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1.
J Infect Public Health ; 13(4): 502-508, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31818708

RESUMO

BACKGROUND: Infectious intestinal disease affects 25% of the UK population annually; 1 in 50 affected people consult health professionals about their illness. AIMS: We tested if anticipated treatment-seeking decisions for suspected infectious intestinal disease could be related to emotional response, tolerance of symptoms, or beliefs about the consequential benefits and harms of seeking treatment (or not). METHODS: Questionnaire survey of adults living in the UK with statistical analysis of responses. A vignette was presented about a hypothetical gastrointestinal illness. People stated their emotional reactions, expected actions in response and beliefs about possible benefits or harms from seeking treatment (or not getting treatment). Multinomial regression looked for predictors of anticipated behaviour. RESULTS: People were inclined to consult a GP when they believed that seeking treatment would be beneficial and that its absence would be harmful. Seeking treatment was less anticipated if the condition was expected to improve quickly. Respondents were also more likely to consult if they strongly disliked fever or headache, and/or if the illness made them feel anxious or angry. Treatment-seeking (or lack of it) was not linked to harms from treatment-seeking, other specific symptoms and emotional responses. CONCLUSION: It was possible to link anticipated treatment-seeking behaviour to specific factors: expected prognosis, perceived benefits of seeking treatment, some emotions and some specific symptoms.


Assuntos
Doenças Transmissíveis/terapia , Enteropatias/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , Atitude Frente a Saúde , Doenças Transmissíveis/psicologia , Emoções , Humanos , Enteropatias/psicologia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Inquéritos e Questionários , Reino Unido
2.
Rev Bras Enferm ; 72(5): 1203-1210, 2019 Sep 16.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31531642

RESUMO

OBJECTIVE: To analyze the playful educational interventions in the knowledge of schoolchildren about intestinal parasitosis. METHOD: This is a quasi-experimental, non-randomized study, based on pre- and post-intervention, conducted in a public elementary school in a peripheric neighborhood in the city of Ribeirão Preto (SP). The study population consisted of 101 students enrolled in the 5th and 6th grade. For comparison, we used the generalized version of the McNemar chi-squared test. RESULTS: Of the 101 schoolchildren who participated in the study, 48 (47.5%) were female and 53 (52.5%) were male, aged from 9 to 14 years. Students' knowledge on intestinal parasitic infections has increased significantly after the playful educational intervention. CONCLUSION: Playful educational interventions are an excellent didactical resource in the teaching-learning process of schoolchildren.


Assuntos
Educação em Saúde/métodos , Enteropatias/psicologia , Ludoterapia/métodos , Adolescente , Amebíase/psicologia , Criança , Feminino , Giardíase/psicologia , Educação em Saúde/estatística & dados numéricos , Humanos , Enteropatias/terapia , Masculino , Ludoterapia/instrumentação , Ludoterapia/estatística & dados numéricos , Instituições Acadêmicas/organização & administração , Instituições Acadêmicas/estatística & dados numéricos , Inquéritos e Questionários
3.
J Pediatr Gastroenterol Nutr ; 68(1): 7-12, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30052565

RESUMO

OBJECTIVE: Survival rates of children with intestinal failure have increased; however, associated co-morbidities may affect long-term motor developmental outcomes. This study evaluates motor proficiency and generalized self-efficacy toward physical activity (PA) in children ages 6 to 12 years with intestinal failure. METHODS: This is an observational, cross-sectional study of children followed in a multidisciplinary intestinal rehabilitation program. Motor proficiency was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form (BOT-2 SF) and the Scales of Independent Behavior (parent-proxy report). Children completed the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) and a PA questionnaire. Relevant demographic and medical variables were correlated with assessment results. RESULTS: Participants include 30 children (18 males), median age 7 years (interquartile range [IQR] 6-9) with gestational age 35 weeks (IQR 32-39) and birth weight 2.13 kg (IQR 1.68-2.77). Thirteen (43%) were dependent on parenteral nutrition. Fifteen (50%) scored below average on the BOT-2 SF. Lower BOT-2 SF scores were significantly associated with lower CSAPPA scores (r = 0.480, P = 0.01), with a common barrier to PA being the presence of a central line or enterostomy tube. Gestational age, height z scores, length of hospital admissions, and number of septic events were all significantly correlated with lower scores in motor proficiency. Number of septic events and total parenteral nutrition days were significant predictors of lower BOT-2 SF scores, when adjusting for birth weight. CONCLUSIONS: Multiple medical variables related to intestinal failure may affect motor proficiency and PA self-efficacy. Developmental follow-up is important to optimize motor skill development and promote PA participation.


