RESUMO
Cystic fibrosis (CF) is traditionally associated with considerable and progressive multisystem pathology, onerous treatment burden, complex psychosocial challenges, and reduced life-expectancy [1-9].This decade has seen transformative change in management for many, but not all, people with CF. The most notable change comes from Cystic Fibrosis Transmembrane Receptor (CFTR) modulators, which bring significant benefits for people who are eligible for, and able to access, them [10]. However alongside, or perhaps because of, this exciting progress, the past few years have also brought important novel challenges to the psychosocial wellbeing of people with CF. This article, written as a collaboration between CF psychologists, social workers, physicians and nurses aims to provide an accessible overview of the novel psychosocial challenges now faced by children, their families, and adults with CF, and to invite consideration of their changing psychosocial requirements to inform future holistic care. Themes include geopolitical stressors such as the pandemic and its wake, a growing divide between those able or unable to access CFTR modulators, potential rapid changes in life expectancy secondary to these drugs and the inevitable associated challenges this brings; evolving body image, mental health side effects of CFTR modulators, the challenges of adherence in apparently well children and young adults, as well as the diagnostic conundrum and associated anxiety of the cystic fibrosis screen positive inconclusive diagnosis (CFSPID) label. It also highlights some unmet research and service delivery needs in the area.
RESUMO
This review critically evaluates the literature on posttraumatic growth in survivors of interpersonal violence, integrating the findings from 12 quantitative and 4 qualitative studies. The following databases were searched using predetermined terms: AMED, EMBASE, MEDLINE, PsycINFO, BNI, CINAHL, and Web of Knowledge. The review's findings suggest that the mean prevalence of growth in interpersonal violence survivors is around 71% (range 58-99%). The highest level of growth was consistently experienced in the "appreciation of life" domain. However, survivors reported growth in the four remaining domains: "personal strength," "new possibilities," "experience of relationships with others," and "outlook on life." The nature of the relationship between growth and distress was inconsistent across studies. A combination of pretrauma, peritrauma, and posttrauma variables were found to be related to the degree of growth survivors experienced. Methodological weaknesses of the quantitative studies included the predominant use of retrospective, cross-sectional, correlational designs, discrepancy in the measurement of growth, insufficient sample sizes for power calculations in five studies and limited external validity. Qualitative findings were limited by sampling methods, insufficient information about interview schedules, the lack of credibility checks, and evidence of reflexivity demonstrated by some studies. Implications for practice, policy, and future research are discussed.