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1.
Clin Rheumatol ; 39(7): 2043-2047, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32514674

RESUMO

COVID-19 is a world health emergency which may inevitably affect the management of a complex autoimmune disease such as systemic sclerosis (SSc). Several SSc patients are frail and, in this pandemic, need a careful protection. The COVID-19 infection might complicate the clinical scenario of interstitial lung disease (ILD) in SSc because it determines a severe pneumonia characterized by radiological features similar to SSc-ILD. The striking CT similarities between the 2 diseases make it difficult to distinguish a worsening of SSc-ILD from COVID-19-ILD superinfection. Moreover, other aspects, like isolation during lock down, may cause a significant psychological stress which will pile up on the already difficult contact with the patients for a routine check-up. Moreover, the drug shortage is a real problem in these times. For these reasons, the rheumatologist in daily clinical practice should carefully differentiate the possible COVID-19 infection in order to optimize the patient management. Therefore, the challenge in everyday life will be to achieve in due time the differential diagnosis as well as the long-term psychological impact.Key Points• SSc patients should be encouraged to continue their chronic therapy; in case of immunosuppressive therapy it must be discontinued for safety in case of COVID-19 infection.• Psychological support must be guaranteed to every SSc patients.• COVID-19 pneuminia is hard to distinguish from an interstitial lung disease due to SSc lung involvment.• Data sharing is fundamental for an optimal managment of SSc patients during COVID-19 pandemia.


Assuntos
Infecções por Coronavirus , Imunossupressores/uso terapêutico , Doenças Pulmonares Intersticiais , Pandemias , Pneumonia Viral/diagnóstico , Escleroderma Sistêmico , Betacoronavirus/isolamento & purificação , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Humanos , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/etiologia , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Angústia Psicológica , Escleroderma Sistêmico/epidemiologia , Escleroderma Sistêmico/psicologia , Escleroderma Sistêmico/terapia , Isolamento Social/psicologia , Tomografia Computadorizada por Raios X/métodos
2.
Sante Publique ; 31(6): 751-759, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32550657

RESUMO

OBJECTIVE: Present the results of a study of the experience of maternity in the context of a recent immigration to Quebec. METHOD: Semi-structured interviews were carried out amongst mothers from different countries, having immigrated within the last five years. L'Écuyer's (1990) developmental analysis of the content was used to analyze the results. RESULTS: The data collected from 15 participants demonstrates that they perceive their motherly role as a great responsibility. During the postnatal phase, these women develop autonomy as mothers, but they also suffer from isolation and often only have their spouse to rely on. They experience a vast range of emotions such as happiness, anxiety, and sadness. Their level of distress depends on their representation of their maternity and immigration. To ensure their wellbeing, they keep in touch with their origins and use the professional services available. CONCLUSION: The transition into motherhood leads to a great disruption of these women's lives. Due to social isolation, their responsibilities as mothers seem even more intense. The partner, considered an ally, thus plays an important role by their side. They struggle with trusting Quebecers, however, some services are greatly appreciated: the in-home visit of nurses, the guide From Tiny Tot to Toddler and the Info-Santé telephone service. It would be relevant to conduct more studies on the reality of immigrant fathers and to consider increasing the number of in-home nurse or midwife visits for mothers who are less socially integrated and who perceive their immigration negatively.


Assuntos
Emigrantes e Imigrantes/psicologia , Serviços de Saúde Materna/estatística & dados numéricos , Tocologia , Mães/psicologia , Angústia Psicológica , Estresse Psicológico/psicologia , Adulto , Feminino , Humanos , Parto , Gravidez , Pesquisa Qualitativa , Quebeque
5.
Cad Saude Publica ; 36(5): e00090520, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32490918

RESUMO

This study aimed to assess the prevalence and variables related to perceived stress associated with the COVID-19 pandemic in a sample of Colombian adults using a designed online cross-sectional survey. Adults answered a version of the Perceived Stress Scale (PSS-10) modified for COVID-19 (PSS-10-C), with Cronbach alpha equal to 0.86. In total, 406 individuals aged between 19 and 88 years (M = 43.9; SD = 12.4) agreed to participate in the survey: 61.8% were females, 90.6% had a university degree, 44.1% were health professionals, and 45.7% considered public health policies for preventing the spread of the disease inconsistent with scientific recommendations. PSS-10-C scores ranged from 0 to 36 (M = 16.5; SD = 7.3); 58 individuals (14.3%) scored for high perceived stress (cut-off point = 25). The inconsistency between policies and scientific evidence was significantly related to high perception of stress associated with COVID-19 (OR = 2.36; 95%CI: 1.32-4.20), after adjusting for gender. We concluded that the study group presented the prevalence of perceived stress associated with COVID-19 at high levels, arising from the inconsistent strategies developed by health authorities in view of scientific recommendations. Further researches must address the psychosocial aspects of epidemics.