Assuntos
Exercício Físico/psicologia , Enteropatias/psicologia , Destreza Motora , Autoeficácia , Criança , Estudos Transversais , Feminino , Humanos , Enteropatias/fisiopatologia , Enteropatias/reabilitação , Masculino , Desempenho Físico Funcional , Inquéritos e Questionários
4.
Semin Pediatr Surg ; 27(4): 273-279, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30342603

RESUMO

Treatment results of pediatric intestinal failure have improved markedly during the last decades. With improved survival the attention is turning to other essential outcomes including quality of life and neurodevelopment. So far, relatively few studies with limited number of patients and variable methodology have addressed these issues. Based on these studies using generic health related quality of life tools, children with intestinal failure demonstrate decreased physical health, while PN-dependence is also associated with compromised emotional functioning. Impairments of social functioning are frequently observed among older children and parents. Few recent studies on neurodevelopment imply significant impairments in motor and mental skills among children with intestinal failure despite small sample sizes and limited follow-up times. Development of a disease-specific survey designed for the pediatric intestinal failure population could better reveal the health issues with greatest impact on quality of life. Robust studies with appropriate methodology on neurodevelopment in pediatric intestinal failure with extended follow-up times are urgently needed. Quality of life and neurodevelopment requires greater attention from medical professionals managing children with intestinal failure.


Assuntos
Enteropatias/complicações , Transtornos do Neurodesenvolvimento/etiologia , Qualidade de Vida , Criança , Indicadores Básicos de Saúde , Humanos , Enteropatias/psicologia , Transtornos do Neurodesenvolvimento/diagnóstico , Qualidade de Vida/psicologia , Síndrome do Intestino Curto/complicações , Síndrome do Intestino Curto/psicologia
5.
Clin Nutr ESPEN ; 26: 77-83, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29908687

RESUMO

BACKGROUND & AIMS: People with chronic, type 3, intestinal failure often require long-term home parenteral nutrition (HPN). People receiving HPN have frequent interactions with their healthcare, due to the need for close monitoring and due to recurrent hospital admissions. Individuals' responses to, and interactions with, their health care service provides are poorly described. We conducted a service evaluation to explore people's experiences of HPN-related healthcare interactions in order to identify how service providers can best meet the individualised needs of patients. METHODS: We interviewed ten people receiving HPN. The participants were asked about their healthcare interactions related to HPN. The data were analysed using a qualitative research method known as interpretive phenomenological analysis. This analytical approach is concerned with the meaning that people ascribe to particular events, in this case their HPN-related healthcare interactions. RESULTS: The participants in this study described a range of psychosocial problems related to their HPN healthcare interactions, including reliance, risk and restrictions. Participants' solutions to these problems included adaptation of their routine, self-guardianship and passivity. Sometimes, these solutions generated secondary problems of their own, including concerns with resource use, negative healthcare interactions and conflicts of responsibility. A range of contextual factors influenced how participants interpreted their healthcare interactions and the solutions available to them. These contextual factors included continuity of healthcare professionals, the attitude of staff, and information and knowledge about HPN. CONCLUSIONS: By attending to the individual meaning ascribed to healthcare events, and the contextual factors that surround these events, we have been able to better understand the decisions made by patients dependent on HPN. This suggests that healthcare professionals may also better understand their patients' decision making by attending to the individual meaning that patients ascribe to healthcare events and to contextual factors. We propose a model to describe the process of problem -> resolution -> problem in which participants are actively engaged.


Assuntos
Enteropatias/terapia , Síndromes de Malabsorção/terapia , Nutrição Parenteral no Domicílio , Participação do Paciente , Resolução de Problemas , Adaptação Psicológica , Idoso , Comportamento de Escolha , Doença Crônica , Efeitos Psicossociais da Doença , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Absorção Intestinal , Enteropatias/diagnóstico , Enteropatias/fisiopatologia , Enteropatias/psicologia , Síndromes de Malabsorção/diagnóstico , Síndromes de Malabsorção/fisiopatologia , Síndromes de Malabsorção/psicologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Nutrição Parenteral no Domicílio/efeitos adversos , Nutrição Parenteral no Domicílio/psicologia , Pesquisa Qualitativa , Resultado do Tratamento
6.
Clin Nutr ESPEN ; 24: 35-40, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29576360

