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1.
Forensic Sci Int ; 306: 110062, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786514

RESUMO

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


Assuntos
Conflitos Armados , Antropologia Forense/organização & administração , Sobreviventes/psicologia , Altruísmo , Arqueologia , Recursos Audiovisuais , Sepultamento , Relações Comunidade-Instituição , Grupos Focais , Antropologia Forense/educação , Direitos Humanos , Humanos , População Rural , Uganda
2.
J Surg Res ; 245: 516-522, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31450039

RESUMO

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


Assuntos
Fasciite Necrosante/cirurgia , Gangrena de Fournier/cirurgia , Gangrena Gasosa/cirurgia , Qualidade de Vida , Infecções dos Tecidos Moles/cirurgia , Adulto , Desbridamento/efeitos adversos , Fasciite Necrosante/complicações , Fasciite Necrosante/psicologia , Feminino , Gangrena de Fournier/complicações , Gangrena de Fournier/psicologia , Gangrena Gasosa/complicações , Gangrena Gasosa/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Tratamento de Ferimentos com Pressão Negativa/efeitos adversos , Países Baixos , Período Pós-Operatório , Estudos Retrospectivos , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos
3.
Disasters ; 44(1): 85-102, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31231844

RESUMO

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


Assuntos
Desastres , Fotografação , Socorro em Desastres/organização & administração , Sobreviventes/psicologia , Tsunamis , Humanos , Japão
4.
Nurs Clin North Am ; 54(4): 569-584, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31703782

RESUMO

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


Assuntos
Assistência à Saúde , Medicina Baseada em Evidências , Tráfico de Pessoas/estatística & dados numéricos , Sobreviventes/psicologia , Adulto , Criança , Pessoal de Saúde , Tráfico de Pessoas/psicologia , Humanos , Serviços de Saúde Mental , Saúde Pública
5.
Medicine (Baltimore) ; 98(39): e17307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574859

RESUMO

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


Assuntos
Ansiedade , Disfunção Cognitiva , Depressão , Transplante de Células-Tronco Hematopoéticas , Complicações Pós-Operatórias , Qualidade de Vida , Adolescente , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/prevenção & controle , Criança , Pré-Escolar , China/epidemiologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Depressão/diagnóstico , Depressão/etiologia , Depressão/prevenção & controle , Intervenção Médica Precoce/métodos , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Destreza Motora , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Técnicas Psicológicas , Sobreviventes/psicologia
6.
Dis Colon Rectum ; 62(11): 1294-1304, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31567919

RESUMO

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


Assuntos
Neoplasias Colorretais , Efeitos Psicossociais da Doença , Desempenho Físico Funcional , Qualidade de Vida , Sobreviventes , Tempo , Idoso , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/psicologia , Neoplasias Colorretais/terapia , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/métodos , Fatores Sexuais , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos
7.
Int J Equity Health ; 18(1): 149, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533738

RESUMO

BACKGROUND: Women's empowerment may require women to change their beliefs and views about their rights and capabilities. Empowerment programs often target women who have survived sexual and gender-based violence (SGBV), with the justification that these women may develop disempowered beliefs as a coping mechanism, or face greater barriers to, or derive greater benefits from, the adoption of empowered beliefs and preferences. We investigated an intensive, six-month residential empowerment program ("City of Joy") for SGBV survivors in eastern Democratic Republic of the Congo (DRC), where more than one in five women have experienced SGBV. METHODS: We asked 175 participants about their beliefs and preferences pertaining to political, financial, and domestic empowerment. Interviews took place immediately before and after participation in the program, and we tested for differences in views of empowerment between entry and exit using paired t-tests and McNemar's test. We also conducted 50 semi-structured interviews about empowerment with an additional 30 women who had completed the program up to 5 years earlier and then returned to their home community. RESULTS: Prior to enrolling in the program, participants had fairly empowered views regarding politics, less empowered views regarding finances, and still less empowered views regarding the domestic sphere. After completing the program, participants had significantly more empowered views in all three domains, particularly regarding domestic violence, how families should treat men and women, and women's economic rights. Participants in their home communities reported taking a more active role in community affairs and speaking out against the mistreatment of women. CONCLUSION: This study adds to the evidence that women's empowerment programs can change participants' beliefs and thus increase the confidence with which they participate in their communities and support one another.