Assuntos
Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Estresse Psicológico/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Medicina Baseada em Evidências , Docentes/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Política de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Estresse Psicológico/epidemiologia , Estudantes/psicologia , Adulto Jovem
6.
Rev Esp Salud Publica ; 942020 Jun 08.
Artigo em Espanhol | MEDLINE | ID: mdl-32507849

RESUMO

OBJECTIVE: The socio-health emergency caused by COVID-19 may have a significant psychological impact on the population. For this reason, it is necessary to identify especially vulnerable social groups and protective factors that may reduce this impact, which was the objective of this study. METHODS: Using snowball sampling approach, 1,596 people residing in Spain during the lockdown answered an online questionnaire that included information on sociodemographic variables, symptoms, and contact with the disease, risk perception, precautionary measures to prevent infection and coping strategies during lockdown. Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status with the Goldberg's General Health Questionnaire (GHQ-12). Simple linear regression models were performed to analyze the associations between the study variables and the psychological impact of the pandemic and the mental health of the participants. RESULTS: Of all respondents, 24.7% reported a moderate or severe psychological impact, and 48.8% showed mental health problems. Women, students and the population with a lower level of economic income, in addition to those having less available space per person in the household presented a more significant psychological impact and worse mental health. Living with someone from the high-risk vulnerable group, and anticipating the adverse economic effects of social-health crisis raised the emotional distress and psychological morbidity. Precautionary measures to prevent infection did not present a connection to the psychological impact of the pandemic; however, several coping strategies did help to reduce it. CONCLUSIONS: These findings outline the existence of especially vulnerable social groups to the impact of the pandemic, and suggest lines of action that help reduce the psychosocial consequences of COVID-19.


Assuntos
Adaptação Psicológica , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Saúde Mental , Morbidade , Pandemias , Pneumonia Viral/epidemiologia , Espanha/epidemiologia , Estresse Psicológico , Inquéritos e Questionários
7.
Artigo em Inglês | MEDLINE | ID: mdl-32503205

RESUMO

The COVID-19 pandemic is an ongoing epidemic of coronavirus disease, caused by severe acute respiratory syndrome, which has spread recently worldwide. Efforts to prevent the virus from spreading include travel restrictions, lockdowns as well as national or regional quarantines throughout the international community. The major negative psychological outcome of the COVID-19 pandemic is the anxiety caused by it. The aim of the present study was to examine the level of concern and the contributions of modes of resilience, well-being and demographic attributes towards decreasing or enhancing anxiety and depression among two samples: Israeli Jews (majority group) and Israeli Arabs (minority group). These random samples included 605 Jews and 156 Arabs who participated in an internet survey. A previous study, which has been conducted in the context of terror attacks, has shown that compared to Israeli Jews, Israeli Arabs expressed a higher level of fear of war and lower levels of resilience supporting personality attributes. The results of the current study indicated a similar pattern that emerged in the context of the COVID-19 pandemic: the Israeli Arabs reported a higher level of distress and a lower level of resilience and well-being.


Assuntos
Árabes/psicologia , Infecções por Coronavirus/epidemiologia , Judeus/psicologia , Pneumonia Viral/epidemiologia , Angústia Psicológica , Resiliência Psicológica , Adulto , Sintomas Afetivos , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Israel/epidemiologia , Masculino , Pandemias , Pneumonia Viral/etnologia , Pneumonia Viral/psicologia
8.
Epidemiol Psychiatr Sci ; 29: e134, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32484148

RESUMO

AIMS: To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. METHODS: People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. RESULTS: In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. CONCLUSION: This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Programas de Rastreamento/métodos , Qualidade de Vida , Estresse Psicológico/etiologia , Adulto , Idoso , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Angústia Psicológica , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-32498401

