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1.
Hu Li Za Zhi ; 66(6): 20-26, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31802451

RESUMO

Chronic diseases often impact the quality of life of the patient, causing complications and increased mortality and medical costs. The World Health Organization proposed applying mindfulness as an important strategy to help transform the situation faced by chronic disease cases and to promote their mental flexibility and adaptability. The author reviewed the related literature on mindfulness and introduces the "SMILE" strategy in this article. This strategy includes several stages, including 1) Starting where I am, 2) Motivating patients to become self-aware of the experience of self and internal and external environment interactions, 3) Developing individual health beliefs, 4) Learning mindfulness-based health-promotion behaviors, 5) Evaluating the efficacy of mindfulness-based health-promotion behaviors and self-regulation. SMILE is a powerful strategy with the potential to promote patient wellbeing, acceptance of the need to coexist with chronic disease, and freedom. Mindfulness is an abstract concept. This article provides a reference on mindfulness intervention for healthcare providers.


Assuntos
Doença Crônica/psicologia , Promoção da Saúde/métodos , Atenção Plena , Humanos
2.
Rev. salud pública Parag ; 9(2): [P9-P15], Dic 2019.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1047044

RESUMO

Introducción: La Diabetes Mellitus tipo 2 es una enfermedad metabólica muy frecuente, siendo una de las principales causas de mortalidad en nuestro país. El enfoque integral, individual, familiar y comunitario de la Atención Primaria de Salud a través de las Unidades de Salud de la Familia permite identificar síntomas de depresión que pueden aparecer durante el curso de la enfermedad. Objetivo: Determinar los niveles de depresión según la cronicidad de la Diabetes Mellitus tipo 2 y sus comorbilidades en pacientes de las Unidades de Salud del distrito de Encarnación en el año 2018. Metodología: Estudio con diseño observacional, analítico de corte transversal sobre 228 pacientes con Diabetes Mellitus tipo 2 entrevistados durante el año 2018. Se aplicó un formulario validado con el test de Kuder- Richardson y la Escala de Hamilton para la depresión. Los datos fueron procesados en EpiInfo v. 7. Resultados: Se detectó depresión en el 66,7 % (152) de las personas incluidas en el estudio, siendo más frecuente la depresión ligera presente en el 32, 9 % (75) de los casos, seguido de depresión moderada y grave. Se encontró asociación estadísticamente significativa entre depresión y años de evolución de Diabetes Mellitus tipo 2 (p = 0.029), hipertensión (p = 0.0024); neuropatía (p = 0.0003). Conclusión: El nivel de depresión más frecuente fue la ligera y la presencia de síntomas de depresión en pacientes con Diabetes Mellitus tipo 2 fue alta, asociada significativamente con años de evolución de la diabetes, hipertensión y neuropatía. Palabras clave: Diabetes mellitus, Depresión, Atención Primaria de Salud.


Introduction: Type 2 Diabetes Mellitus is a very frequent metabolic disease, being one of the main causes of mortality in our country. The integral, individual, family and community approach of Primary Health Care through the Family Health Units allows to identify symptoms of depression that may appear during the course of the disease. Objective: To determine the levels of depression according to the chronicity of Type 2 Diabetes Mellitus and its comorbidities in patients of the Health Units of the district of Encarnación in the year 2018. Methodology: Study with observational, analytical cross-sectional design on 228 patients with Type 2 Diabetes Mellitus interviewed during 2018. A validated form was applied with the Kuder-Richardson test and the Hamilton Scale for depression. The data was processed in EpiInfo v. 7. Results: Depression was detected in 66.7% (152) of the people included in the study, with mild depression being more frequent in 32.9% (75) of the cases, followed by moderate and severe depression. A statistically significant association was found between depression and years of evolution of Type 2 Diabetes Mellitus (p = 0.029), hypertension (p = 0.0024); neuropathy (p = 0.0003). Conclusion: The most frequent level of depression was mild and the presence of depression symptoms in patients with Type 2 Diabetes Mellitus was high, significantly associated with years of evolution of diabetes, hypertension and neuropathy. Keywords: Diabetes mellitus, Depression, Primary Health Care.