RESUMO

BACKGROUND & AIMS: Several studies have been published reporting on the impact of Home Parenteral Nutrition (HPN) on the lives of people with Type 3 Intestinal Failure. These studies focused on symptoms and functional limitations resulting from the treatment. The aim of this study was to determine how dependence on HPN affects individuals' ability to fulfil their human needs. METHODS: Unstructured qualitative interviews were conducted with people dependent on HPN, who were asked to explain how their lives were affected by the treatment. Theoretical thematic analysis was conducted on the interview transcripts to identify statements describing aspects of human needs that were left unfulfilled. Care was taken to separate the impact of HPN from that of the underlying disease. RESULTS: Interviews were conducted with 30 patients (53% female; mean age, 55.9 (range 35-76) years). Most of the sample (87%) had short bowel syndrome. Major aspects of need affected by HPN were related to: autonomy, cognition, relationships, role fulfilment, socialisation, appearance and self-esteem, appetite and perceived vulnerability. CONCLUSIONS: The study illustrates how patients' lives are affected by HPN. Statements generated from this qualitative study were used to produce the Parenteral Nutrition Impact Questionnaire (PNIQ), a patient-centric measure of quality of life specific to people using HPN.


Assuntos
Enteropatias/terapia , Nutrição Parenteral no Domicílio , Cooperação do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Autocuidado , Adulto , Idoso , Feminino , Humanos , Enteropatias/fisiopatologia , Enteropatias/psicologia , Masculino , Pessoa de Meia-Idade , Necessidades Nutricionais , Pesquisa Qualitativa , Autocuidado/estatística & dados numéricos , Inquéritos e Questionários , Resultado do Tratamento
7.
Transplant Proc ; 50(1): 226-233, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29407314

RESUMO

BACKGROUND: Clinical and psychosocial outcomes of a multimodal surgical approach for chronic intestinal pseudo-obstruction were analyzed in 24 patients who were followed over a 2- to 12-year period in a single center after surgery or intestinal/multivisceral transplant (CTx). METHODS: The main reasons for surgery were sub-occlusion in surgery and parenteral nutrition-related irreversible complications with chronic intestinal failure in CTx. RESULTS: At the end of follow-up (February 2015), 45.5% of CTx patients were alive: after transplantation, improvement in intestinal function was observed including a tendency toward recovery of oral diet (81.8%) with reduced parenteral nutrition support (36.4%) in the face of significant mortality rates and financial costs (mean, 202.000 euros), frequent hospitalization (mean, 8.8/re-admissions/patient), as well as limited effects on pain or physical wellness. CONCLUSIONS: Through psychological tests, transplant recipients perceived a significant improvement of mental health and emotional state, showing that emotional factors were more affected than were functional/cognitive impairment and social interaction.


Assuntos
Enteropatias/cirurgia , Pseudo-Obstrução Intestinal/cirurgia , Intestinos/transplante , Qualidade de Vida/psicologia , Vísceras/transplante , Adolescente , Adulto , Doença Crônica , Terapia Combinada , Feminino , Seguimentos , Humanos , Enteropatias/etiologia , Enteropatias/psicologia , Pseudo-Obstrução Intestinal/psicologia , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral Total/efeitos adversos , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
Rev. psiquiatr. infanto-juv ; 35(4): 302-308, 2018.
Artigo em Espanhol | IBECS | ID: ibc-184290

RESUMO

Las enfermedades crónicas infantiles influyen negativamente en el desarrollo psicológico. Los niños y adolescentes con enfermedades crónicas digestivas presentan de forma predominante síntomas ansiosos y depresivos. Factores ambientales como el manejo de la sintomatología, la influencia de la respuesta de los pares o de la propia familia pueden determinar el manejo que de la enfermedad tenga el paciente. Estos aspectos son muy relevantes en enfermedades como la Enfermedad de Crohn, la Colitis Ulcerosa, el Dolor Abdominal Recurrente y los Vómitos Psicógenos. Los factores psicológicos que afectan a enfermedades médicas y/o la presencia comórbida de patología mental disminuyen la calidad de vida de estos pacientes afectando también al sistema familiar. La medicina psicosomática aborda estos aspectos de dichas patologías ayudando al paciente y a sus familias. Un abordaje integral por parte digestivo y de salud mental incrementa la salud percibida de los niños y adolescentes con patología digestiva crónica


