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Jenkins V, Matthews L, Solis-Trapala I, Gage H, May S, Williams P, Bloomfield D, Zammit C, Elwell-Sutton D, Betal D, Finlay J, Nicholson K, Kothari M, Santos R, Stewart E, Bell S, McKinna F, Teoh M. Patients' experiences of a suppoRted self-manAGeMent pAThway In breast Cancer (PRAGMATIC): quality of life and service use results. Support Care Cancer 2023; 31:570. [PMID: 37698629 PMCID: PMC10497681 DOI: 10.1007/s00520-023-08002-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To describe trends and explore factors associated with quality of life (QoL) and psychological morbidity and assess breast cancer (BC) health service use over a 12-month period for patients joining the supported self-management (SSM)/patient-initiated follow-up (PIFU) pathway. METHODS Participants completed questionnaires at baseline, 3, 6, 9 and 12 months that measured QoL (FACT-B, EQ 5D-5L), self-efficacy (GSE), psychological morbidity (GHQ-12), roles and responsibilities (PRRS) and service use (cost diary). RESULTS 99/110 patients completed all timepoints; 32% (35/110) had received chemotherapy. The chemotherapy group had poorer QoL; FACT-B total score mean differences were 8.53 (95% CI: 3.42 to 13.64), 5.38 (95% CI: 0.17 to 10.58) and 8.00 (95% CI: 2.76 to 13.24) at 6, 9 and 12 months, respectively. The odds of psychological morbidity (GHQ12 >4) were 5.5-fold greater for those treated with chemotherapy. Financial and caring burdens (PRRS) were worse for this group (mean difference in change at 9 months 3.25 (95% CI: 0.42 to 6.07)). GSE and GHQ-12 scores impacted FACT-B total scores, indicating QoL decline for those with high baseline psychological morbidity. Chemotherapy patients or those with high psychological morbidity or were unable to carry out normal activities had the highest service costs. Over the 12 months, 68.2% participants phoned/emailed breast care nurses, and 53.3% visited a hospital breast clinician. CONCLUSION The data suggest that chemotherapy patients and/or those with heightened psychological morbidity might benefit from closer monitoring and/or supportive interventions whilst on the SSM/PIFU pathway. Reduced access due to COVID-19 could have affected service use.
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Affiliation(s)
- V Jenkins
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK.
| | - L Matthews
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK
| | - I Solis-Trapala
- School of Medicine, Keele University, University Road, Staffordshire, England, UK
| | - H Gage
- Surrey Health Economics Centre/Department of Clinical and Experimental Medicine, Leggett Building, University of Surrey, Guildford, Surrey, England, UK
| | - S May
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK
| | - P Williams
- Department of Mathematics, University of Surrey, Guildford, Surrey, England, UK
| | - D Bloomfield
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - C Zammit
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - D Elwell-Sutton
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
| | - D Betal
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - J Finlay
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - K Nicholson
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - M Kothari
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - R Santos
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - E Stewart
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - S Bell
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - F McKinna
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - M Teoh
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
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Biyyala D, Joseph R, Varadharajan N, Krishnamoorthy Y, Menon V. Incidence and prevalence of depressive, anxiety, and insomnia symptoms among adult liver transplant recipients: A systematic review and meta-analysis. Gen Hosp Psychiatry 2023; 80:26-34. [PMID: 36549018 DOI: 10.1016/j.genhosppsych.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Psychological morbidity among transplant recipients may negatively impact post-transplantation outcomes. Our objectives were to compute pooled incidence and prevalence estimates for depressive, anxiety, and insomnia symptoms among adults who underwent liver transplant. METHODS Electronic searches of MEDLINE, PubMed Central, CINAHL, and Google Scholar were carried out from inception to October 2022 to identify observational studies conducted among adult liver transplant recipients which measured depression, anxiety, and/or insomnia. We used the Joanna-Briggs tool for study quality appraisal. RESULTS Sixty-five studies (pooled N = 12,183) provided data for meta-analysis. The one-year pooled point prevalence rate for depressive symptoms was 25% (95% Confidence Intervals [CI]: 20% to 30%; I2 = 94%; 37 studies; N = 6088) while that of anxiety and insomnia symptoms were 29% (95% CI: 21% to 38%; I2 = 96%; 28 studies; N = 4016) and 28% (95% CI: 16% to 43%; I2 = 98%; 14 studies; N = 1834), respectively. The findings remained robust across subgroup and sensitivity analyses. Most included studies had low or moderate risk of bias. CONCLUSIONS Depressive, anxiety, and insomnia symptoms are commonly prevalent following liver transplantation. Our findings, though limited by high heterogeneity across analyses, have important implications for screening, management, and prevention of psychological morbidity in this group. SYSTEMATIC REVIEW REGISTRATION This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD 42021276008).