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Depressão , Diabetes Mellitus/psicologia , Doença Crônica/psicologia
3.
Ann Agric Environ Med ; 26(4): 630-635, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885238

RESUMO

INTRODUCTION: The way of functioning in everyday life and the style of coping with the challenges encountered, including the situations of financial difficulties, are shaped by various adaptation mechanisms conditioned by the state of psychophysical health, as well as social and cultural factors. They are related to the intrapsychic features, among which the personality plays a key role. MATERIAL AND METHODS: The research sample consisted of 2 groups - 50 patients with mobility impairment resulting from chronic pathologies of the locomotor system hospitalized in the Department of General and Neuro Rehabilitation, Institute of Rural Health in Lublin, and 50 healthy people. The research was carried out using the NEO-FFI Personality Inventory, Perceived Stress Scale, Self-Esteem Scale, General Self-Efficacy Scale, Impulsiveness Inventory and the APSZ Questionnaire. RESULTS: In the group of patients with impaired mobility resulting from chronic pathologies of the locomotor system, the leading correlate of the tendency to seek help in the situation of indebtedness was extraversion. In the healthy group, the leading correlates of the tendency to undertake this type of activity were the intensity of perceived stress, neuroticism, self-esteem, self- efficacy and empathy. CONCLUSIONS: In the group of patients with impaired mobility resulting from chronic diseases of the locomotor system, extroversion was the factor conducive to seeking help in the situation of indebtedness. In the group of healthy people, self-esteem, self- efficacy and empathy were the factors conducive to taking such actions, whereas intensity of perceived stress and neuroticism were the risk factors.


Assuntos
Doença Crônica/psicologia , Comportamento de Busca de Ajuda , Adulto , Idoso , Feminino , Nível de Saúde , Humanos , Locomoção , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Neuroticismo , Personalidade , Projetos Piloto , Autoimagem , Inquéritos e Questionários
4.
BMC Public Health ; 19(1): 1486, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703664

RESUMO

BACKGROUND: Students living with a chronically ill family member may experience significant pressure, stress, and depression due to their caregiving situation. This may also lead to them delaying or dropping out of school when the combination of being a caregiver and their education program are too demanding. This survey study aims to explore the consequences for students of bachelor or vocational education programs when they are growing up with a chronically ill family member and the influence of various background characteristics and risk factors. METHODS: A survey was sent to 5997 students (aged 16-25 years) enrolled in bachelor or vocational education programs in the north of the Netherlands. The content of the survey was based on a literature study and consultation with experts. Descriptive statistics, Chi-square tests, and logistic regression analyses were performed. RESULTS: A total of 1237 students (21%) responded to the survey. A sub group of 237 (19%) students (mean age 21(2.2); 87% female) identified themselves as growing up with a chronically ill family member. More than half (54.9%) of these students indicated that they experienced negative consequences in daily life. A significant association (OR .42, p < .02) was found for these consequences and the level of education for which attending vocational education yields a higher risk. In addition, growing up with a mentally ill family member was associated with a 2.74 (p = .04) greater risk of experiencing negative consequences in daily life compared to students living with a family member with a physical disorder or multiple disorders. CONCLUSION: Since a substantial number of students growing up with a chronically ill family member indicate serious physical, mental, and social consequences as a result of this care situation, awareness for this specific age-group is needed. Students with a mentally ill family member and students undertaking vocational education appear to be especially at risk. Further research is required in order to gain insight that is more in-depth into the exact type of problems that these students encounter and the specific needs that they have regarding support.