Chronic childhood diseases negatively influence on the child's psychological development. Children and adolescents with chronic digestive diseases have predominantly anxious and depressive symptoms. Environmental factors such as management of gastrointestinal symptoms, the influence of the response of peers or family itself can determine the handling of the disease. These aspects are very important in diseases like Crohn's disease, ulcerative colitis, recurrent abdominal pain and psychogenic vomiting. Psychological factors affecting medical conditions and / or the presence of comorbid mental illness diminish the quality of life of these patients also the family system is affecting. Psychosomatic medicine addresses these aspects of these diseases helping patients and their families. A comprehensive approach to improving gastrointestinal and psychiatric symptoms increases the perceived health of children and adolescents with chronic digestive diseases


Assuntos
Humanos , Criança , Adolescente , Transtornos Psicofisiológicos/psicologia , Doença Crônica/psicologia , Doença de Crohn/psicologia , Colite Ulcerativa/psicologia , Qualidade de Vida , Psicoterapia/métodos , Medicina Psicossomática/métodos , Estresse Psicológico/psicologia , Enteropatias/psicologia , Doença Celíaca/psicologia
9.
Hum Reprod ; 32(9): 1812-1818, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-28854723

RESUMO

STUDY QUESTION: Is it possible to develop a validated score that can identify women with Bowel Endometriosis Syndrome (BENS) and be used to monitor the effect of medical and surgical treatment? SUMMARY ANSWER: The BENS score can be used to identify women with BENS and to monitor the effect of medical and surgical treatment of women suffering from bowel endometriosis. WHAT IS KNOWN ALREADY: Endometriosis is a heterogeneous disease with extensive variation in anatomical and clinical presentation, and symptoms do not always correspond to the disease burden. Current endometriosis scoring systems are mainly based on anatomical and surgical findings. STUDY DESIGN, SIZE, DURATION: The score was developed and validated from a cohort of 525 women with medically or surgically treated bowel endometriosis from Aarhus and Copenhagen University Hospitals, Denmark. PARTICIPANTS/MATERIALS, SETTING AND METHODS: Patients filled in questionnaires on pelvic pain, quality of life (QoL) and urinary, sexual and bowel function. Items were selected for the final score using clinical and statistical criteria. The chosen variables were included in a multivariate analysis. Individual score values were designated items to form the BENS score, which was divided into 'no BENS', 'minor BENS' and 'major BENS.' Internal and external validations were performed. MAIN RESULTS AND THE ROLE OF CHANCE: The six most important items were 'pelvic pain', 'use of analgesics', 'dyschezia', 'straining to urinate', 'fecal urgency' and 'satisfaction with sexual life'. The range of the BENS score (0-28) was divided into 0-8 (no BENS), 9-16 (minor BENS) and 17-28 (major BENS). External validation showed a significant association between BENS score and QoL (P = 0.0001). LIMITATIONS, REASONS FOR CAUTION: The BENS scoring system is limited by the fact that it was developed from a single endometriosis unit in Denmark, making it susceptible to social, cultural and demographic bias. WIDER IMPLICATIONS OF THE FINDINGS: It is the first endometriosis classification system to be based directly on the symptomatology of the patient. Validation in other languages will promote comparison of treatments and results across borders. STUDY FUNDING/COMPETING INTEREST(S): No external funding was either sought or obtained for this study. A.F. is an investigator for Bayer, outside this work.


Assuntos
Dispareunia/diagnóstico , Endometriose/diagnóstico , Enteropatias/diagnóstico , Dor Pélvica/diagnóstico , Qualidade de Vida/psicologia , Disfunções Sexuais Fisiológicas/diagnóstico , Adulto , Dispareunia/etiologia , Dispareunia/psicologia , Endometriose/complicações , Endometriose/psicologia , Feminino , Humanos , Enteropatias/complicações , Enteropatias/psicologia , Pessoa de Meia-Idade , Dor Pélvica/etiologia , Dor Pélvica/psicologia , Índice de Gravidade de Doença , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Inquéritos e Questionários , Adulto Jovem
10.
J Pediatr Surg ; 51(6): 1001-4, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27233371

RESUMO

BACKGROUND: Maternal separation (MS) leads to intestinal barrier dysfunction in neonatal mice. Endoplasmic reticulum (ER) stress is associated with apoptosis and pro-inflammatory response induction. We hypothesized that MS induced gut damage is associated with ER stress and that administration of an ER stress inhibitor protects gut damage. METHODS: C57BL/6 mice received intraperitoneal PBS (n=10) or Salubrinal (1mg/kg/day, n=10). MS was performed soon after treatment for 3h daily between P5 and P9. Ten untreated neonatal mice served as control. The colon was harvested on P9 and analyzed for ER stress markers (BiP, CHOP), apoptosis (CC3), goblet cell number per crypt and crypt length (Alcian blue, hematoxylin/eosin), and transcellular permeability (Ussing chamber). Groups were compared using one-way ANOVA with Bonferroni post-test. RESULTS: Compared to controls, MS mice had higher relative protein expression of ER stress and apoptosis markers (p<0.05) and reduced goblet cell number per crypt and crypt length (p<0.001). In comparison to PBS mice, Salubrinal treated mice had higher goblet cell number (p<0.05), crypt length (p<0.001), and lower transcellular permeability (p<0.05). CONCLUSIONS: Maternal separation induces ER stress and causes colon damage, but ER stress inhibitor protects morphology and permeability. This provides insights on bowel pathogenesis and potential novel treatments for diseases such as necrotizing enterocolitis.


Assuntos
Colo/fisiologia , Estresse do Retículo Endoplasmático/fisiologia , Enteropatias/fisiopatologia , Enteropatias/psicologia , Mucosa Intestinal/fisiologia , Privação Materna , Animais , Apoptose , Permeabilidade da Membrana Celular/efeitos dos fármacos , Permeabilidade da Membrana Celular/fisiologia , Cinamatos/farmacologia , Colo/efeitos dos fármacos , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Fármacos Gastrointestinais/farmacologia , Mucosa Intestinal/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Tioureia/análogos & derivados , Tioureia/farmacologia
11.
Tech Coloproctol ; 20(4): 215-20, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26754654

RESUMO

BACKGROUND: Up to 90 % of patients undergoing low anterior resection complain of increased daily bowel movements, urgency, and a variable degree of incontinence. A symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer has recently been developed and validated. The aim of our study was to adapt the low anterior resection syndrome (LARS) scale questionnaire to the Lithuanian language, and assess its psychometric properties. METHODS: The LARS questionnaire was translated into Lithuanian by the Scientific Advisory Committee of the Medical Outcomes Trust using a standard procedure of double-back translation. The Lithuanian version of the LARS (LARS-LT) questionnaire was completed by 111 patients who underwent low anterior resection with total mesorectal excision in the period from January 1, 2008, to December 31, 2012, at the National Cancer Institute. An anchor question from the Wexner score assessing the impact of bowel function on lifestyle was included. A subgroup of 20 patients completed the LARS-LT questionnaire twice. Validity was tested using a factor analysis, and internal reliability was estimated using the Cronbach's alpha and intraclass correlation coefficients. RESULTS: Twenty-seven patients (25 %) had no LARS, 26 (24 %) had minor LARS, and 55 (56 %) had major LARS. The response rate was 60.7 %. The LARS-LT showed significantly high reliability and internal consistency [Cronbach's α = 0.88, interclass correlation coefficient-0.86 (0.71-0.98)]. The LARS score showed significant correlations with the lifestyle question (p < 0.05). It could not detect differences between female and male patient groups (p = 0.33), patients' age (p = 0.45), patients who had/had not undergone radiation therapy (p = 0.07), and those in whom the distal edge of the tumor was close to or far from the anal verge (p = 0.17). CONCLUSIONS: The Lithuanian version of the LARS-LT shows acceptable psychometric properties and can be considered a valuable and specific instrument to assess bowel function in rectal cancer patients, both for research purposes and in clinical practice.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Enteropatias/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Neoplasias Retais/cirurgia , Inquéritos e Questionários/normas , Idoso , Incontinência Fecal/diagnóstico , Incontinência Fecal/etiologia , Incontinência Fecal/psicologia , Feminino , Humanos , Enteropatias/etiologia , Enteropatias/psicologia , Intestinos/fisiopatologia , Lituânia , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/psicologia , Psicometria , Neoplasias Retais/psicologia , Reto/fisiopatologia , Reto/cirurgia , Reprodutibilidade dos Testes , Síndrome
12.
Am J Mens Health ; 10(6): 474-486, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-25759368

