrevivientes de cáncer de colon y recto jóvenes (<50 años) es escasa.Nuestro estudio tuvo como objetivo comparar los déficits funcionales específicos de la enfermedad y los síntomas de los sobrevivientes de cáncer de colon y recto 5-16 años después del diagnóstico, estratificados por edad al momento del diagnóstico y por género.Transversal.Utilizamos datos del estudio Supervivencia de CAncEr basada en la población: Un estudio multirregional en colaboración con cinco bases de datos alemanas de cáncer basados en la población.Sobrevivientes de cáncer de colon y recto.Los encuestados respondieron el módulo de calidad de vida específica para la enfermedad en cáncer colorrectal de la Organización Europea para la Investigación y Tratamiento del Cáncer. Las categorías de edad al diagnóstico fueron <50, 50-59, 60-69 y ≥70 años. Los puntajes de CVRS (calidad de vida relacionada a la salud) medios mínimos cuadrados, derivados de la regresión lineal, se ajustaron por género, educación, tiempo desde el diagnóstico, sitio del cáncer, etapa del cáncer y tratamiento, cuando apropiado.La muestra comprendió 697 y 479 sobrevivientes de cáncer de colon y de recto, respectivamente. En general, los sobrevivientes de cáncer de colon y recto diagnosticados con <50 años de edad reportaron una menor funcionalidad y una mayor carga de síntomas en comparación con los sobrevivientes diagnosticados a una edad más avanzada. Cuando se estratificaron por género, las mujeres sobrevivientes de cáncer de colon tendieron a informar más preocupaciones sobre la pérdida de cabello pero menos problemas sexuales en comparación con los hombres sobrevivientes de colon de la misma edad. Las mujeres sobrevivientes de cáncer rectal en todos los grupos de edad tendieron a informar niveles más bajos de interés sexual que los hombres sobrevivientes de cáncer rectal de la misma edad.Estudio transversal con hallazgos que podrían estar sesgados hacia sobrevivientes a largo plazo más saludables. La generalización de los resultados se limitó a los sobrevivientes diagnosticados antes de 2005.Nuestros resultados sugieren que los cuidados de soporte para los sobrevivientes de cáncer de colon y recto para mejorar su automanejo de síntomas deben adaptarse según el tipo de cáncer, la edad en el momento del diagnóstico y el género. Vea el resumen en video en http://links.lww.com/DCR/B29.


Asunto(s)
Neoplasias Colorrectales , Costo de Enfermedad , Rendimiento Físico Funcional , Calidad de Vida , Sobrevivientes , Tiempo , Anciano , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/psicología , Neoplasias Colorrectales/terapia , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Atención al Paciente/métodos , Factores Sexuales , Sobrevivientes/psicología , Sobrevivientes/estadística & datos numéricos
17.
Artículo en Inglés | MEDLINE | ID: mdl-31658681

RESUMEN

It is important to explore factors that could help or hinder one's wellbeing following a suicide attempt, which could yield not only negative consequences but also posttraumatic growth (PTG; positive changes following a traumatic event). The present study used a multivariate analysis of covariance (MANCOVA) to test the relationship between disclosure, PTG, and posttraumatic depreciation among suicide attempt survivors when controlling for time since attempt and to test whether these effects remained after controlling for quality of support from family and friends. Suicide attempt survivors (n = 159) completed an online survey about their experiences. Increases in disclosure to family and friends but not to healthcare providers predicted changes in PTG. The effects of family disclosure remained even after controlling for quality of support. Disclosure to healthcare providers demonstrated some statistical effects on PTG, yet in the opposite direction and only after controlling for quality of support. The control variables-time since attempt and quality of support-were the only variables that predicted a change in posttraumatic depreciation. These findings suggest there is value in disclosing one's personal story to family regardless of whether one receives supportive responses and that social support can impact one's PTG.