Assuntos
Cuidadores/psicologia , Filho de Pais Incapacitados/psicologia , Transtornos Mentais/psicologia , Estudantes/psicologia , Adolescente , Adulto , Doença Crônica/psicologia , Depressão/epidemiologia , Depressão/psicologia , Família/psicologia , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Fatores de Risco , Instituições Acadêmicas , Inquéritos e Questionários , Educação Vocacional , Adulto Jovem
5.
BMJ ; 367: l5922, 2019 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690561

RESUMO

OBJECTIVE: To investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice. DESIGN: Pragmatic, three armed, parallel group, individually randomised controlled trial. SETTING: 59 general practices in the Netherlands. PARTICIPANTS: 322 adults aged 50 and older with a chronic vestibular syndrome. INTERVENTIONS: Stand alone VR comprising a six week, internet based intervention with weekly online sessions and daily exercises (10-20 minutes a day). In the blended VR group, the same internet based intervention was supplemented by face-to-face physiotherapy support (home visits in weeks 1 and 3). Participants in the usual care group received standard care from a general practitioner, without any restrictions. MAIN OUTCOME MEASURES: The primary outcome was vestibular symptoms after six months as measured by the vertigo symptom scale-short form (VSS-SF range 0-60, clinically relevant difference ≥3 points). Secondary outcomes were dizziness related impairment, anxiety, depressive symptoms, subjective improvement of vestibular symptoms after three and six months, and adverse events. RESULTS: In the intention-to-treat analysis, participants in the stand alone and blended VR groups had lower VSS-SF scores at six months than participants in the usual care group (adjusted mean difference -4.1 points, 95% confidence interval -5.8 to -2.5; and -3.5 points, -5.1 to -1.9, respectively). Similar differences in VSS-SF scores were seen at three months follow-up. Participants in the stand alone and blended VR groups also experienced less dizziness related impairment, less anxiety, and more subjective improvement of vestibular symptoms at three and six months. No serious adverse events related to online VR occurred during the trial. CONCLUSION: Stand alone and blended internet based VR are clinically effective and safe interventions to treat adults aged 50 and older with a chronic vestibular syndrome. Online VR is an easily accessible form of treatment, with the potential to improve care for an undertreated group of patients in general practice. TRIAL REGISTRATION: Netherlands Trial Register NTR5712.


Assuntos
Medicina Geral/métodos , Modalidades de Fisioterapia , Qualidade de Vida , Telemedicina/métodos , Doenças Vestibulares/reabilitação , Idoso , Doença Crônica/psicologia , Doença Crônica/reabilitação , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Países Baixos , Síndrome , Resultado do Tratamento , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/psicologia
6.
BMC Public Health ; 19(1): 1468, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694606

RESUMO

BACKGROUND: It has been suggested that poor health has influenced vote for Brexit and the US presidential election. No such research has been published regarding the 2017 French presidential election. METHODS: We performed a cross-sectional analysis using a comprehensive set of socioeconomic and health indicators, to be compared with voting outcome at the first round of the 2017 French presidential election. The 95 French departments were selected as the unit of analysis. Data were obtained from publicly available sources. The linear model was used for both univariate and multivariate analysis to investigate the relation between voting patterns and predictors. Sensitivity analyses were done using the elastic-net regularisation. RESULTS: Emmanuel Macron and Marine Le Pen arrived ahead. When projected on the first factorial plane (~ 60% of the total inertia), Emmanuel Macron and Marine Le Pen tended to be in opposite directions regarding both socioeconomic and health factors. In the respective multivariate analyses of the two candidates, both socio-economic and health variables were significantly associated with voting patterns, with wealthier and healthier departments more likely to vote for Emmanuel Macron, and opposite departments more likely to vote for Marine Le Pen. Mortality (p = 0.03), severe chronic conditions (p = 0.014), and diabetes mellitus (p < 0.0001) were among the strongest predictors of voting pattern for Marine Le Pen. Sensitivity analyses did not substantially change those findings. CONCLUSIONS: We found that areas associated with poorer health status were significantly more likely to vote for the far-right candidate at the French presidential election, even after adjustment on socioeconomic criteria.