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Affiliation(s)
- Deepika Biyyala
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur 342005, India
| | - Rini Joseph
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Natarajan Varadharajan
- Department of Psychiatry, ESIC Medical College and PGIMSR, K.K.Nagar, Chennai 600078, India
| | - Yuvaraj Krishnamoorthy
- Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai 600078, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India.
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Gough K, Bergin RJ, Drosdowsky A, Aranda S, Mileshkin L, Jackson M, Kinnane N, Bernshaw D, Juraskova I, White K, Mohamed M, Schofield P. Women with gynaecological cancer awaiting radiotherapy: Self-reported wellbeing, general psychological distress, symptom distress, sexual function, and supportive care needs. Gynecol Oncol 2022; 167:42-50. [PMID: 36064679 DOI: 10.1016/j.ygyno.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To better serve women with gynaecological cancers, we need a sound understanding of their health, wellbeing and needs. This study sought to explore these issues in a sample of Australian women before commencing curative radiotherapy. METHODS We undertook a secondary analysis of baseline data from a supportive care trial (n = 311). Descriptive statistics were used to summarise responses to measures of wellbeing, general psychological distress, symptom distress, sexual function and vaginal changes, and supportive care needs. Pre-specified regression models were used to examine sources of variation in wellbeing and sexual function. RESULTS Women reported lower emotional, functional and physical wellbeing than population norms (all p < 0.001). The prevalence of general psychological distress was 31% (95% CI 26-36%). Distress caused by physical symptoms was typically low. Health system and information needs comprised eight of the top ten moderate-to-high supportive care needs. Most women reported no change in interest for physical contact or sex compared to pre-diagnosis, but some sexually active women (16-24%) reported smaller vaginal size, increased dryness, and more pain on intercourse. General psychological distress was a robust marker of poorer wellbeing and sexual function. CONCLUSIONS Before radiotherapy, a substantial minority of women with gynaecological cancers experience general psychological distress, reduced wellbeing and moderate-to-high health system and information needs. A model of comprehensive care incorporating assessment of unmet needs, general psychological distress, and sexual issues is recommended. Healthcare providers may require training to elicit and respond to a constellation of interrelated issues and access relevant services for women requiring additional support.
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Affiliation(s)
- Karla Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia.
| | - Rebecca Jane Bergin
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, Australia; Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison Drosdowsky
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sanchia Aranda
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
| | - Linda Mileshkin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Jackson
- School of Clinical Medicine, Randwick Campus, UNSW Sydney, New South Wales, Australia
| | - Nicole Kinnane
- Gynaecology Services, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David Bernshaw
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Ilona Juraskova
- Centre of Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kate White
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia; Cancer Care Research Unit, Sydney Local Health District, New South Wales, Australia; The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council, New South Wales, Australia
| | - Mustafa Mohamed
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Penelope Schofield
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; Department of Psychological Sciences, Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Wijesinghe V, Rishard M, Srisanjeevan S. Quality of surgical management of placenta accreta spectrum in a tertiary center in Sri Lanka: baseline study for quality improvement project: problems and solutions. BMC Pregnancy Childbirth 2022; 22:509. [PMID: 35739493 PMCID: PMC9230081 DOI: 10.1186/s12884-022-04840-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 06/16/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Placenta accreta spectrum (PAS) is associated with a multitude of maternal and fetal complications. Events related to its management have resulted in significant psychological morbidity, with lifelong consequences which warrant continuous support to cope with their lives. The objective of the study is to highlight the importance of multidisciplinary holistic care and explore room for improvement in the provision of care for women with PAS. Methods Our study was conducted on deliveries complicated with PAS from January 2019 to June 2021. 27 women were diagnosed with PAS during this period and received treatment. Impact of life event scale- revised (IES-R) and short form health survey-36(SF-36) questionnaires were administered to assess the impact of PAS on their lives. In depth interviews were conducted with the women. A multidisciplinary team meeting was later conducted to formulate a comprehensive care plan for women with PAS. Results The response rate was 96.2%. Mean age of the sample is 34.1 years (SD 4.3). Interval to current pregnancy varies from 0.6 years to 10 years with mean of 4.6 years. Mean gestational age of diagnosis of PAS was 25.4(SD 6.7) weeks. The care bundle provided for women with PAS was evaluated in all cases. Surgery was conducted electively in 82% of patients. Blood transfusions were noted in 85%. Mean pre-operative stay was 9.5 days (SD 8.3) and mean post-operative stay was 8.8 days (SD 8). Total hospital stay ranged from 6 to 48 days (mean 19.5 days, SD 11.4). IES-R scores were significant in 4/26 patients. There was no correlation with the interval from the surgery with any of the subscales or with the total scores. The lapsed time after the surgery had a significant correlation with physical functioning and pain domains of the SF-36 questionnaire. Description of the experience, loss of femininity with loss of the uterus, concerns and fears about the future and measures to improve the quality of care were the themes identified and described. A multidisciplinary team meeting, consisting of consultant obstetricians performing surgery for PAS, anesthetists, hematologist, transfusion medicine specialist, urologist, physiotherapist, nutritionist and nursing officers from ICU and wards, was held and their contributions helped to map out a definitive care plan. Conclusions PAS is associated with long term physical and psychological morbidity. Continuous support through quarterly clinic visits and telephone conversations may alleviate the psychological trauma. However, some physical disabilities may be lifelong and life changing. Importance of reducing primary caesarean section and promoting trial of labour after caesarean delivery should be promoted among patients and caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04840-7.