Assuntos
Atitude , Delitos Sexuais , Sobreviventes/psicologia , Adolescente , Adulto , República Democrática do Congo , Feminino , Grupos Focais , Humanos , Avaliação de Programas e Projetos de Saúde , Sobreviventes/estatística & dados numéricos , Adulto Jovem
8.
J Stroke Cerebrovasc Dis ; 28(11): 104359, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31495671

RESUMO

AIMS: Awareness of stroke symptoms and risk factors, and actions taken in order to reduce the risk of new stroke events, should be of great importance among stroke survivors. The aims of this study were to assess changes in stroke-related knowledge and lifestyle behavior among patients experiencing a cerebrovascular event, and to assess the agreement between the patients' self-reported diagnosis, and the discharge diagnosis. METHODS: All patients discharged with a diagnosis of stroke or transient ischemic attack during a 1-year period, received postal survey questionnaires at 3 and 12 months after discharge. The questionnaires included questions about symptom knowledge, lifestyle behavior, and patients were asked to report on their diagnosis. RESULTS: A total of 282 patients were included (mean age 71.8 years, 57.1% men). Self-reported symptom knowledge was increased at 3 months (P < .001), and this persisted at 12 months. There was a poor correlation (r = .082; P = .171) between increasing symptom knowledge and stated lifestyle behavior changes. In all, 63% of the respondents correctly identified their own cerebrovascular subtype. Thirty-seven percent had quit smoking after 12 months, 30% reported that they used less sugary items, and 26% used less fatty food after the cerebrovascular event. CONCLUSIONS: Stroke survivors reported increased stroke symptoms knowledge after 3 and 12 months. A proportion of patients made changes in lifestyle behavior. Only 2 out of 3 patients correctly identified their own cerebrovascular subtype, indicating room for improvement in clinical practice when informing and communicating with stroke and transient ischemic attack patients about their diagnosis.


Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Comportamento de Redução do Risco , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Sobreviventes/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Educação de Pacientes como Assunto , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Autorrelato , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de Tempo , Resultado do Tratamento
9.
Artigo em Inglês | MEDLINE | ID: mdl-31487834

RESUMO

Media exposure during a traumatic event has been found to be associated with negative psychological consequences. However, the post-disaster role of the mass media and the possible positive psychological consequences of media exposure has received less attention. In the present study, we hypothesized that exposure to memorial media reports would lead to improved post-traumatic growth (PTG). Further, we evaluated the moderating role of self-esteem and long-term post-traumatic stress disorder (PTSD) symptoms in the relationship between media exposure and PTG. Using a cross-sectional design, we surveyed individuals (N = 1000, mean age = 45.62, 43.5% male) who were recruited from disaster-affected communities ten years after the 5.12 Wenchuan earthquake which was the largest country-level trauma in the past three decades. Results revealed that individuals with lower self-esteem or lower PTSD symptoms would have higher psychological growth with greater exposure to memorial news reports. For individuals who reported having both high levels of self-esteem and PTSD symptoms, the relationship between media exposure and PTG was negative. These findings help present trauma in a new light, particularly regarding the rapid and instantaneous new coverage of the digital age. This study also has multi-disciplinary, cross-cultural, and clinical implications for the fields of psychology, public health, and communications.


Assuntos
Terremotos , Autoimagem , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Adulto , China , Comunicação , Estudos Transversais , Feminino , Humanos , Masculino , Meios de Comunicação de Massa , Pessoa de Meia-Idade , Inquéritos e Questionários
10.
Health Qual Life Outcomes ; 17(1): 149, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481073