Assuntos
Doença Crônica/psicologia , Governo Federal/história , Indicadores Básicos de Saúde , Nível de Saúde , Política , Adulto , Estudos Transversais , Feminino , França , História do Século XXI , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Adulto Jovem
8.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 561-565, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31642236

RESUMO

OBJECTIVE: To understand the effects of social capital on depressive symptoms of elderly patients with chronic diseases in urbanized communities, and to explore preventive measures to promote their mental health. METHODS: A multi-stage stratified cluster sampling method was used to extract 740 elderly patients with chronic diseases in the urbanized communities in Chengdu and Kunming. The questionnaire survey was conducted by using the center of depression rating scale (CES-D) and the self-made social capital scale. Multivariate unconditional logistic regression was used to analyze the impact of urbanized residents' social capital on depressive symptoms. RESULTS: The self-made social capital scale has good reliability and validity. The incidence of depressive symptoms in this study was 24.9%. The incidence of depressive symptoms in elderly females with chronic diseases was higher (P < 0.05); the residents with high "sense of social trust and security" had lower risk of incidence of depressive symptoms 〔odds ratio (OR)=0.489〕; the residents with higher "community belonging" had a lower risk of incidence of depressive symptoms (OR=0.570), and the residents with higher "social support" scores had a lower risk of incidence of depressive symptoms (OR=0.233). CONCLUSION: Targeted measures should be taken to intervene in the social capital factors affecting the depressive symptoms of elderly patients with chronic diseases in urbanized communities to improve their mental health.


Assuntos
Doença Crônica/psicologia , Depressão/epidemiologia , Capital Social , Idoso , China , Feminino , Humanos , Modelos Logísticos , Masculino , Reprodutibilidade dos Testes , Apoio Social , Inquéritos e Questionários , População Urbana
9.
Rev Infirm ; 68(254): 27-28, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31587847

RESUMO

The doctor-patient relationship tends to reconfigure. The chronic patient is recognised for the ability to perform certain healthcare activities, but also for a type of expertise related to his or her personal experience with illness. However, what are the individual and collective benefits of this expertise? How is it enhanced by connected medical systems?


Assuntos
Doença Crônica/terapia , Relações Médico-Paciente , Autocuidado/psicologia , Doença Crônica/psicologia , Humanos
10.
Pediatr Phys Ther ; 31(4): 315-322, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31568372

RESUMO

PURPOSE: The purpose of this systematic review is to identify quality-of-life issues that affect participation in age-appropriate activities in chronically ill children, as reported by the children and their families. SUMMARY OF KEY POINTS: Social and emotional functioning scores on the Pediatric Quality of Life Inventory (PedsQL) 4.0 were found to have the greatest frequency of poor agreement between parents and children in 4 of the 6 studies included in this review, suggesting parents and children have wide variation in their assessment in these areas of psychosocial function. CONCLUSIONS: Cumulative evidence appears to indicate that parents of children with chronic illness perceive their children as having a poorer quality of life than the children report for themselves. RECOMMENDATIONS FOR CLINICAL PRACTICE: Identifying differences and commonalities between these reports can guide health care practitioners to specific activities that should be the focus of caring for children; specifically, functional goal development can become more personalized and appropriate.


Assuntos
Doença Crônica/psicologia , Nível de Saúde , Pais/psicologia , Qualidade de Vida , Criança , Feminino , Humanos , Masculino
11.
J Drugs Dermatol ; 18(9): 950, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31524995

RESUMO

Psoriasis is a common, chronic inflammatory skin disease that can affect any part of the body. It is a highly visible condition with symptoms that include the appearance of red, thick, scaly patches on the arms, legs, trunk, soles of the feet, palms, and nails, but most commonly on the elbows, knees, and scalp.


Assuntos
Emoções , Psoríase/psicologia , Qualidade de Vida , Saúde da Mulher , Doença Crônica/psicologia , Estética , Feminino , Humanos , Psoríase/diagnóstico , Índice de Gravidade de Doença
12.
PLoS Negl Trop Dis ; 13(9): e0007710, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31490931