RESUMO

Measures to prevent and contain the COVID-19 health crisis include population confinement, with the consequent isolation and interruption of their usual activities. The aim of the study is to analyse psychological distress during the COVID-19 pandemic. For this, a cross-sectional observational study with a sample of 4180 people over the age of 18 during quarantine was developed. Variables considered were sociodemographic variables, physical symptoms, health conditions, COVID-19 contact history and psychological adjustment. The data were collected through a self-developed questionnaire and the General Health Questionnaire (GHQ-12). Bivariate analyses were performed, including Chi-Squared test and Student's T-test. Predictive ability was calculated through logistic regression. Results obtained showed a high level of psychological distress (72.0%), with a higher percentage in women and people of lower middle age. Statistically significant differences were found in the variable working situation (χ² = 63.139, p ≤ 0.001, V = 0.123) and living with children under the age of 16 (χ² = 7.393, p = 0.007, V = 0.042). The predictive variables with the highest weight were sex (OR = 1.952, 95% IC = (1.667, 2.286)), presence of symptoms (OR = 1.130, 95% CI = (1.074, 1.190)), and having had close contact with an individual with confirmed COVID-19 (OR = 1.241, 95% CI = (1.026, 1.500)). These results could enrich prevention interventions in public health and, in particular, in mental health in similar pandemic situations.


Assuntos
Infecções por Coronavirus/epidemiologia , Saúde Mental/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Angústia Psicológica , Adulto , Infecções por Coronavirus/psicologia , Estudos Transversais , Humanos , Modelos Logísticos , Pneumonia Viral/psicologia , Quarentena , Espanha/epidemiologia
10.
Hu Li Za Zhi ; 67(3): 64-74, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32495331

RESUMO

BACKGROUND: The global outbreak of coronavirus disease (COVID-19) began in December 2019. The high levels of stress experienced by nurses during this pandemic may have immediate and long-term effects on their mental health. PURPOSE: To explore the stress and psychological problems of nurses during this pandemic and to identify strategies used by these nurses to relieve stress. METHODS: A cross-sectional online survey was conducted that included a basic information datasheet, stress of nursing staff during COVID-19 outbreak scale, psychological distress scale, and stress relief methods survey form. Convenience sampling was used and a total of 469 practicing nurses participated in this study. RESULTS: Most of the participants expressed concerns about living problems (72.7%). On the stress questionnaire, the facets of "burden of taking care of patients" and "worries about social isolation" earned the first and second highest scores, respectively. In terms of items, "worrying about infecting family members and friends" and "worrying about being separated from family after being infected" earned the two highest scores (2.35 ± 0.79 and 2.17 ± 0.92, respectively). Scores for psychological distress averaged 5.49 ± 3.83, with stress anxiety (1.32 ± 0.84) earning the highest mean subscale score followed by distress and irritability (1.17 ± 0.92) and depression (1.12 ± 0.94). Nearly two-thirds (61.8%) of the participants earned psychological and emotional distress scores within the 'normal' range, and 3.4% earned scores indicating severe distress. "Receiving education and training" was the most common method used by the participants to relieve stress (2.27 ± 0.51). CONCLUSIONS: The following six strategies are proposed based on the above findings: (1) Caring: provide psychological assessment and care; (2) Supporting: create a friendly team atmosphere and provide support; (3) Inquiring: recruit volunteers with relevant experience; (4) Informing: provide timely, open, and transparent epidemic-prevention information; (5) Equipping: provide complete and appropriate epidemic-prevention education and training; (6) Assisting: establish a strategy for family support and caring to reduce the stress and worries of nurses.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Recursos Humanos de Enfermagem , Pandemias , Pneumonia Viral , Angústia Psicológica , Estresse Psicológico , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Surtos de Doenças , Humanos , Pneumonia Viral/epidemiologia , Taiwan
11.
J Prim Health Care ; 12(2): 115-117, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32594977

RESUMO

The psychological effects of mass quarantine following the COVID-19 lockdown are likely to be significant. Emotional and behavioural responses to quarantine are related to a psychological state of anxiety. These and other emotions are normal and may even be adaptive. The exceptional circumstances of a national lockdown provide an opportunity to develop mental health literacy in the form of psychological first aid, to enable wider awareness of how individuals can contribute to listening and supporting others psychologically. This has potential implications for skilling clinicians and the public about responding to mental distress. As frontline health-care workers, general practitioners may themselves need to be recipients of psychological first aid and support as they deal with adverse consequences of the quarantine period.


