Psychological interventions for people with hemophilia

Study on Psychiatric Aspects, Psychosocial and Cognitive Functioning in Adolescents With Haemophilia

INTRODUCTION

Haemophilia, an inherited bleeding disorder, impacts physical and mental health. With improving survival, the focus is on mental health issues.

AIM

We examined and compared mental health issues in adolescents with haemophilia (AwH) in India with those of healthy controls. Additionally, we examined the relationship between quality of life and these mental health issues.

METHODS

Standardized assessments were applied (between 2021 and 2022) on male cases (n = 31) and controls (n = 31) to measure psychiatric morbidity, psychosocial, and neuro-cognitive functioning. Correlational analysis of quality of life with various mental health issues was also performed.

RESULTS

AwH had more emotional, social and behavioural problems, poor quality of life, more cognitive dysfunction, with no statistically significant difference in self-esteem as compared to healthy controls. There was a significant negative correlation between the quality of life and psychiatric morbidities, emotional and behavioural problems and cognitive dysfunction.

CONCLUSION

These findings corroborate evidence from other countries and emphasize the need for assessment of mental health issues and integration of mental health professionals in clinical services for AwH in India.

Interventions for improving self-efficacy in patients after stroke based on self-efficacy-related principles of Bandura's cognition theory: a systematic review and meta-analysis

BACKGROUND

Interventional approaches based on Bandura's cognition theory are effective in improving self-efficacy poststroke. However, a systematical investigation for identifying effectives therapeutic components of the intervention has not yet been conducted.

OBJECTIVE

This meta-analysis was conducted to systematically investigated the effects of interventions with different principles on improving self-efficacy after stroke.

METHODS

Searches were conducted in PubMed, EMBASE, CINAHL, PsycINFO, MEDLINE, Cochrane Library, and two randomized controlled trials registration websites for randomized controlled trials from inception to 18th January 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The meta-analysis was performed using Review Manager and Stata software.

RESULTS

In total, 36 RCTs were included. Interventions using any one of the self-efficacy principles - principle 1 (Mastery), principle 2 (Modeling), principle 3 (Social persuasion), and principle 4 (Understanding), were more effective in improving self-efficacy in patients with stroke at post-training and follow-up, compared with the control group. Psycho-educational interventions might significantly improve self-efficacy in both post-intervention and follow-up stages, compared with control group. Meta-regression revealed time since stroke onset was significantly associated with effect sizes.

CONCLUSION

Interventions developed based on Bandura's cognition theory are beneficial to the improvement of self-efficacy. This review highlights principles of Bandura's cognition theory are worth considering to be integrated to interventions targeted at improving self-efficacy. The application of self-efficacy principles with Bandura's cognitive theory could be encouraged in clinical practice in the future.

PROTOCOL REGISTRATION NUMBER

PROSPERO CRD42020154984.

Depression and anxiety among hemophilia patients enrolled in clinical trials: a multi-center cohort study

Hemophilia patients enrolled in clinical trials often exhibit various physical and psychological symptoms. However, little is known about anxiety and depression among them. This study assessed the effects of depression and anxiety on hemophilia patients enrolled in clinical trials and identified risk factors for these disorders. A multi-center, cohort study was conducted from January to December 2022. Sixty-nine hemophilia patients who enrolled in clinical trials participated at baseline (T1, prior to treatment initiation) and completed the informed consent. Risk factors were measured at baseline to predict depression and anxiety at 3 months (T2). Sixty-four hemophilia patients were included in the final analysis. More hemophilia patients had moderate-severe depression (28 [43.75%]) and anxiety (16 [25.00%]) at T2 than at T1 (12 [18.75]), (5 [7.81%]). Depression was aggravated in 23 (35.94%) patients and anxiety was aggravated in 12 (18.75%) patients. Frequently acquired medical information (OR 11.378, CI 1.319-98.114, P = 0.027), baseline GAD-7 (OR 1.341, CI 1.015-1.772, P = 0. 039) and PHQ-9 (OR 1.465, CI 1.039-2.065, P = 0.029) are important factors predicting depression and anxiety in hemophilia patients. Hemophilia patients enrolled in a clinical trial have significant anxiety and depression. The frequency of acquiring medical information and the baseline PHQ-9 and GAD-7 scores were risk factors for anxiety and depression. Thus, hemophilia patients should receive education regarding clinical trials and undergo evaluations of their anxiety and depression; these changes will enable prompt detection of their psychological burden and identify potential psychological intervention strategies.

Comparative analysis of oral health and treatment necessities in hemophilia individuals of Davangere population - A case control study

Background:

The integrated approach towards the oral care of individuals with special needs requires proper motivation and prophylactic guidance by primary health care professionals, including musculoskeletal support to psychological therapy. In developing countries like India, oral care is not of primary importance as oral hygiene practices are less performed by compromised individuals suffering from hemophilia. Here, primary health care professionals play a significant role. The present study was commenced to evaluate oral health and treatment necessities in hemophilic individuals of Davangere population, Karnataka.

Objective:

The present study was conducted to assess and compare the oral hygiene, dentition status, and treatment needs of individuals with hemophilia.

Methods:

Simplified Oral Hygiene Index (OHI-S), decayed, missed, filled tooth (DMFT) indices and treatment needs in 50 hemophiliac patients registered at Karnataka hemophilia society were evaluated along with an Oral health-related quality of life (OHR-QoL) questionnaire. They were matched with healthy controls of the same age and gender. The data was analyzed using t test and Chi square test.

Results:

The oral hygiene was fair in both hemophilic and healthy individuals with a mean value of 1.82 ± 0.79 and 1.83 ± 0.73, respectively. All the parameters such as OHIS, DMFT indices, and teatment needs were not statistically significant. The spontaneous oral bleeding was the only significant factor in OHR-Qol questionnaire.

Conclusion:

The present study concluded that oral hygiene, dental caries prevalence, and treatment needs were similar in both hemophiliac and control groups. With proper guidance, motivation, and preventive care by primary health care professionals, it was relatively easy for individuals with congenital blood disorder (CBD) to maintain oral health-related quality of life in Davangere population, Karnataka.