RESUMO

BACKGROUND: Integrated disease management, disability and inclusion (DMDI) for NTDs is increasingly prioritised. There is limited evidence on the effectiveness of integrated DMDI from the perspective of affected individuals and how this varies by differing axes of inequality such as age, gender, and disability. We used narrative methods to consider how individuals' unique positions of power and privilege shaped their illness experience, to elucidate what practical and feasible steps could support integrated DMDI in Liberia and beyond. METHODS: We purposively selected 27 participants affected by the clinical manifestations of lymphatic filariasis, leprosy, Buruli Ulcer, and onchocerciasis from three counties in Liberia to take part in illness narrative interviews. Participants were selected to ensure maximum variation in age, gender and clinical manifestation. Narrative analysis was grounded within feminist intersectional theory. FINDINGS: For all participants, chronic illness, morbidity and disability associated with NTDs represented a key moment of 'biographical disruption' triggering the commencement of a restitution narrative. Complex health seeking pathways, aetiologies and medical syncretism meant that adoption of the 'sick role' was initially acceptable, but when the reality of permanency of condition was identified, a transition to periods of chaos and significant psycho-social difficulty occurred. An intersectional lens emphasises how biographical disruption is mediated by intersecting social processes. Gender, generation, and disability were all dominant axes of social inequity shaping experience. SIGNIFICANCE: This is one of the first studies to use narrative approaches to interrogate experience of chronic disabling conditions within LMICs and is the only study to apply such an analysis to NTDs. The emotive power of narrative should be utilised to influence the value base of policy makers to ensure that DMDI strategies respond holistically to the needs of the most marginalised, thus contributing to more equitable people-centred care.


Assuntos
Doença Crônica/psicologia , Doenças Negligenciadas/psicologia , Adaptação Psicológica , Adolescente , Adulto , Úlcera de Buruli/psicologia , Pessoas com Deficiência/psicologia , Filariose Linfática/psicologia , Feminino , Humanos , Hanseníase/psicologia , Libéria , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Oncocercose/psicologia
13.
Niger J Clin Pract ; 22(9): 1180-1188, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489851

RESUMO

Background: Assessment of health-related quality of life (HRQOL) in resource-limited settings is critical to evaluate and improve the burden of morbidity and mortality associated with chronic medical disorders. There is a dearth of data on HRQOL among patients suffering from chronic medical disorders in Nigeria. This study assessed the HRQOL of participants with diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, and cancer in a hospital setting with limited resources and highlighted associated factors. Methods: The WHOQOL-BREF instrument was used to study a cross section of the participants at the University of Nigeria Teaching Hospital, Enugu. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results: The distribution of the 613 study population was diabetes mellitus 120, HIV 389, and various cancers 104. Majority (67.9%) earned less than $1 per day and only 7.5% had any form of health insurance. The HIV group had higher QoL scores. Younger age, higher educational status, being employed, and having a care giver were positively associated with higher QoL. Patients with no comorbidities (76.6%) had an overall higher QoL score. Conclusion: Majority of the patients living with chronic medical diseases in Enugu, Nigeria were poor, vulnerable, and without access to health insurance. People living HIV generally had better quality life than those with other health conditions. There is a huge unmet need for people living with chronic medical conditions in Nigeria, which require strategies to counteract.


Assuntos
Doença Crônica/terapia , Assistência à Saúde/métodos , Diabetes Mellitus Tipo 2/psicologia , Infecções por HIV/psicologia , Neoplasias/psicologia , Qualidade de Vida , Adolescente , Adulto , Idoso , Doença Crônica/psicologia , Comorbidade , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Recursos em Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Nigéria/epidemiologia , Inquéritos e Questionários , Adulto Jovem
14.
Med Care ; 57(9): 667-672, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31404013

RESUMO

BACKGROUND: Although buprenorphine is an evidence-based treatment for opioid use disorder (OUD), it is unknown whether buprenorphine use may affect patients' adherence to treatments for chronic, unrelated conditions. OBJECTIVES: To quantify the effect of buprenorphine treatment on patient adherence to 5 therapeutic classes: (1) antilipids; (2) antipsychotics; (3) antiepileptics; (4) antidiabetics; and (5) antidepressants. RESEARCH DESIGN: This was a retrospective cohort study. SUBJECTS: We started with 12,719 commercially ensured individuals with a diagnosis of OUD and the buprenorphine initiation between January 2011 and June 2015 using Truven Health's MarketScan data. Individuals using any of the 5 therapeutic classes of interest were included. MEASURES: Within the 180-day period post buprenorphine initiation, we derived 2 daily indicators: having buprenorphine and having chronic medication on hand for each therapeutic class of interest. We applied logistic regression to assess the association between these 2 daily indicators, adjusting for demographics, morbidity, and baseline adherence. RESULTS: Across the 5 therapeutic classes, the probability with a given treatment on hand was always higher on days when buprenorphine was on hand. After adjustment for demographics, morbidity, and baseline adherence, buprenorphine was associated with a greater odds of adherence to antilipids [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.04-1.54], antiepileptics (OR, 1.22; CI, 1.10-1.36) and antidepressants (OR, 1.42; CI, 1.32-1.60). CONCLUSIONS: Using buprenorphine to treat OUD may increase adherence to treatments for chronic unrelated conditions, a finding of particular importance given high rates of mental illness and other comorbidities among many individuals with OUD.


Assuntos
Analgésicos Opioides/uso terapêutico , Buprenorfina/uso terapêutico , Doença Crônica/psicologia , Adesão à Medicação/psicologia , Tratamento de Substituição de Opiáceos/psicologia , Transtornos Relacionados ao Uso de Opioides/psicologia , Adulto , Doença Crônica/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Estudos Retrospectivos
15.
Med Care ; 57(10): 809-814, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31415340

RESUMO

BACKGROUND: Personal health records offer patients access to view their own health information and to manage their care online through secure patient portal tools. Little is known about the patient-reported experience in using health portals to manage chronic conditions. OBJECTIVE: In a patient-centered research study, we examined how using portal tools affects patient health care experiences among patients with chronic conditions. We also examined barriers among nonportal users. RESEARCH DESIGN: A cross-sectional patient survey. SUBJECTS: Patients with a chronic condition in an integrated delivery system offering a patient portal. MEASURES: Respondents reported barriers, preferences, and experiences in using the patient portal, and whether using the portal changed their overall health. RESULTS: Among all the 1824 respondents (70% response rate), portal nonusers reported preferring in-person health care (54%) or experiencing internet access barriers (41%). Portal users reported that using the portal was convenient (90%), the information available was useful (92%), and that it integrated well with other health care (92%). Among users, 31% reported that using the portal had improved their overall health. After adjustment, patients were significantly more likely to report that portal use improved their health if they had also reported convenience, information usefulness, or integration with other care (P<0.05). Reassuringly, patient-reported impacts on overall health did not vary by patient characteristics (including age, race, sex, education, income, complex conditions). CONCLUSION: Patients with chronic conditions using the portal reported convenience, information usefulness, and integration of the patient portal with their health care; these may act as potential pathways improving health.


Assuntos
Doença Crônica/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Portais do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , California , Estudos Transversais , Prestação Integrada de Cuidados de Saúde , Gerenciamento Clínico , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-31398793

RESUMO

(1) Background: The aim of this research was to analyze factors associated with quality of life (QoL) and marital satisfaction in married family caregivers of patients with mental disorders. (2) Methods: A cross-sectional study was conducted in all community mental health services in Goiania municipality, Brazil, in 2016-2017. Married family caregivers of patients with severe and persistent mental disorders were recruited and their QoL and marital satisfaction was assessed by using the World Health Organization Quality of Life Instrument Abbreviated version (WHOQOL-BREF) and Marital Satisfaction Scale. Multiple linear regressions were performed to identify factors associated with QoL and marital satisfaction. (3) Results: For 163 family caregivers, the psychological and environmental QoL domains presented the best and the worst scores, respectively. Factors independently associated with better QoL for caregivers were male caregiver, the younger age of a caregiver, >8 years of schooling, ≥5 years as a caregiver who performed physical activities, caregiver without chronic disease, and no patient's crisis in the last 30 days. Factors independently associated with marital satisfaction of the caregiver were male caregiver, caregiver with >8 years of schooling, caregiver who received support by relatives to care for the patient, caregiver who performed physical activities, no patient's crisis in the last 30 days, and patient hospitalization in the last six months; (4) Conclusions: The main predictor for marital satisfaction was support by relatives, and for QoL it was no patient's crisis in the last 30 days.