Assuntos
Ansiedade/psicologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Angústia Psicológica , Quarentena/psicologia , Infecções por Coronavirus/epidemiologia , Humanos , Nova Zelândia/epidemiologia , Pneumonia Viral/epidemiologia
12.
Rev Psiquiatr Salud Ment ; 13(2): 90-94, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32389516

RESUMO

INTRODUCTION: The world is currently undergoing an extremely stressful scenario due to the COVID-19 pandemic. This unexpected and dramatic situation could increase the incidence of mental health problems, among them, psychotic disorders. The aim of this paper was to describe a case series of brief reactive psychosis due to the psychological distress from the current coronavirus pandemic. MATERIALS AND METHODS: We report on a case series including all the patients with reactive psychoses in the context of the COVID-19 crisis who were admitted to the Virgen del Rocío and Virgen Macarena University Hospitals (Seville, Spain) during the first two weeks of compulsory nationwide quarantine. RESULTS: In that short period, four patients met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a brief reactive psychotic disorder. All of the episodes were directly triggered by stress derived from the COVID-19 pandemic and half of the patients presented severe suicidal behavior at admission. CONCLUSIONS: We may now be witnessing an increasing number of brief reactive psychotic disorders as a result of the COVID-19 pandemic. This type of psychosis has a high risk of suicidal behavior and, although short-lived, has a high rate of psychotic recurrence and low diagnostic stability over time. Therefore, we advocate close monitoring in both the acute phase and long-term follow-up of these patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Transtornos Psicóticos/etiologia , Quarentena/psicologia , Estresse Psicológico/complicações , Adulto , Infecções por Coronavirus/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/psicologia , Fatores de Risco , Espanha , Suicídio/psicologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-32370116

RESUMO

The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18-22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Angústia Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Infecções por Coronavirus/prevenção & controle , Depressão/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Fatores de Risco , Adulto Jovem
14.
PLoS One ; 15(5): e0233410, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407409

RESUMO

As the epidemic outbreak of 2019 coronavirus disease (COVID-19), general population may experience psychological distress. Evidence has suggested that negative coping styles may be related to subsequent mental illness. Therefore, we investigate the general population's psychological distress and coping styles in the early stages of the COVID-19 outbreak. A cross-sectional battery of surveys was conducted from February 1-4, 2020. The Kessler 6 psychological distress scale, the simplified coping style questionnaire and a general information questionnaire were administered on-line to a convenience sample of 1599 in China. A multiple linear regression analysis was performed to identify the influence factors of psychological distress. General population's psychological distress were significant differences based on age, marriage, epidemic contact characteristics, concern with media reports, and perceived impacts of the epidemic outbreak (all p <0.001) except gender (p = 0.316). The population with younger age (F = 102.04), unmarried (t = 15.28), with history of visiting Wuhan in the past month (t = -40.86), with history of epidemics occurring in the community (t = -10.25), more concern with media reports (F = 21.84), perceived more impacts of the epidemic outbreak (changes over living situations, F = 331.71; emotional control, F = 1863.07; epidemic-related dreams, F = 1642.78) and negative coping style (t = 37.41) had higher level of psychological distress. Multivariate analysis found that marriage, epidemic contact characteristics, perceived impacts of the epidemic and coping style were the influence factors of psychological distress (all p <0.001). Epidemic of COVID-19 caused high level of psychological distress. The general mainland Chinese population with unmarried, history of visiting Wuhan in the past month, perceived more impacts of the epidemic and negative coping style had higher level of psychological distress in the early stages of COVID-19 epidemic. Psychological interventions should be implemented early, especially for those general population with such characteristics.


Assuntos
Adaptação Psicológica , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , China , Estudos Transversais , Feminino , Humanos , Internet , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Pandemias , Inquéritos e Questionários , Adulto Jovem
15.
J Zhejiang Univ Sci B ; 21(5): 400-404, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32425006

RESUMO

Public health crises, such as the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since Dec. 2019, are widely acknowledged as severe traumatic events that impose threats not only because of physical concerns but also because of the psychological distress of infected patients. We designed an internet-based integrated intervention and evaluated its efficacy on depression and anxiety symptoms in patients infected by SARS-CoV-2.


Assuntos
Ansiedade/terapia , Infecções por Coronavirus/psicologia , Depressão/terapia , Internet , Pneumonia Viral/psicologia , Autocuidado/métodos , Adulto , Betacoronavirus , Telefone Celular , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Plena , Pandemias , Estudos Prospectivos , Angústia Psicológica , Terapia de Relaxamento
17.
Anesth Analg ; 130(6): 1504-1515, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32384340

RESUMO

Patients with frailty experience substantial physical and emotional distress related to their condition and face increased morbidity and mortality compared with their nonfrail peers. Palliative care is an interdisciplinary medical specialty focused on improving quality of life for patients with serious illness, including those with frailty, throughout their disease course. Anesthesiology providers will frequently encounter frail patients in the perioperative period and in the intensive care unit (ICU) and can contribute to improving the quality of life for these patients through the provision of palliative care. We highlight the opportunities to incorporate primary palliative care, including basic symptom management and straightforward goals-of-care discussions, provided by the primary clinicians, and when necessary, timely consultation by a specialty palliative care team to assist with complex symptom management and goals-of-care discussions in the face of team and/or family conflict. In this review, we apply the principles of palliative care to patients with frailty and synthesize the evidence regarding methods to integrate palliative care into the perioperative and ICU settings.


