RESUMO
Heart surgery patients are at high risk for psychological trauma and comorbid psychological disorders. Depression, anxiety, and post-traumatic stress disorders in this patient group are predictors of outcomes after cardiac surgery. Medical hypnosis is effective for non-pharmacologic prevention and treatment of psychological disorders and has been associated with improved health-related quality of life and better cardiovascular outcomes. This contribution makes note of evidence of the effectiveness of medical hypnosis in a discussion of the clinical experience with specific hypnotherapeutic tools and interventions from the perspective of the mental health team in one large cardiac center in Germany. Based on our experience, we encourage heart centers to educate their heart surgery care teams about the core concepts of medical hypnosis and to make hypnotherapeutic techniques available as an adjunctive therapy.
Assuntos
Aconselhamento , Demência , Demência/diagnóstico , Demência/terapia , Alemanha , Humanos , Princípios Morais , Padrões de ReferênciaRESUMO
OBJECTIVES: Because of the high prevalence of psychological disorders among ventricular assist device patients, mental health support is consensually recommended. No study as yet has provided an overview of recommended and reported mental health interventions. This article presents the results of a scoping review on these questions. METHODS: We searched standard databases for relevant search criteria and found 4 consensus guidelines and 13 publications with original research mentioning mental health interventions for ventricular assist device patients. These publications are synthesized and augmented with practical recommendations from our reports and from a single-centre experience of others. RESULTS: Consensus guidelines recommend mental health interventions in 4 areas: screening and diagnostics, assessment, support and treatment and education. Interventions vary across treatment phases and by device therapy strategy, as do typical sources of mental distress. A flow chart of interventions over the course of treatment summarizes these findings. CONCLUSIONS: The delivery of consensually recommended mental health support for ventricular assist device patients involves the performance of multiple, complex tasks that vary across treatment phases. Mental health professionals should have specialized skills and should interact frequently with other caregivers in care teams.
Assuntos
Consenso , Insuficiência Cardíaca/psicologia , Coração Auxiliar , Saúde Mental , Insuficiência Cardíaca/cirurgia , HumanosRESUMO
Rosacea is associated with mental distress and depression, yet no studies have looked at the mediating effect of stigmatization and other factors on psychological sequelae. Using a survey of affected individuals, the objective of this study was to explore relationships between self-reported symptom severity, discomfort, stress reactivity, quality of life, and symptoms of depression and anxiety. Participants were recruited from the mailing list of a German rosacea organization. The survey instrument included the Dermatology Life Quality Index (DLQI), the rejection scale of the Questionnaire on Experience with Skin Complaints (QES), and the German version of the Hospital Anxiety and Depression Scale (HADS-D). A total of 168 persons with rosacea were participated. The sample returned a HADS anxiety score of 7.2 ± 4.60, a HADS depression score of 5.1 ± 4.09, a DLQI of 4.05 ± 4.67, and a QES rejection score of 2.,61 ± 3.,37. Path analysis suggested that symptoms of anxiety and depression are linked with somatic symptoms indirectly, mediated through quality of life and stigmatization. Men are more negatively affected. Physicians treating rosacea patients should consider recommending psychological co-treatment for patients who have experienced stigmatization or who report low life quality.