Assuntos
Cuidadores/psicologia , Doença Crônica/enfermagem , Doença Crônica/psicologia , Casamento/psicologia , Transtornos Mentais/enfermagem , Transtornos Mentais/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
17.
Res Nurs Health ; 42(5): 334-348, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31418465

RESUMO

Well siblings of chronically ill children experience family disruptions that profoundly affect them. Previous research focusing on well siblings' experiences has often produced inconsistent findings, likely the result of varying study designs and samples. The purposes of this synthesis research study were twofold: (a) to assess the applicability of existing grounded theory of sibling response to a child's cancer to a wider range of childhood conditions; and (b) to refine the existing theory to reflect the experiences of the broader sample. Data for the synthesis came from a National Institute of Nursing Research-funded mixed-methods synthesis examining the intersection of childhood chronic illness and family life. The current analysis was based on well sibling results extracted from 78 research reports published between 2000 and 2014. An existing grounded theory, Creating a Tenuous Balance (CTB), was discovered at the outset of analysis and used as the primary framework for coding and synthesizing results. The focus of most studies was siblings' responses to 14 chronic conditions, with cancer being the most often studied. Results reflected siblings' perspectives of their experiences as well as perspectives of parents and the ill child. The analysis substantiated all four patterns of sibling behavior included in CTB, with the patterns of adapting to changes in personal and family life, and handling strong emotions being especially challenging aspects of the sibling experience. Moreover, the results expanded several aspects of CTB. The analysis provided evidence of the applicability of the theory to a varied group of chronic conditions and enabled us to identify important areas for developing interventions to support siblings.


Assuntos
Adaptação Psicológica , Doença Crônica/psicologia , Crianças com Deficiência/psicologia , Voluntários Saudáveis/psicologia , Neoplasias/psicologia , Qualidade de Vida/psicologia , Irmãos/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino
18.
PLoS Med ; 16(8): e1002864, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31449518

RESUMO

BACKGROUND: One in 5 women experience mental illness in pregnancy or post partum. Universal preventive interventions have not lowered the incidence of perinatal mental illness, perhaps because those at highest risk were not targeted. Outside of pregnancy, chronic physical conditions are known to confer increased risk for mental illness. Our objective was to examine the association between chronic physical conditions and risk of perinatal mental illness. METHODS AND FINDINGS: We conducted a population-based retrospective cohort study using linked health administrative data sets in Ontario, Canada, in 2005 to 2015. We compared 77,385 women with chronic physical conditions to 780,619 women without such conditions, all of whom had a singleton live birth. Excluded were women with a mental illness diagnosis within 2 years before pregnancy. Chronic physical conditions were captured using the Agency for Healthcare Research and Quality Chronic Condition Indicator, applied to acute healthcare encounters in the 2 years before pregnancy. The outcome was perinatal mental illness, defined by a mental illness or addiction diagnosis arising between conception and 365 days post partum. The outcome was further defined by timing (prenatal or post partum) and specific diagnosis (psychotic disorder, mood or anxiety disorder, substance use disorder, self-harm, or other). Modified Poisson regression generated relative risks and 95% confidence intervals (CIs), adjusted for age, parity, rural residence, income quintile, and remote history of mental health care. Women in the cohort had an average age of 29.6 years (standard deviation 5.4), 44.2% were primiparous, 11.0% lived in a rural area, 40.1% were in the lowest 2 income quintiles, and 47.9% had a remote history of mental health care. More women with (20.4%) than without (15.6%) a chronic physical condition experienced perinatal mental illness-an adjusted relative risk (aRR) of 1.20 (95% CI 1.18-1.22, p < 0.0001). The aRRs were statistically significant for mental illness in pregnancy (1.12, 95% CI 1.10-1.15, p < 0.0001) and post partum (1.25, 95% CI 1.23-1.28, p < 0.0001). Psychotic disorders (aRR 1.50, 95% CI 1.36-1.65, p < 0.0001), mood or anxiety disorders (aRR 1.19, 95% CI 1.17-1.21, p < 0.0001), substance use disorders (aRR 1.47, 95% CI 1.34-1.62, p < 0.0001), and other mental illness (aRR 1.68, 95% CI 1.50-1.87, p < 0.0001) were more likely in women with than without chronic physical conditions, but not self-harm (aRR 1.14, 95% CI 0.87-1.48, p = 0.34). The study was limited by reliance on acute health care encounters to measure chronic physical conditions and the inability to capture undiagnosed mental health problems. CONCLUSIONS: Findings from this study suggest that women with a chronic physical condition predating pregnancy may be at heightened risk of developing mental illness in the perinatal period. These women may require targeted efforts to lower the severity of their condition and improve their coping strategies and supports in pregnancy and thereafter.