Asunto(s)
Revelación , Crecimiento Psicológico Postraumático , Intento de Suicidio/psicología , Sobrevivientes/psicología , Adolescente , Adulto , Anciano , Femenino , Amigos , Humanos , Masculino , Persona de Mediana Edad , Apoyo Social , Encuestas y Cuestionarios , Adulto Joven
18.
BMC Health Serv Res ; 19(1): 718, 2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31638998

RESUMEN

BACKGROUND: Domestic violence and abuse (DVA) damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services. METHODS: Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3544; T2 N = 2780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the 6 months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services. RESULTS: Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2050 per patient per year. This offset the average cost of providing hospital IDVA services. CONCLUSIONS: Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Servicio de Urgencia en Hospital , Maternidades , Defensa del Paciente , Sobrevivientes/estadística & datos numéricos , Adulto , Víctimas de Crimen/psicología , Violencia Doméstica/psicología , Servicio de Urgencia en Hospital/organización & administración , Estudios de Evaluación como Asunto , Femenino , Guías como Asunto , Maternidades/organización & administración , Humanos , Masculino , Sobrevivientes/psicología
20.
PLoS Med ; 16(9): e1002919, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31550249

RESUMEN

BACKGROUND: Torture and other forms of ill treatment have been reported in at least 141 countries, exposing a global crisis. Survivors face multiple physical, psychological, and social difficulties. Psychological consequences for survivors are varied, and evidence on treatment is mixed. We conducted a systematic review and meta-analysis to estimate the benefits and harms of psychological, social, and welfare interventions for torture survivors. METHODS AND FINDINGS: We updated a 2014 review with published randomised controlled trials (RCTs) for adult survivors of torture comparing any psychological, social, or welfare intervention against treatment as usual or active control from 1 January 2014 through 22 June 2019. Primary outcome was post-traumatic stress disorder (PTSD) symptoms or caseness, and secondary outcomes were depression symptoms, functioning, quality of life, and adverse effects, after treatment and at follow-up of at least 3 months. Standardised mean differences (SMDs) and odds ratios were estimated using meta-analysis with random effects. The Cochrane tool was used to derive risk of bias. Fifteen RCTs were included, with data from 1,373 participants (589 females and 784 males) in 10 countries (7 trials in Europe, 5 in Asia, and 3 in Africa). No trials of social or welfare interventions were found. Compared to mostly inactive (waiting list) controls, psychological interventions reduced PTSD symptoms by the end of treatment (SMD -0.31, 95% confidence interval [CI] -0.52 to -0.09, p = 0.005), but PTSD symptoms at follow-up were not significantly reduced (SMD -0.34, 95% CI -0.74 to 0.06, p = 0.09). No significant improvement was found for PTSD caseness at the end of treatment, and there was possible worsening at follow-up from one study (n = 28). Interventions showed no benefits for depression symptoms at end of treatment (SMD -0.23, 95% CI -0.50 to 0.03, p = 0.09) or follow-up (SMD -0.23, 95% CI -0.70 to 0.24, p = 0.34). A significant improvement in functioning for psychological interventions compared to control was found at end of treatment (SMD -0.38, 95% CI -0.58 to -0.18, p = 0.0002) but not at follow-up from only one study. No significant improvement emerged for quality of life at end of treatment (SMD 0.38, 95% CI -0.28 to 1.05, p = 0.26) with no data available at follow-up. The main study limitations were the difficulty in this field of being certain of capturing all eligible studies, the lack of modelling of maintenance of treatment gains, and the low precision of most SMDs making findings liable to change with the addition of further studies as they are published. CONCLUSIONS: Our findings show evidence that psychological interventions improve PTSD symptoms and functioning at the end of treatment, but it is unknown whether this is maintained at follow-up, with a possible worsening of PTSD caseness at follow-up from one study. Further interventions in this population should address broader psychological needs beyond PTSD while taking into account the effect of multiple daily stressors. Additional studies, including social and welfare interventions, will improve precision of estimates of effect, particularly over the longer term.


Asunto(s)
Depresión/terapia , Psicoterapia/métodos , Bienestar Social , Servicio Social/métodos , Trastornos por Estrés Postraumático/terapia , Sobrevivientes/psicología , Tortura/psicología , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Masculino , Salud Mental , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Resultado del Tratamiento
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA