Onset of mobility limitations in old age: the combined effect of socioeconomic position and social relations

PURPOSE

to examine the combined effect of cohabitation status and social participation, respectively, and socioeconomic position on onset of mobility limitations in a prospective study among older Danes.

DESIGN AND METHODS

logistic regression analyses with combined exposure variables were performed in a study population of 2,839 older men and women from the Danish Intervention Study on Preventive Home Visits.

RESULTS

among men low financial assets, living alone or having low social participation significantly increased the odds ratios (OR) for onset of mobility limitations. Among women only low financial assets and low social participation significantly increased the ORs for onset of mobility limitations. Analyses with combined exposure variables showed that simultaneous exposure to low financial assets and poor social relations significantly increased the ORs for onset of mobility limitations among both genders, yet the tendencies appeared stronger for males. In particular, men with simultaneous exposure to low financial assets and low social participation had increased odds ratios for onset of mobility limitations, OR = 5.36 (2.51-11.47), compared with the non-exposed.

CONCLUSION

the study suggests that future interventions to increase social participation might alleviate the negative effects on mobility experienced by older people in low socioeconomic position, perhaps especially among older males.

Models of care for socially isolated older rural carers: barriers and implications

INTRODUCTION

In response to population ageing, the numbers of older carers residing in rural areas are increasing. However, rural older carers are at risk of social isolation due to the decreased social networks associated with ageing and caring responsibilities, and the geographical isolation associated with rurality. This broad, systematic review of the literature was undertaken to: (1) identify barriers to social participation for rural older carers; and (2) summarise features of interventions that were effective in reducing social isolation for rural and/or older carers.

METHODS

Literature was obtained through systematic searches of selected electronic databases; selected Australian and international government and research based websites and Google Scholar. Searches were limited to material published from 1999 to 2009, and literature was included which either identified barriers to social participation, or outlined interventions that were effective in reducing social isolation and increasing social support in rural and/or older carers.

RESULTS

67 articles, book chapters and reports identified which addressed the review objectives. Findings indicate that rural older carers experience considerable barriers to socialisation, and six dimensions are identified that are effective in reducing barriers, decreasing social isolation and increasing social participation. Interventions must address individual needs; incorporate a dual carer-care recipient focus and/or an educational component; facilitate informal social interaction; utilise existing networks and experienced personnel; and be both sustainable and long term.

CONCLUSIONS

Reducing social isolation in rural older carers is a two-stage process. First, barriers to attendance, both logistical and perceived, must be addressed, and the focus of the intervention must be relevant to the carer. Second, opportunities for informal social interaction must be maximised within the intervention. However, a secondary focus may be necessary to ensure attendance, and the provision of education is also integral to achieving long-term outcomes. Integration of service providers in an informal capacity is also important in providing long-term support options. Addressing these issues will assist in developing interventions for rural older carers that are both appropriate and sustainable.

Use of multicriteria involvement processes to enhance transparency and stakeholder participation at Bergen Harbor, Norway

Use of participatory stakeholder engagement processes could be important to reduce the risk of potential conflicts in managing contaminated sites. Most stakeholder engagement techniques are qualitative in nature and require experienced facilitators. This study proposes a multicriteria involvement process to enhance transparency and stakeholder participation and applies it to a contaminated sediment management case study for Bergen Harbor, Norway. The suggested multicriteria involvement process builds on the quantitative principles of multicriteria decision analysis and also incorporates group interaction and learning through qualitative participatory methods. Three different advisory groups consisting of local residents, local stakeholders, and nonresident sediment experts were invited to participate in a stakeholder engagement process to provide consensual comparative advice on sediment remediation alternatives. In order for stakeholders or residents to be able to embrace a complex decision such as selection of remediation alternatives, the involvement process with lateral learning, combined with multicriteria decision analysis providing structure, robustness and transparent documentation was preferable. In addition, a multicriteria involvement process resulted in consistent ranking of remediation alternatives across residents, stakeholder, and experts, relative to individual intuitive ranking without the multicriteria involvement process.

[The social and professional integration of the patient]

The rehabilitation and social and professional integration department of the Mutual Centre for Re-education and Functional Rehabilitation in Kerpape, Brittany, is part of an early integration approach. It assesses situations of disability and a person's individual and social circumstances, notably after a stroke. A multi-disciplinary team supports patients for one year after they leave the centre, with the aim of supporting their social and professional reintegration.

The role of large carnivore committees in legitimising large carnivore management in Finland and Sweden

Many countries, including Sweden and Finland, are decentralizing the management of large carnivore species within their borders and emphasizing the role of stakeholder participation in legitimizing formal policy. Regional large carnivore committees (RLCCs), including representatives of authorities and non-governmental organizations, are essential to these endeavors. These committees are formally constituted in Sweden, whereas in Finland, they are informally developed from the bottom-up. In both countries, the declared roles of these committees are consultative. A comparative study based on survey data is described here, which address the question of how procedural legitimacy is shaped and maintained in institutional settings with different origins, such as top-down or bottom-up. The results indicate no clear difference in the representatives' general satisfaction with the country-specific arrangements. Notable differences were found in specific perceptions of the clarity and purposes of the RLCCs. In both countries, the perceived rationale for the establishment of RLCCs emphasized the knowledge and expertise of the represented interest groups and authorities. Between the countries, similarities were also found in the strong links between overall satisfaction and personally perceived success and progress in communication and information exchange, i.e., deliberative processes. The capacity of the RLCCs to improve trust and acceptability with regard to different opinions was viewed as a key element underlying satisfactory RLCC activities, irrespective of the institutional settings.