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Affiliation(s)
- Vindya Wijesinghe
- Resident Obstetrician and Gynaecologist, Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka.
| | - Mohamed Rishard
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Consultant Obstetrician and Gynaecologist, University of Colombo Sri Lanka, Colombo, Sri Lanka
| | - Sriskanthan Srisanjeevan
- Registrar in Obstetrics and Gynaecology, Post Graduate Institute of Medicine, Colombo, Sri Lanka
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Matthews A, Kramer RA, Mitan L. Eating disorder severity and psychological morbidity in adolescents with anorexia nervosa or atypical anorexia nervosa and premorbid overweight/obesity. Eat Weight Disord 2022; 27:233-42. [PMID: 33751464 DOI: 10.1007/s40519-021-01168-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/10/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE A significant proportion of adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) experience premorbid overweight/obesity, yet distinct characteristics among this subset of patients remain unclear. This study examined eating disorder (ED) symptom severity, psychological morbidity, and weight stigma in patients with premorbid overweight/obesity as compared to patients with premorbid normal weights. METHODS Participants included adolescents with AN or AAN (aged 12-18) who received multidisciplinary treatment at a pediatric medical center in the United States. ED symptoms, anxiety, and depression were compared among patients with premorbid overweight/obesity (n = 43) and premorbid normal weights (n = 63). Associations between weight stigma, ED severity, and psychological morbidity were also examined. RESULTS Patients with premorbid overweight/obesity reported greater ED severity (p = 0.04), anxiety (p < 0.003), depression (p = 0.02), and a higher frequency of weight-based teasing by peers (p = 0.003) and parent weight talk about their own weights (p < 0.001). Weight-based teasing was positively associated with ED symptoms, anxiety, and depression for all patients, regardless of premorbid weight status. CONCLUSIONS Adolescents with AN or AAN and a history of overweight/obesity may present with greater ED symptom severity and psychological morbidity than patients with normal weight histories. Distinct prevention and treatment interventions for adolescents with AN or AAN and premorbid overweight/obesity may be warranted. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Schmitz L, Schulte S, Stoffel-Wagner B, Bartmann P, Plamper M, Schreiner F, Woelfle J, Gohlke B. Birthweight Differences in Adolescent Monozygotic Twins Influence Androgens, Psychological Morbidity, and Health-Related Quality of Life. Horm Res Paediatr 2021; 93:433-441. [PMID: 33567430 DOI: 10.1159/000512653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/23/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adverse prenatal conditions can exert a long-lasting impact in later life. PATIENTS AND METHODS Thirty-eight post-pubertal monozygotic twin pairs (16 female pairs) with divergent birthweight (bw) due to twin-to-twin transfusion syndrome were examined at a median of 15.1 years. Auxological and endocrine parameters were measured. To evaluate effects of intra-twin bw and hormone differences on mental health, adolescents and their parents completed the Strengths and Difficulties Questionnaire (SDQ), identifying psychological problems. Twins answered the questionnaire on health-related quality of life (HrQoL, KIDSCREEN-52). RESULTS Parents attributed a higher number of psychological challenges to the formerly smaller twins, for example, total difficulties (8.8 vs. 6.5, p = 0.009). Differences in bw were associated with differences in parental evaluation of problems, for example, peer relationship problems (r = -0.57 and p = 0.0001). In contrast, bw differences did not affect subjects' self-assessment of psychological factors but on physical well-being (r = 0.42, p = 0.017). The formerly smaller discordant twins showed significantly lower HrQoL regarding psychological well-being (24.9 vs. 26.6, T1,15 = -2.2, and p = 0.043) and moods and emotions (29.8 vs. 32.0, T1,15 = -2.3, p = 0.039). Higher concentrations of androstenedione were linked to greater psychological well-being (r = 0.39 and p = 0.036) in all twin pairs. CONCLUSION Our results show that the prenatal environment leading to bw differences exerts a long-lasting impact on diverging parental evaluation of mental health. Formerly smaller discordant twins showed significantly lower HrQoL regarding psychological well-being and moods and emotions. Higher androstenedione concentrations were linked to greater psychological well-being.