RESUMO

BACKGROUND: Religious beliefs and practices influence coping mechanisms and quality of life in patients with various chronic illnesses. However, little is known about the influence of religious practices on changes in health-related quality of life (HRQOL) among hospital survivors of an acute coronary syndrome (ACS). The present study examined the association between several items assessing religiosity and clinically meaningful changes in HRQOL between 1 and 6 months after hospital discharge for an ACS. METHODS: We recruited patients hospitalized for an ACS at six medical centers in Central Massachusetts and Georgia (2011-2013). Participants reported making petition prayers for their health, awareness of intercessory prayers by others, and deriving strength/comfort from religion. Generic HRQOL was assessed with the SF-36®v2 physical and mental component summary scores. Disease-specific HRQOL was evaluated using the Seattle Angina Questionnaire Quality of Life subscale (SAQ-QOL). We separately examined the association between each measure of religiosity and the likelihood of experiencing clinically meaningful increase in disease-specific HRQOL (defined as increases by ≥10.0 points) and Generic HRQOL (defined as increases by ≥3.0 points) between 1- and 6-months post-hospital discharge. RESULTS: Participants (n = 1039) were, on average, 62 years old, 33% were women, and 86% were non-Hispanic White. Two-thirds reported praying for their health, 88% were aware of intercessions by others, and 85% derived strength/comfort from religion. Approximately 42, 40, and 26% of participants experienced clinically meaningful increases in their mental, physical, and disease-specific HRQOL respectively. After adjustment for sociodemographic, psychosocial, and clinical characteristics, petition (aOR:1.49; 95% CI: 1.09-2.04) and intercessory (aOR:1.72; 95% CI: 1.12-2.63) prayers for health were associated with clinically meaningful increases in disease-specific and physical HRQOL respectively. CONCLUSIONS: Most ACS survivors in a contemporary, multiracial cohort acknowledged praying for their health, were aware of intercessory prayers made for their health and derived strength and comfort from religion. Patients who prayed for their health and those aware of intercessions made for their health experienced improvement in their generic physical and disease-specific HRQOL over time. Healthcare providers should recognize that patients may use prayer as a coping strategy for improving their well-being and recovery after a life-threatening illness.


Assuntos
Síndrome Coronariana Aguda/psicologia , Qualidade de Vida , Religião e Medicina , Sobreviventes/psicologia , Adaptação Psicológica , Idoso , Estudos de Casos e Controles , Feminino , Georgia , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Prospectivos , Inquéritos e Questionários
13.
Artigo em Inglês | MEDLINE | ID: mdl-31450676

RESUMO

Sexual assault is associated with a range of poor mental health outcomes. To enhance access to care by this population, technology-based mental health interventions have been implemented in the emergency room; however, more accessible and easily disseminated interventions are needed. The aim of the present study was to test the usability of a mobile health intervention targeting alcohol and drug misuse, suicide prevention, posttraumatic stress symptoms, coping skills, and referral to formal assistance for individuals who have experienced sexual assault. Feedback on the usability of the intervention was collected from individuals who received a sexual assault medical forensic examination (n = 13), and feedback on the usability and likelihood of recommending the application was collected from community providers (n = 25). Thematic analysis was used to describe qualitative data. Content themes related to aesthetics, usability, barriers to resources, and likes/dislikes about the intervention arose from interviews following the intervention. Participants found the intervention to be user friendly and endorsed more likes than dislikes. Providers rated the intervention as being helpful and would recommend it to survivors of sexual assault. Findings suggest that the intervention is usable and fit for future effectiveness testing, filling an important gap in treatment for individuals who experience sexual assault.


Assuntos
Serviços de Saúde Mental , Delitos Sexuais , Telemedicina , Adaptação Psicológica , Adulto , Emergências , Feminino , Humanos , Masculino , Encaminhamento e Consulta , Transtornos Relacionados ao Uso de Substâncias , Suicídio/prevenção & controle , Sobreviventes/psicologia
16.
BMC Womens Health ; 19(1): 106, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387561

RESUMO

BACKGROUND: Domestic violence and abuse (DVA) is a serious public health issue, threatening the health of individuals the world over. Whilst DVA can be experienced by both men and women, the majority is still experienced by women; around 30% of women worldwide who have been in a relationship report that they have experienced violence at the hands of their partner, and every week in England and Wales two women are killed by their current or ex-partner. The purpose of this study was to explore the concept of thrivership with women who have experienced DVA, to contribute to our understandings of what constitutes 'thriving' post-abuse, and how women affected can move from surviving to thriving. METHODS: Thirty-seven women took part in this qualitative study which consisted of six focus groups and four in-depth interviews undertaken in one region of the UK in 2018. Data were analysed using a thematic analysis approach. Initial findings were reported back to a group of participants to invite respondent validation and ensure co-production of data. RESULTS: The process of 'thrivership' - moving from surviving to thriving after DVA - is a fluid, non-linear journey of self-discovery featuring three 'stages' of victim, survivor, and thriver. Thriving after DVA is characterised by a positive outlook and looking to the future, improved health and well-being, a reclamation of the self, and a new social network. Crucial to ensuring 'thrivership' are three key components that we propose as the 'Thrivership Model', all of which are underpinned by education and awareness building at different levels: (1) Provision of Safety, (2) Sharing the Story, (3) Social Response. CONCLUSIONS: The study findings provide a new view of thriving post-abuse by women who have lived through it. The proposed Thrivership Model has been developed to illustrate what is required from DVA-services and public health practitioners for the thrivership process to take place, so that more women may be supported towards 'thriving' after abuse.