RESUMO

The current study aims to explor how men would advise other men about seeking help for lower bowel symptoms and also to determine the factors that may influence help seeking. A purposive sample of Western Australian men aged 18 years and older was recruited for the study. Participants completed 8 of the 28 randomly assigned video vignettes (video clips) displaying men (older or younger) with various combinations of one or more lower bowel symptoms. Participants were asked if the person in the vignette should seek health advice. Subsequently, the participants answered a set of questions based on the Health Belief Model. A total of 408 participants (response rate = 51%) answered 3,264 vignettes. Participants younger than 50 years, participants who were not tertiary educated and those who had lower incomes, or those living in regional or remote areas were less likely to advise help seeking from general practitioner (GP). Participants who visited their general practitioner less frequently were also less likely to advisehelp seeking. There was a trend to consider unintentional weight loss and diarrhea as minor symptoms not necessitating medical attention compared with rectal bleeding. The findings suggest for a need to improve public awareness among men about the need to seek timely medical advice for lower bowel symptoms in primary care. The importance of early presentation of persistent lower bowel symptoms must be specifically targeted at men younger than 50 years, those with lower incomes, or residing in regional or remote areas.


Assuntos
Atitude Frente a Saúde , Enteropatias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravação em Vídeo , Adulto , Humanos , Enteropatias/psicologia , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Inquéritos e Questionários , Austrália Ocidental
13.
J Pediatr Gastroenterol Nutr ; 62(1): 145-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26147629

RESUMO

BACKGROUND: Home parenteral nutrition (HPN) is an established therapy in children with intestinal failure. Parenteral nutrition (PN) management allows most paediatric patients to participate in age-appropriate activities; however, HPN may lead to significant restrictions, particularly going on holiday. We aimed to identify sociodemographic and illness-specific variables that influence if and how families with children on HPN travel. METHODS: A standardised questionnaire was sent to all 40 children on HPN within a large tertiary intestinal failure centre in the United Kingdom. Depending on whether the family had/had not been on holiday since their child had started HPN, questions were asked to understand the reasons for not travelling or to gather information about individual travel experiences. RESULTS: A total of 30 children were enrolled, 20 of 30 went at least once on holiday, and 5 of 30 travelled more than once per year, 70% travelled outside Britain. Going on vacation was more common, the longer the child had been on HPN (P = 0.022); hours spent on PN tolerance of enteral feeds or the child's age did not influence travel behaviour; 80% of parents who went on vacation had a good/worthy experience, 95% would travel again. The biggest reported obstacle was the transportation of PN bags. Ten families sacrificed a holiday over fear that it may be difficult to arrange or because of the child's unstable medical condition. CONCLUSIONS: A significant proportion of families chose to go on holiday away from home despite their child being on HPN. The experience is considered good by most.


Assuntos
Enteropatias/terapia , Nutrição Parenteral no Domicílio/estatística & dados numéricos , Pais/psicologia , Viagem/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Nutrição Enteral/métodos , Nutrição Enteral/psicologia , Feminino , Humanos , Lactente , Enteropatias/psicologia , Masculino , Nutrição Parenteral no Domicílio/métodos , Nutrição Parenteral no Domicílio/psicologia , Inquéritos e Questionários , Viagem/psicologia , Reino Unido
14.
J Pediatr Gastroenterol Nutr ; 61(4): 384-92, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26192701

RESUMO

OBJECTIVES: The aim of the study was to determine the prevalence of stressful life events including (sexual) abuse in children with functional defecation disorders by performing a systematic review. METHODS: We searched MEDLINE, EMBASE, and PsycINFO for cohort, case-control and cross-sectional studies investigating the prevalence of stressful life events, including (sexual) abuse in children with functional defecation disorders. RESULTS: The search yielded 946 articles, of which 8 were included with data from 654 children with functional constipation and 1931 children with (constipation-associated) fecal incontinence (FI). Overall, children with functional defecation disorders had been significantly more exposed to stressful life events than healthy children, with prevalence rates ranging from 1.6% to 90.9%. Being bullied, being a relational victim, interruption of toilet training, punishment by parents during toilet training, and hospitalization were significantly related to FI, whereas separation from the best friend, failure in an examination, severe illness in a close family member, loss of job by a parent, frequent punishment, and living in a war-affected area were significantly related to constipation. Only 1 study measured the prevalence of child abuse, which reported a significantly higher prevalence of child (sexual) abuse in children with FI compared with controls. CONCLUSIONS: The prevalence of stressful life events, including (sexual) abuse is significantly higher in children with functional defecation disorders compared with healthy children. To gain more insight into the true prevalence of child (sexual) abuse in children with functional defecation disorders, more studies are clearly needed.