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Affiliation(s)
- Lioba Schmitz
- Paediatric Endocrinology Division, Children's University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Sandra Schulte
- Paediatric Endocrinology Division, Children's University Hospital Bonn, University of Bonn, Bonn, Germany,
| | - Birgit Stoffel-Wagner
- Institute of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Peter Bartmann
- Department of Neonatology, Children's University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Michaela Plamper
- Paediatric Endocrinology Division, Children's University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Felix Schreiner
- Paediatric Endocrinology Division, Children's University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Joachim Woelfle
- Paediatric Endocrinology Division, Children's University Hospital Bonn, University of Bonn, Bonn, Germany.,Children's University Hospital Erlangen, University of Erlangen, Erlangen, Germany
| | - Bettina Gohlke
- Paediatric Endocrinology Division, Children's University Hospital Bonn, University of Bonn, Bonn, Germany
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Mishra A, Marwah S, Arora R, Yadav A, Anand N, Mushahary D. Comparison of Psychological Morbidity of Health Care Workers Posted in COVID and Non COVID Labour Rooms. J Obstet Gynaecol India 2021; 71:36-41. [PMID: 33824551 PMCID: PMC8017430 DOI: 10.1007/s13224-021-01465-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background The COVID-19 pandemic had not only burdened healthcare systems all over the world but had also affected mental health of frontline Health Care Workers. Purpose Purpose of our study was to compare the psychological morbidity of health care workers posted in Covid labour room with their counter parts in Non Covid labour room. Material and Methods Present study was a cross-sectional study conducted on HCW of Covid and Non Covid labour in a span of 6 months. Results Insomnia in Covid labour room was found to be in 57% HCW as compared to none in non Covid labour room (mean score 7.47 ± 2.74 vs 1.82 ± 1.25, P Value < .0001). Depression was prevalent in 92% of participants in Covid labour room as compared to 12.5% in Non Covid labour room; however, severe depression was found in 6% participants (mean score 17.32 ± 4.88 vs 2.12 ± 1.65, P Value < .0001). Prevalence of anxiety in present study was 90% in Covid labour room and 6% in non Covid labour room (mean score 11.47 ± 4.57 vs 1.94 ± 1.43, P Value < .0001). Psychological morbidity as tested by Symptom Check List-k-9 was positive in 21.8% participants in Covid Labour room as compared to 1% in Non Covid labour room (mean score 5.57 ± 2.58 vs 2.22 ± 1.89, P Value < .0001). Conclusion Study revealed significantly high psychological morbidity, insomnia, anxiety and depression in the health care workers in Covid labour room than Non Covid labour room. Supplementary Information The online version contains supplementary material available at 10.1007/s13224-021-01465-2.
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Affiliation(s)
- Archana Mishra
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi India
| | - Sheeba Marwah
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi India
| | - Renu Arora
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi India
| | - Abhilasha Yadav
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi India
| | - Nupur Anand
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi India
| | - Dalimi Mushahary
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi India
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Pereira MG, Vilaça M, Pereira M, Ferreira G, Monteiro S, Coelho H, Geraldes C, Gonçalves C, da Costa FL, Marques H, Bacalhau R. The mediator role of unmet needs on quality of life in myeloma patients. Qual Life Res 2020; 29:2641-50. [PMID: 32356277 DOI: 10.1007/s11136-020-02511-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The diagnosis of multiple myeloma (MM) has a significant impact on patients. This study analyzed the mediating role of patients' unmet needs in the relationship between psychological morbidity/social support and quality of life (QoL). METHODS This study included 213 patients with MM recruited from the outpatient medical oncology and clinical hematology services from five hospitals. Patients who meet the study criteria were referred by physicians and invited to participate in the study by the researcher. All participants answered the following questionnaires: Hospital Anxiety and Depression Scale, Satisfaction with Social Support Scale, Short-Form Survivor Unmet Needs Survey, and The European Organization for Research and Treatment of Cancer's Multiple Myeloma Module. Descriptive statistics, bivariate correlations, and structural equation modeling were performed to analyze the data. RESULTS The indirect effect of psychological morbidity on patients' future perspectives (MYFP) was partially mediated by information unmet needs (INF), while the indirect effect of psychological morbidity on treatment side effects (MYSE) was partially mediated by relationship and emotional unmet needs (REH). In turn, the indirect effect of psychological morbidity on disease symptoms (MYDS) was fully mediated by REH. Social support had an indirect effect on MYDS and MYSE fully mediated by REH. CONCLUSION Intervention programs tailored to promote MM patients' QoL should specifically address information and emotional needs, raising awareness and training health professionals, caregivers, and family members to attend MM patients' unmet needs.