Assuntos
Violência Doméstica/psicologia , Sobreviventes/psicologia , Sobrevivência , Vítimas de Crime/psicologia , Inglaterra , Feminino , Grupos Focais , Humanos , Modelos Psicológicos , Otimismo , Pesquisa Qualitativa
17.
Acta Dermatovenerol Croat ; 27(2): 67-74, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31351499

RESUMO

Aim of this study was to investigate changes in health behavior of melanoma survivors with emphasis on safe sun behavior (SSB) and skin self-examination (SSE). We also identified factors with significant impact on SSE improvement. We performed a cross-sectional (epidemiological) survey based on a structured questionnaire. 150 patients from three medical institutions were invited and 144 patients responded. Statistical analysis was performed with SPSS version 23.0, with the level of significance set to 0.05. After being diagnosed with cutaneous melanoma, patients significantly improved preventive health behavior: 68.1% showed improvement in SSE, and 91.5% of patients improved SSB. There was statistically significant (P<0.001) improvement in the frequency of skin examination, examination of poorly visible areas (between the toes, genitals), and obtaining help in examination. Use of melanoma images remained scarce. Results for SSB were even better, and statistically significant improvement was recorded in all areas: using higher UV protection filters, wearing sunglasses, headgear, long sleeves, and trousers, and especially in staying in deep shade during hours of heavy UV radiation. The only factor with a positive influence on expected improvement in SSE was female gender. On the other hand, there were two factors that had a negative impact on SSE: patients with melanoma stage 1 and patients who had already self-examined themselves before their melanoma diagnosis. Preventive health behavior improved significantly after diagnosis of cutaneous melanoma. Patients markedly improved SSB and substantially enhanced SSE. We believe that it is reasonable to improve SSE further, encouraging patients by increasing their feeling of self-efficacy.


Assuntos
Comportamentos Relacionados com a Saúde , Melanoma/prevenção & controle , Melanoma/psicologia , Neoplasias Cutâneas/prevenção & controle , Neoplasias Cutâneas/psicologia , Sobreviventes/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Roupa de Proteção , Autoexame , Fatores Sexuais , Eslovênia , Queimadura Solar/prevenção & controle , Inquéritos e Questionários
19.
Medicina (Kaunas) ; 55(7)2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31323758

RESUMO

Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors' attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57-9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92-13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10-30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74-9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors' attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner-survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services.


Assuntos
Terapias Complementares/psicologia , Doença pelo Vírus Ebola/psicologia , Sobreviventes/psicologia , Adolescente , Adulto , Terapias Complementares/normas , Estudos Transversais , Ebolavirus/patogenicidade , Feminino , Doença pelo Vírus Ebola/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Serra Leoa , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos
20.
Artigo em Inglês | MEDLINE | ID: mdl-31323963

RESUMO

The Yezidis who represent a religious minority living in Northern Iraq were particularly affected by the persecution by ISIS (Islamic state of Iraq and Syria, syn.: ISIL-Islamic state of Iraq and the Levant) that gained power after 2013. This paper gives an overview of the events and the mental health consequences on the Yezidi community as well as associated influences on affected female Yezidis. Based on a systematic literature search, the aspects of "Persecution by ISIS and actual situation of the Yezidi community", "Gender-specific aspects of the persecution and its consequences", "Mental health of the affected women", and "Cultural-historical and religious context" are worked out. Research indicates a high burden of health strain and mental health problems in the surviving Yezidi women, especially post-traumatic stress disorders (PTSD) and depression. Concerning transgenerational trauma, the recent genocide has revived past experiences in the history of the community. Like the narrow cultural and religious rules of the community, this can be both a resource and a burden. The actual extent of the attacks is neither predictable for the affected individuals nor for the community, consequences could also be passed onto descendants. Long-term care and support of the affected persons, their descendants, and the Yezidi community seems indispensable.


Assuntos
Genocídio/psicologia , Islamismo/psicologia , Saúde Mental/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Guerra/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Iraque , Pessoa de Meia-Idade
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