Participation by adults with lifelong disability: more than a trip to the bowling alley

Community participation by people with lifelong disability is not a new concept. Yet, within the field of disability there is ongoing debate about the barriers to participation and how these can be solved. At a practical level, participation remains an issue that is often misunderstood by many who seek to promote the integration of adults with lifelong disability into the community. Community presence alone does not denote participation or integration. Furthermore, the role of the speech-language pathologist is rarely, if ever, discussed in the research into participation by people with lifelong disability. In this paper a brief overview is given of the barriers and solutions to participation by people with lifelong disability, including those with complex communication needs who use or require augmentative and alternative communication (AAC). Two innovative solutions, the Change Laboratory and Second Life™, are discussed. These may be useful for the speech-language pathologist to consider when seeking additional ways to support community participation by adults with lifelong disability.

Health status and health risks of the "hidden majority" of adults with intellectual disability

Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco and less likely to access some health services and promotion activities than those who do use these services. In addition, they are more likely to be exposed to some known social determinants of poorer health (greater material hardship, greater neighborhood deprivation, reduced community, and social participation).

Prelinguistic predictors of language development in children with autism spectrum disorders over four-five years

This study examined relationships between prelinguistic variables from the MacArthur-Bates CDI and the development of language comprehension and production in children with autism. Forty-four children were assessed at baseline and 6, 12, 24, 33 and 53 months later. Growth Curve Modeling was used to examine the extent to which three composite CDI variables and three CDI item groupings predicted language development over 4-5 years. When examined individually, prespeech and early gestures were significant predictors of change for both comprehension and production, but late gestures were not. In addition, initiating joint attention and games and routines predicted comprehension and production over 4-5 years, and conventional gestures also predicted production. When all factors were considered simultaneously, children's ability to participate in games and routines was the only significant predictor of language production over time. The results are discussed with regard to their implications for understanding the complex factors that affect developmental outcomes.

Social contexts and customary fisheries: marine protected areas and Indigenous use, Australia

Worldwide, the implementation of marine protected areas (MPAs) offers opportunities for delivering fisheries and biodiversity management objectives. In Australia however, the primary function of an MPA is that of biodiversity conservation. Nonetheless, the management of Indigenous customary fisheries is one area where fisheries and biodiversity issues converge. This article examines the relationship between biodiversity and customary fisheries in an MPA context by investigation of the role and importance of Indigenous social contexts. Using case study examples from Australia, I explore the role of Indigenous social contexts in two dimensions: (i) management of traditional fisheries and (ii) Indigenous contribution to fisheries within an MPA. Findings demonstrate two narratives concerning social contexts, one of recognition and the other concerning Indigenous involvement in management. I conclude with a survey of Indigenous management initiatives within MPAs. The article ends with a discussion of the utility of understanding social contexts in any marine management endeavour, specifically other social contexts within an MPA.

Inclusion in political and public life: the experiences of people with intellectual disability on government disability advisory bodies in Australia

BACKGROUND

Civil and political participation lies at the core of citizenship. Increasingly, people with intellectual disability are members of disability advisory bodies. This study investigated the political orientations of advisory body members with intellectual disability, their participatory experiences, and the types of support they received.

METHOD

The 9 people with intellectual disability who in 2005 were members of disability advisory bodies at a state, national, and Victorian local government level were interviewed, together with 12 other members or secretariat staff of these bodies. Observations were also conducted of advisory body meetings.

RESULTS

The political perspective of members with intellectual disability varied, but all had a background in self-advocacy. They found the work hard but rewarding and encountered both practical and intangible obstacles to participation. Members received varying types of practical support, but a supportive collegial milieu was characteristic among members who felt most confident about their participation.

CONCLUSIONS

The milieu, structures, and processes of advisory bodies must all be adjusted to accommodate people with intellectual disability if they are to participate meaningfully.

Social participation of people affected by leprosy after discontinuation of multidrug therapy

OBJECTIVES

To evaluate social participation of individuals completing treatment for leprosy and to describe the relationship with physical sequelae and sociodemographic characteristics.

DESIGN

A cross-sectional, descriptive study was performed involving all leprosy affected people who were treated between 1998 and 2006 in São José do Rio Preto, Brazil. General and clinical data were collected and the subjects were assessed using the degree of physical disability of the WHO (DPD-WHO), the Eye-hand-foot (EHF) score, and the participation scale (PS), which measures social participation of individuals with stigmatising problems.