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Mulchandani R, Armstrong B, Beck CR, Waite TD, Amlôt R, Kovats S, Leonardi G, Rubin GJ, Oliver I. The English National Cohort Study of Flooding & Health: psychological morbidity at three years of follow up. BMC Public Health 2020; 20:321. [PMID: 32223747 PMCID: PMC7104503 DOI: 10.1186/s12889-020-8424-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Flooding is expected to increase due to climate change, population growth and urban development. The longer-term mental health impacts of flooding are not well understood. In 2015, the English National Study of Flooding and Health was established to improve understanding of the impact of flooding on health and inform future public health action. METHODS We used 3 years of data from the English National Study of Flooding and Health. Participants who had consented to follow up were sent a questionnaire. Participants were classified into either "unaffected", "disrupted" or "flooded" according to their exposure. Logistic regression models were used to calculate adjusted odds ratios for probable depression, anxiety and post-traumatic stress disorder (PTSD) in each exposure group. The Wald test was used to assess the difference in probable mental health outcomes for those who did and did not experience "persistent damage" to their home. Conditional logistic regression was conducted to assess change in prevalence over the 3 years and to identify possible determinants of recovery. RESULTS Eight hundred nineteen individuals were included in the final analysis - 119 were classified as unaffected, 421 disrupted and 279 flooded. Overall, 5.7% had probable depression, 8.1% had probable anxiety and 11.8% had probable PTSD, with higher prevalence in the flooded group compared with the unaffected group. After adjustment for potential confounders, probable mental health outcomes were higher in the flooded group compared to the unaffected group, significantly for probable depression (aOR 8.48, 95% CI 1.04-68.97) and PTSD (aOR 7.74, 95% CI 2.24-26.79). Seventy-seven (9.4%) participants reported experiencing persistent damage to their home, most commonly damp (n = 40) and visible mould (n = 26) in liveable rooms. Of the 569 participants who responded at all 3 years, a significant reduction in prevalence for all probable mental health outcomes was observed in the flooded group. CONCLUSIONS Flooding can have severe long-lasting consequences on mental health in affected populations. If these problems are not identified and treated early, they may persist for years. Further research is necessary to develop and evaluate interventions to increase resilience in at risk populations and to ensure timely access to support services following flooding.
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Affiliation(s)
- Ranya Mulchandani
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK. .,NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, BS8 2BN, UK.
| | - Ben Armstrong
- NIHR Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Charles R Beck
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK.,NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Thomas David Waite
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK.,Global Public Health, Field Service, Public Health England, Wellington House, London, SE1 8UG, UK
| | - Richard Amlôt
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire, OX11 0RQ, UK
| | - Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health at the London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Giovanni Leonardi
- Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire, OX11 0RQ, UK
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK
| | - Isabel Oliver
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, BS1 6EH, UK.,NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
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10
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Cheng K, de Silva R. Implantation of a Coronary Sinus Reducer to Treat Refractory Angina in a 38-Year-Old with an Anomalous Left Coronary Artery and No Revascularization Options. Cardiology 2020; 145:126-129. [PMID: 32007999 DOI: 10.1159/000505261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 11/28/2019] [Indexed: 11/19/2022]
Abstract
A 38-year-old female with anomalous left coronary artery from the pulmonary artery presented with refractory angina (Canadian Cardiovascular Society [CCS] class 4). Having failed two previous internal mammary artery grafts to the left anterior descending artery and with no percutaneous revascularization options, she underwent coronary sinus reducer implantation, which improved her symptoms (CCS 0), quality of life, and corresponded to an improvement in ischemia on myocardial perfusion scanning. This case report describes an unusual case of refractory angina in the context of congenital heart disease, illustrates the benefit of this novel hourglass-shaped stent in improving ischemia, quality of life, depression and anxiety, and highlights the importance of managing these patients in multidisciplinary teams.
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Affiliation(s)
- Kevin Cheng
- National Heart and Lung Institute, Imperial College London, London, United Kingdom, .,Specialist Angina Service, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom,
| | - Ranil de Silva
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,Specialist Angina Service, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
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11
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Cayabyab CR, O'Reilly P, Murphy AM, O'Gorman C. Psychological morbidity among forcibly displaced children-a literature review. Ir J Med Sci 2020; 189:991-7. [PMID: 31993955 DOI: 10.1007/s11845-020-02186-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/23/2020] [Indexed: 01/05/2023]
Abstract
In 2018, nearly 75 million people were displaced from their place of origin of which 20.4 million are considered as refugees. Children constitute over half of this population. A review of the currently available literature regarding the psychological impact of forced displacement on children was performed with the concept examined under three stages of flight: pre-migration, intra-migration and post-migration. The resilience of children despite adversities is explored. Post-traumatic stress disorder (PTSD), depression and anxiety are the most commonly studied effects of forced migration on children. Rates range from 20 to 52.7%, 23 to 44.1% and 38.3 to 69% respectively. PTSD is associated with pre-migration disturbances such as witnessing death or torture of relatives, assaults and separation from family. Intra-migration difficulties relate to the hazardous journey, length of detention, type of facility and failed asylum application. Post-migration difficulties highlighted are insecure asylum status, housing worries, multiple relocations and poor acculturation technique and are more related to depression and anxiety. Despite these challenges and the tremendous horror witnessed, the majority of children report good functionality in their host countries in the long-term. The purpose of this report is to provide an overview of the factors contributing to the manifestation of mental health issues in child refugees as well as to examine mechanisms which enhance successful resettling in the host society. Health and social care providers must understand the complex interplay between the damaging effects of displacement, and the innate protective factors that persecuted children possess. Management should involve a holistic approach that considers children, families and native communities.
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12
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Dhungana RR, Aryal N, Adhikary P, Kc RK, Regmi PR, Devkota B, Sharma GN, Wickramage K, van Teijlingen E, Simkhada P. Psychological morbidity in Nepali cross-border migrants in India: a community based cross-sectional study. BMC Public Health 2019; 19:1534. [PMID: 31730454 PMCID: PMC6858657 DOI: 10.1186/s12889-019-7881-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since Nepali cross-border migrants can freely enter, work and stay in India, they are largely undocumented. The majority is involved in semi-skilled or unskilled jobs with limited labour rights and social security, a fact which predisposes them to psychological distress. We aimed to assess the prevalence of and factors associated with psychological morbidity among Nepali migrants upon their return from India. METHODS A community based cross-sectional study was conducted in six districts of Nepal between September 2017 and February 2018. A total of 751 participants who had worked at least six months in India and returned to Nepal were interviewed from 24 randomly selected clusters. The General Health Questionnaire (GHQ)-12 was used to measure the psychological morbidity. Data were analysed using Poisson regression analysis. RESULTS The majority was younger than 35 years (64.1%), male (96.7%), married (81.8%), had at least a primary education (66.6%), and belonged to Dalit, Janajati and religious minorities (53.7%). The prevalence of psychological morbidity was 13.5% (CI: 11.2-16.1%). Participants aged 45 years and above (adjusted prevalence ratio (aPR) = 2.74), from the Terai (aPR = 3.29), a religious minority (aPR = 3.64), who received no sick leave (aPR = 2.4), with existing health problems (aPR = 2.0) and having difficulty in accessing health care (aPR = 1.88) were more likely than others to exhibit a psychological morbidity. CONCLUSION This study demonstrated that psychological morbidity was prevalent in the study participants and varied significantly with individual characteristics, work conditions and health. Multifaceted approaches including psychological counselling for returnees and protection of labour and health rights in the workplace are recommended to help reduce psychological morbidity.
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Affiliation(s)
- Raja Ram Dhungana
- Green Tara Nepal, Kathmandu, Nepal. .,Institute for Health & Sport (IHES), Victoria University, Melbourne, Australia.
| | - Nirmal Aryal
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Pratik Adhikary
- Green Tara Nepal, Kathmandu, Nepal.,School of Public Health, University of California, Berkeley, USA
| | | | - Pramod Raj Regmi
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | | | | | | | | | - Padam Simkhada
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK.,International School of Health and Human Science, The University of Huddersfield, Huddersfield, UK
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13
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Abstract
BACKGROUND Assessing and evaluating mental health status can provide educational planners valuable information to predict the quality of physicians' performance at work. These data can help physicians to practice in the most desired way. The study aimed to evaluate factors affecting psychological morbidity in Iranian emergency medicine practitioners at educational hospitals of Tehran. METHODS In this cross sectional study 204 participants (emergency medicine residents and specialists) from educational hospitals of Tehran were recruited and their psychological morbidity was assessed by using a 28-question Goldberg General Health Questionnaire (GHQ-28). Somatization, anxiety and sleep disorders, social dysfunction and depression were evaluated among practitioners and compared to demographic and job related variables. RESULTS Two hundreds and four participants consisting of 146 (71.6%) males and 58 (28.4%) females were evaluated. Of all participants, 55 (27%) were single and 149 (73%) were married. Most of our participants (40.2%) were between 30-35 years old. By using GHQ-28, 129 (63.2%) were recognized as normal and 75 (36.8%) suffered some mental health disorders. There was a significant gender difference between normal practitioners and practitioners with disorder (P=0.02) while marital status had no significant difference (P=0.2). Only 19 (9.3%) declared having some major mental health issue in the previous month. CONCLUSION Females encountered more mental health disorders than male (P=0.02) and the most common disorder observed was somatization (P=0.006).
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Affiliation(s)
- Mehdi Momeni
- Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshid Fahim
- Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Vahidi
- Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Nejati
- Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Saeedi
- Emergency Medicine Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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14
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Schofield P, Gough K, Lotfi-Jam K, Bergin R, Ugalde A, Dudgeon P, Crellin W, Schubach K, Foroudi F, Tai KH, Duchesne G, Sanson-Fisher R, Aranda S. Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial. BMC Cancer 2016; 16:637. [PMID: 27530156 PMCID: PMC4986252 DOI: 10.1186/s12885-016-2687-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 08/08/2016] [Indexed: 02/02/2023] Open
Abstract
Background Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer. Methods This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index −26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data. Results Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life. Conclusions Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions. Trial registration Australian and New Zealand Clinical Trials Registry ANZCTRN012606000184572. 1 March 2006.
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Affiliation(s)
- Penelope Schofield
- Department of Psychology, Swinburne University of Technology, Hawthorn, Australia. .,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia. .,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia. .,School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
| | - Karla Gough
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.,School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Kerryann Lotfi-Jam
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Rebecca Bergin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Anna Ugalde
- Deakin University, Faculty of Health, 221 Burwood Highway, Burwood, Australia.,Cancer Council Victoria, Cancer Information and Support Services, 615 St Kilda Rd, Melbourne, Australia
| | - Paul Dudgeon
- School of Behavioural Science, University of Melbourne, Parkville, Australia
| | - Wallace Crellin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Kathryn Schubach
- Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Farshard Foroudi
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Keen Hun Tai
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Gillian Duchesne
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Australia
| | - Sanchia Aranda
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Cancer Council Australia, Sydney, NSW, Australia
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15
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Imran N, Tariq KF, Pervez MI, Jawaid M, Haider II. Medical Students' Stress, Psychological Morbidity, and Coping Strategies: a Cross-Sectional Study from Pakistan. Acad Psychiatry 2016; 40:92-6. [PMID: 26381814 DOI: 10.1007/s40596-015-0413-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 09/03/2015] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The authors studied the prevalence of psychological morbidity, sources and severity of stresses, as well as coping strategies in Pakistani medical students. METHODS Medical students in Lahore, Pakistan, completed a cross-sectional, self-administered questionnaire in 2013 on the sources and severity of various stressors. The General Health Questionnaire-12 (GHQ-12) and Brief COPE assessed the psychological morbidity and coping strategies. RESULTS Out of 1500 students, 527 responded to the survey. The prevalence of psychological morbidity was 23.3%; 52.3% respondents showed evidence of distress. By logistic regression analysis, GHQ-12 caseness was associated with being male and occurrence of health-related stressors. The most common stressors were related to academic concerns. Coping strategies showed variation by GHQ-caseness. CONCLUSION The significant psychological morbidity and distress warrants establishing support systems to support students and bringing about evidence-based changes to teaching and evaluation systems. Adequate counseling facilities should be made available and students encouraged to seek help.
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Affiliation(s)
- Nazish Imran
- King Edward Medical University/Mayo Hospital, Lahore, Pakistan.
| | | | | | - Masood Jawaid
- Dow University of Health Sciences, Karachi, Pakistan
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16
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Pucci SHM, Pereira MDG. The mediator role of psychological morbidity on sleep and health behaviors in adolescents. J Pediatr (Rio J) 2016; 92:53-7. [PMID: 26632248 DOI: 10.1016/j.jped.2015.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/22/2015] [Accepted: 03/25/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study examined the mediation role of psychological morbidity, defined in this study as depression/anxiety, in the relationship between excessive daytime sleepiness and sleep quality, and between sleep habits and health behaviors, in adolescents. METHODS A total of 272 students, between 12 and 18 years old, underwent a psychological protocol assessing excessive daytime sleepiness, sleep quality, sleep habits, health behavior, and psychological morbidity. RESULTS Psychological morbidity was not associated with the relationship between excessive daytime sleepiness and sleep quality, but was associated, with statistical significance, in the relationship between sleep habits and health behaviors. These results emphasize the role of psychological morbidity in adolescent health behaviors. CONCLUSION Analyzing the symptoms of depression and anxiety in pediatric patients may help in a more accurate diagnosis, especially in relation to sleep problems and health behaviors.
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Abstract
OBJECTIVE This study attempted to examine psychological morbidity among co-residents of older people living in Vellore, Tamil Nadu, India. METHOD This cross-sectional study evaluated psychological morbidity among co-residents using the Self-Reporting Questionnaire and psychiatric morbidity among older people using the 10/66 Dementia Research Group's population-based studies protocol. Socio-demographic data were also collected. Logistic regression was used for multivariate analysis. RESULTS Of 807 residents evaluated, 73 (9.0%) had significant psychological morbidity. Such morbidity was associated with being older, female, poorer, illiterate, currently employed and being a spouse of the older person. A diagnosis of depression, neuropsychiatric symptoms and greater disability in older people were also associated with psychological morbidity among co-residents. CONCLUSION Co-residents living with older people have significant psychological morbidity, which needs to be recognised and treated.