Assuntos
Constipação Intestinal/etiologia , Incontinência Fecal/etiologia , Enteropatias/etiologia , Acontecimentos que Mudam a Vida , Estresse Fisiológico , Estresse Psicológico/fisiopatologia , Criança , Abuso Sexual na Infância/psicologia , Constipação Intestinal/psicologia , Defecação , Incontinência Fecal/psicologia , Humanos , Enteropatias/psicologia , Intestinos/fisiopatologia , Prevalência , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
15.
Radiat Oncol ; 10: 130, 2015 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-26054532

RESUMO

BACKGROUND: To assess the relationship between dosimetric parameters and the quality of life (QL) outcomes of patients with low-intermediate-risk localised prostate cancer (LPC) treated with low-dose-rate brachytherapy (LDR-BT). MATERIALS AND METHODS: We evaluated the participants in two consecutive prospective studies of the QL of patients treated with LDR-BT for LPC. QL was evaluated by means of a patient-completed questionnaire assessing non functional [physical (PHY) and psychological (PSY) well-being, physical autonomy (POW), social relationships (REL)] and functional scales [urinary (URI), rectal (REC), and sexual (SEX) function]; a scale for erectile function (ERE) was included in the second study. Urethra (D10 ≤ 210 Gy) and rectal wall constraints (V100 ≤ 0.5 cc) were used for pre-planning dosimetry and were assessed with post planning computerized tomography one month later for each patient. RESULTS: QL was assessed in 251 LPC patients. Dosimetry did not influence the non-functional scales. As expected, a progressive impairment in sexual and erectile function was reported one month after LDR-BT, and became statistically significant after the third year. Rectal function significantly worsened after LDR-BT, but the differences progressively decreased after the 1-year assessment. Overall urinary function significantly worsened immediately after LDR-BT and then gradually improved over the next three years. Better outcomes were reported for V100 rectal wall volumes of ≤ 0.5 cc and D10 urethra values of ≤ 210 Gy. CONCLUSIONS: The findings of this study show that dosimetric parameters influence only functional QL outcomes while non-functional outcomes are only marginally influenced.


Assuntos
Adenocarcinoma/radioterapia , Braquiterapia/efeitos adversos , Neoplasias da Próstata/radioterapia , Qualidade de Vida , Dosagem Radioterapêutica , Atividades Cotidianas , Adenocarcinoma/psicologia , Idoso , Braquiterapia/métodos , Seguimentos , Genitália Masculina/efeitos da radiação , Humanos , Relações Interpessoais , Enteropatias/etiologia , Enteropatias/psicologia , Masculino , Pessoa de Meia-Idade , Órgãos em Risco/efeitos da radiação , Estudos Prospectivos , Neoplasias da Próstata/psicologia , Planejamento da Radioterapia Assistida por Computador , Reto/efeitos da radiação , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Inquéritos e Questionários , Uretra/efeitos da radiação , Bexiga Urinária/efeitos da radiação , Transtornos Urinários/etiologia , Transtornos Urinários/psicologia
16.
J Dig Dis ; 16(7): 395-9, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25997996

RESUMO

OBJECTIVE: This study aimed to investigate the prevalence of the overlap between gastroesophageal reflux disease (GERD) and functional bowel disorders (FBD) in the general population in rural areas in China. METHODS: A population-based cross-sectional study was conducted in six villages in Nanmazhuang area in Lankao County (Henan Province, China) from December 2010 to October 2011. The GERD questionnaire (GerdQ) and Rome III criteria were used for the diagnosis of GERD and FBD and to determine the prevalence of GERD-FBD overlap. RESULTS: The response rate to the questionnaires of the patients was 91.5%. In all, 2950 of 3700 residents with a mean age of 42.4 ± 16.8 years were included. Among them, 4.8% were diagnosed with GERD and 4.6% with FBD. The proportion of respondents with FBD was significantly higher in the GERD group than that in the non-GERD group (25.53% vs 3.60%, P < 0.05). The prevalence of GERD in the FBD group was significantly higher than that in the non-FBD group (26.28% vs 3.73%, P < 0.05). The prevalence of GERD-FBD overlap in the general rural population was 1.22%. Logistic regression analysis indicated that anxiety was an independent predictor for the GERD-FBD overlap in GERD and FBD (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.09 and OR 1.06, 95% CI 1.02-1.10, respectively). CONCLUSION: GERD-FBD overlap is more common than expected by chance in the general rural population, and anxiety is significantly related to the overlap.