Assuntos
Doença Crônica/psicologia , Transtornos Mentais/etiologia , Complicações na Gravidez/psicologia , Adolescente , Adulto , Doença Crônica/epidemiologia , Feminino , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Ontário/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
19.
J Clin Neurosci ; 68: 51-54, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31375305

RESUMO

Heart failure is a chronic disease that impairs the quality of life and leads to several psychiatric disorders, especially depression and anxiety. The present study intended to investigate suicide risk and its association with depression, hopelessness and self-esteem in patients with chronic heart failure. 32 patients with chronic heart failure and 32 healthy control subjects with similar sociodemographic attributes were included in the present case control study. Sociodemographic data form, Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSE) and Suicide Probability Scale (SPS) were applied to all subjects. It was determined that the BHS (11.4 ±â€¯3.74 vs. 4.8 ±â€¯4.02, p < 0.001), BDI (22.2 ±â€¯11.9 vs 9.2 ±â€¯7.6, p < 0.001) and SPS (67.6 ±â€¯15.9 vs 59.2 ±â€¯10.9, p = 0.018) scores were statistically higher in the patient group when compared to the control group. It was also established that the self-esteem of subjects in the patient group was lower when compared to the control (p < 0.001). A positive correlation was determined between the SPS and BHS, and BDI and RSE scores (p < 0.001). Suicide risk was higher among the patients with heart failure when compared to the control group. This increase in suicide risk significantly correlated with high levels of hopelessness, depression, and low self-esteem in the patient group. Heart failure is one of the chronic diseases that increases suicidal ideation. The identification of suicidal ideation in the present patient group facilitated both the prevention of suicidal behavior and positive contribution to treatment.


Assuntos
Depressão/etiologia , Insuficiência Cardíaca/psicologia , Autoimagem , Ideação Suicida , Adulto , Estudos de Casos e Controles , Doença Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Suicídio
20.
Health Psychol ; 38(11): 960-974, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31368717

RESUMO

OBJECTIVE: This review aims to inform research and clinical care on the current state of knowledge on the relationship between positive affect and medication adherence. METHOD: Searches were carried out in PsycINFO, PubMed MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and Embase. There were no limits on study type, publication date, language, or participant demographics. Studies reporting a relationship between positive affect and medication adherence were eligible for inclusion if positive affect was measured prior to or concurrently with medication adherence. RESULTS: Nine studies met inclusion criteria. All studies were prospective cohort or cross-sectional and examined positive affect and medication adherence in people living with HIV or cardiovascular conditions. The majority of results indicated positive associations between positive affect and medication adherence, with Cohen's d effect sizes ranging from -0.40 to 1.27. CONCLUSIONS: Consistent with previous theoretical work, this systematic review provides evidence of a link between positive affect and improved medication adherence. Better measurement of both affect and medication adherence across chronic conditions is an important focus for future research and will inform targeted interventions to improve adherence and, ultimately, decrease the morbidity, mortality, and cost associated with suboptimal adherence in chronic physical conditions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Doença Crônica/psicologia , Adesão à Medicação/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
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