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Affiliation(s)
- M Khurram Malik
- Specialist Mental Health Services for Older People, Penrith, NSW, Australia
| | - K S Jacob
- Specialist Mental Health Services for Older People, Penrith, NSW, Australia Department of Psychiatry, Christian Medical College, Vellore, India
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18
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Darwish M, Atlantis E, Mohamed-Taysir T. Psychological outcomes after hysterectomy for benign conditions: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2014; 174:5-19. [PMID: 24398028 DOI: 10.1016/j.ejogrb.2013.12.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/27/2013] [Accepted: 12/06/2013] [Indexed: 11/23/2022]
Abstract
Hysterectomy is one of the commonest operative procedures in the developed world, mostly occurring among premenopausal women, with contradictory results regarding post-operative psychological wellbeing. This review aims to inform practice by examining whether hysterectomy predicts depression or anxiety outcomes. We searched PubMed, EMBASE, and PsycINFO electronic databases for articles published before November 2012. Reference lists of relevant articles were hand searched, and expert opinions were sought. Refereed studies investigating an association between hysterectomy for benign (non-cancerous) conditions and post-operative symptoms of depression or anxiety were chosen for this review. Two authors independently abstracted data from original articles. Authors of relevant studies were contacted for data that could not be extracted from the published articles. Review Manager 5.1 was used throughout the meta-analysis to calculate the summary relative risks (RRs), and the weighted standardized mean difference (WstdMD), and their corresponding 95% confidence intervals (CI). A random effects model was used in data analysis and verified using a fixed effect model. Overall, hysterectomy was associated with a decreased risk of clinically relevant depression (RR=1.69, 95% CI 1.19-2.38). Additionally, hysterectomy was associated with a decrease in standardized depression outcomes (standardized mean difference (SMD) 0.38 (95% CI 0.27-0.49)). Conversely, there was no significant association between hysterectomy and risk of clinically relevant anxiety (RR=1.41, 95% CI 0.72-2.75). In conclusion, data from before and after studies suggest that hysterectomy for benign gynecological conditions is not adversely associated with anxiety and may be positively rather than adversely associated with depression.
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Abstract
The study included 70 consecutive patients with fracture of the lower and upper limbs each and an equal number of age and sex matched normal control subjects. All the subjects were screened using the General Health Questionnaire (GHQ), the Michigan Alcoholism Screening Test (MAST), Carroll Rating Scale for Depression (CRSD), State-Trait Anxiety Inventory (STAI), Impact of Events Scale (IES), Fatigue Scale (FS) and the Perceived Stress Questionnaire (PSQ). Probable "Psychiatric cases" identified by the questionnaires underwent diagnostic psychiatric evaluation. As compared to normal controls, the limb fracture patients obtained significantly higher scores on the GHQ, MAST, CRSD, IES & FS but not on the STAI & PSQ. Psychiatric evaluation revealed significantly higher prevalence of psychiatric disorders in lower limb fracture patients (n=31) as compared to upper limb fracture patients (n=18) and control subjects (n=6). Limb fracture patients had a high prevalence of alcohol dependence/abuse (243%) and depressive disorders (6.4%). The results indicate that psychological intervention would greatly facilitate the management of these patients.
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Affiliation(s)
- S Chaudhury
- Reader, Department of Psychiatry, Armed Forces Medical College, Pune - 411 040
| | - T R John
- Classified Specialist (Psychiatry), Command Hospital (Southern Command), Pune 411 040
| | - A Kumar
- Commandant, Artificial Limb Centre, Pune - 411 040
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20
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Chawla S. TECHNOLOGY UPDATE: PINLESS EXTERNAL FIXATOR. Med J Armed Forces India 2001; 57:234-6. [PMID: 27407345 DOI: 10.1016/s0377-1237(01)80051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Pinless fixator is an outstanding system designed for external fixation without invading the medullary canal in polytrauma patients. The pinless external fixation allows immediate stabilization and reduction of compound tibial fractures with or without skin loss. This is an ideal tool for emergency stabilization of tibial fractures in a peripheral setup because the application technique is easy to learn by general surgeons. This device can be applied quickly even under local anaesthesia, average application time being 20 minutes in our setup. It does not transfix the bone and therefore avoids the contamination of the medullary canal and thus does not preclude the use of any further treatment methods eg. repeated wound debridement, soft tissue coverage and internal fixation of the fracture. Transportation to referral centre can be done after application of the external fixator if considered necessary in patients with multiple injuries.
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Affiliation(s)
- S Chawla
- Classified Specialist (Surgery), Military Hospital, Bhopal - 462 031
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21
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Chandorkar H, Chakraborty PK. Psychological morbidity of parents of mentally retarded children. Indian J Psychiatry 2000; 42:271-4. [PMID: 21407956 PMCID: PMC2958351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The magnitude of the problem of mental retardation in our country hardly needs any exaggeration. The psychological burden that these parents carry has been varied. The present study was undertaken to delineate the psychological problems of parents of mentally retarded children and to establish whether these problems were more prevalent in the parents of mentally retarded children than in the parents of normal children. The material comprised of three groups of subjects: The first group comprised of parents of twenty students of a school for mentally handicapped children; the second group comprised of parents of ten mentally retarded children who were not institutionalised or attended any special school for mentally retarded in the past: the third group comprised of parents of twenty normal school going children. The results of the study conclusively proved that the parents of mentally retarded children had a higher prevalence of psychological morbidity than the parents of normal children. The commonest psychiatric disorder was Dysthymia followed by Generalised Anxiety Disorder and Moderate Depression.
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Affiliation(s)
- H Chandorkar
- HEMANT CHANDORKAR, Surg. Lt. Cdr., Psychiatrist, Command Hospital, Central Command, Lucknow
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