Assuntos
Refluxo Gastroesofágico/epidemiologia , Enteropatias/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Ansiedade/complicações , Ansiedade/epidemiologia , China/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/psicologia , Humanos , Enteropatias/diagnóstico , Enteropatias/psicologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Inquéritos e Questionários
18.
Am J Health Behav ; 39(2): 212-21, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25564834

RESUMO

OBJECTIVE: To explore the barriers to help-seeking among men experiencing lower bowel symptoms. METHODS: Semi-structured interviews were conducted with 13 men recruited via purposive sampling. Interviews were audio-taped, transcribed, and analyzed thematically. RESULTS: Misinterpretation of the symptoms and the attribution of the symptoms to non-medical causes were common barriers to help-seeking. Other barriers include the cost of consulting a GP, llow level of confidence in consultation, and fear of cancer diagnosis. Some participants did not seek medical advice as the symptoms were intermittent or resolved with over-the-counter medications. CONCLUSION: There is a need for health promotion campaigns for men with regards to seeking timely medical advice for lower bowel symptoms.


Assuntos
Atitude Frente a Saúde , Enteropatias/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade
19.
World J Urol ; 33(10): 1373-80, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25552205

RESUMO

PURPOSE: Patients after radical cystectomy (RC) frequently complain about bowel disorders (BDs). Reports addressing related long-term complications are sparse. This cross-sectional study assessed changes in bowel habits (BH) after RC. METHODS: A total of 89 patients with a minimum follow-up ≥1 year after surgery were evaluated with a questionnaire. Patients with BD prior to surgery were excluded. Symptoms such as diarrhea, constipation, bloating/flatulence, incomplete defecation, uncontrolled stool loss, and impact on quality of life (QoL) were assessed. RESULTS: A total of 46.1 % of patients reported changes in BH; however, only 25.8 % reported experiencing related dissatisfaction. Primary causes of dissatisfaction were diarrhea and uncontrolled stool loss. The most common complaints were bloating/flatulence and the feeling of incomplete defecation, but these symptoms did not necessarily lead to dissatisfaction or impairment in quality of life. No difference was identified between an orthotopic neobladder and ileal conduit, and even patients without bowel surgery were affected. QoL, health status, and energy level were significantly decreased in unsatisfied patients. CONCLUSIONS: About 25 % of patients complain about BDs after RC. More prospective studies assessing symptoms, comorbidities, and dietary habits are necessary to address this issue and to identify strategies for follow-up recommendations.


Assuntos
Cistectomia/efeitos adversos , Enteropatias/etiologia , Qualidade de Vida , Inquéritos e Questionários , Idoso , Estudos Transversais , Comportamento Alimentar , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Incidência , Enteropatias/epidemiologia , Enteropatias/psicologia , Masculino , Estudos Prospectivos , Neoplasias da Bexiga Urinária/cirurgia
20.
Psychooncology ; 24(6): 691-8, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25060033

RESUMO

OBJECTIVE: Limited research has investigated the psychosocial processes that underpin the effect of physical symptoms on fear of cancer recurrence. Additionally, despite evidence of increased vulnerability of marginalized populations to negative outcomes, few studies have examined the unique experience of gay men coping with the cancer process. The goals of this study were to determine whether disease-related self-efficacy and satisfaction with medical care mediated the relationship between greater physical symptoms and worse fear of recurrence among gay or bisexual prostate cancer survivors. METHODS: Participants were composed of 92 self-identified gay or bisexual men, who had received a diagnosis of prostate cancer in the past 4 years. Participants provided demographic information and completed self-report questionnaires that assessed symptom function, self-efficacy for prostate cancer symptoms, satisfaction with healthcare, and fear of recurrence. Bootstrapping procedures were used to assess for significant mediation. RESULTS: Results suggested significant mediation of the relationship between each of bowel, hormonal, and sexual function with fear of recurrence by self-efficacy and satisfaction with healthcare. Mediation was not significantly supported for the association between urinary function and fear of recurrence. CONCLUSIONS: Findings support the explanatory effects of self-efficacy for symptom management and satisfaction with healthcare on the relationship between symptom function and fear of recurrence. These results indicate that psychological processes, specifically psychological factors that hold particular relevance to gay or bisexual men, reflect a potential avenue for intervention to decrease fear of cancer recurrence.


Assuntos
Bissexualidade , Medo/psicologia , Homossexualidade Masculina , Recidiva Local de Neoplasia/psicologia , Satisfação do Paciente , Neoplasias da Próstata/psicologia , Autoeficácia , Sobreviventes/psicologia , Adaptação Psicológica , Humanos , Enteropatias/psicologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/terapia , Disfunções Sexuais Fisiológicas/psicologia , Inquéritos e Questionários , Transtornos Urinários/psicologia
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