Assuntos
Fragilidade/terapia , Cuidados Paliativos/organização & administração , Idoso , Anestesiologia/tendências , Cuidados Críticos , Idoso Fragilizado , Fragilidade/psicologia , Humanos , Unidades de Terapia Intensiva , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente/organização & administração , Período Perioperatório , Angústia Psicológica , Qualidade de Vida , Assistência Terminal/organização & administração , Resultado do Tratamento
18.
Diabet Med ; 37(7): 1146-1154, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32392380

RESUMO

AIM: To map COVID-19-specific worries and overall psychosocial health among people with diabetes in the initial phase of the COVID-19 pandemic in Denmark, and to explore characteristics of people with diabetes and high levels of worries related to the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted by distributing online questionnaires to 2430 adult members (> 18 years) of two user panels consisting of people with diabetes who have volunteered to share information about their life with diabetes. The questionnaire included items on COVID-19-specific worries as well as such worries related to diabetes, sociodemographic and health status, social relations, diabetes-specific social support, diabetes distress and changes in diabetes-specific behaviours. Responses were analysed with descriptive statistics and logistic regressions. RESULTS: People with diabetes have COVID-19-specific worries related to their diabetes. More than half were worried about being overly affected due to diabetes if infected with COVID-19, about one-third about being characterized as a risk group due to diabetes and not being able to manage diabetes if infected. Logistic regressions showed that being female, having type 1 diabetes, diabetes complications and diabetes distress, feeling isolated and lonely, and having changed diabetes behaviours were associated with being more worried about COVID-19 and diabetes. CONCLUSION: People with diabetes have COVID-19-specific worries related to their diabetes which is associated with poorer psychosocial health. These worries should be addressed through support targeting specific questions and needs of individuals with diabetes as well as frequent updates on new knowledge regarding COVID-19 and diabetes.


Assuntos
Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Medo/psicologia , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral/epidemiologia , Angústia Psicológica , Apoio Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Estudos Transversais , Dinamarca/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Feminino , Humanos , Modelos Logísticos , Solidão/psicologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Fatores Sexuais , Adulto Jovem
19.
Epilepsia ; 61(6): 1166-1173, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32353184

RESUMO

OBJECTIVE: To compare the severity of psychological distress between patients with epilepsy and healthy controls during the COVID-19 outbreak in southwest China, as well as identify potential risk factors of severe psychological distress among patients with epilepsy. METHODS: This cross-sectional case-control study examined a consecutive sample of patients older than 15 years treated at the epilepsy center of West China Hospital between February 1 and February 29, 2020. As controls, sex- and age-matched healthy visitors of inpatients (unrelated to the patients) were also enrolled during the same period. Data on demographics and attention paid to COVID-19 were collected by online questionnaire, data on epilepsy features were collected from electronic medical records, and psychological distress was evaluated using the 6-item Kessler Psychological Distress Scale (K-6). Potential risk factors of severe psychological distress were identified using multivariate logistic regression. RESULTS: The 252 patients and 252 controls in this study were similar along all demographic variables except family income. Patients with epilepsy showed significantly higher K-6 scores than healthy controls and spent significantly more time following the COVID-19 outbreak (both P < .001). Univariate analyses associated both diagnosis of drug-resistant epilepsy and time spent paying attention to COVID-19 with severe psychological distress (defined as K-6 score >12; both P ≤ .001). Multivariate logistic regression identified two independent predictors of severe psychological distress: time spent paying attention to COVID-19 (odds ratio [OR] = 1.172, 95% confidence interval [CI] = 1.073-1.280) and diagnosis of drug-resistant epilepsy (OR = 0.283, 95% CI = 0.128-0.623). SIGNIFICANCE: During public health outbreaks, clinicians and caregivers should focus not only on seizure control but also on mental health of patients with epilepsy, especially those with drug-resistant epilepsy. K-6 scores > 12 indicate severe psychological distress. This may mean, for example, encouraging patients to engage in other activities instead of excessively following media coverage of the outbreak.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Epilepsia/epidemiologia , Pandemias , Pneumonia Viral , Angústia Psicológica , Adolescente , Adulto , Ansiedade/psicologia , Atenção , Betacoronavirus , Estudos de Casos e Controles , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Surtos de Doenças , Epilepsia Resistente a Medicamentos/epidemiologia , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
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