RESULTS

Of the 335 people treated in the period, 223 (66.6%) were interviewed. Of these, 51.6% were women, the mean age was 54 years (+/- 15.7 years), 66.4% had up to 6 years of formal education, 42.6% worked and 26.9% were retired. There was a predominance of dimorphous (borderline) leprosy (39.9%). Participants' physical and mental health was considered good in the month preceding the interview in 50.2% and 59.2%, respectively. Disabilities according to the DPD-WHO and EHF scores affected 32% of the participants and restrictions in social participation occurred in 35.4%. Multivariate analysis demonstrated a significant association between restrictions in social participation and family income of less than three minimum salaries (US$ 160.50), associated diseases, hospitalisation within the previous year and physical disability.

CONCLUSION

The prevalence of restrictions in social participation is high, even after completing treatment for leprosy. Physical disability, associated diseases, recent hospitalisation and low family incomes influence the social participation of these individuals.

Skin problems of the stump in lower-limb amputees: 2. Influence on functioning in daily life

The aim of this study was to analyse the influence of stump skin problems on functioning in daily life in lower-limb amputees. A cross-sectional study was performed by means of a questionnaire containing 9 questions assessing functioning in daily life. Question scores were added to give a total score (range 0 (no influence) to 27 (maximum negative influence)). Two thousand and thirty-nine people were invited to participate, with 805 participants completing a questionnaire. Of these, 507 reported one or more skin problems. Skin problems had a negative influence on ability to perform household tasks, prosthesis use, social functioning, and participation in sports. The mean total score was 5.5 ± 4.1. This correlated significantly with the number of skin complaints (r = 0.483; p = 0.01). In linear regression analyses, gender (β = -0.15) and number of skin problems (β = 0.25) accounted for 23% of the total score. This study confirms the influence of skin problems on functioning in daily life.

Academic and social success in adolescents with previous febrile seizures

OBJECTIVE

To study academic achievement and social success in adolescents with febrile seizures (FS) before their 5th birthday.

SUBJECTS AND METHODS

A random birth cohort (n=900) was prospectively followed from early pregnancy and examined at ages 12 and 18 years to study the relationships between FS and school achievement (three most important school marks), behavior and social competence (Achenbach Childhood Behavior Checklist, Youth Self-Report), life management (Antonovsky Sense of Coherence Scale) and social participation.

RESULTS

No significant differences could be detected between children with vs. without FS or between boys vs. girls in academic achievement, behavior, social competence, life management, or social participation, either at age 12 or 18 years, except for more somatic complaints of girls at age 18. Of adolescents with previous FS, 29% had not participated in the maturity examination, 20% had participated but failed and 51% had passed, comparing 35%, 18% and 47%, respectively, of those without FS (p=0.6676).

CONCLUSIONS

Our study confirms the findings of the previous population studies reporting similar academic and social success between children with and without febrile seizures before the 5th birthday. Reassurance of the parents about a favorable future may ameliorate their worries at this frightening event in their child's life.

Association between participation in community groups and being more physically active among older adults from Florianópolis, Brazil

OBJECTIVE

In Brazil, older adults frequently participate in community groups. However, the influence of this participation on physical activity levels has not been fully investigated. It is known that both regular physical activity and social support are beneficial for health. The aim of this study is to evaluate the association between participation in community groups and physical activity among older adults from Florianópolis, Brazil.

METHODS

The sample consisted of 1062 adults with a mean age of 71.9 (±7.6) years. Among these individuals, 293 subjects participated in community groups and 769 did not. A questionnaire to collect sociodemographic data and the long version of the International Physical Activity Questionnaire were used for the assessment.

RESULTS

The prevalence of active older adults was 66.6% among participants in community groups and 58.4% among non-participants. Participation in these groups was significantly associated with being more physically active in the transportation and domestic domains, but with being less physically active in the leisure-time domain. Some changes in these associations were observed when the sample was stratified by age, gender, body mass index, and health status. With respect to total physical activity, participation in community groups was associated with being more physically active in only two strata (subjects younger than 70 years and women).

CONCLUSION

The results of this study indicate that older adults who participate in community groups are characterized by a greater probability of being more physically active. However, longitudinal studies are needed to determine whether participation in community groups facilitates the adoption of physically active behavior.

[Improvements in spontaneity and social functioning in patients with schizophrenia after cognitive training]

Cognitive rehabilitation approaches are in the spotlight as a novel strategy for promoting social participation in patients with schizophrenia, as the connection between cognitive deficits and functional outcomes in schizophrenia has been consistently demonstrated over the last decade. Divergent thinking is typically applied when someone is confronted with questions that do not have a single fixed answer. We identified divergent thinking deficits in patients with schizophrenia using qualitative measures involving idea and design fluency tests, and found that the impairment in generating high-quality responses on divergent thinking tasks was an important determinant of poor community functioning among patients. Based on our findings, we suggested that divergent thinking was an important neurocognitive skill that deserves consideration as a potential target for intervention, and developed a training program specifically for divergent thinking deficits in patients with schizophrenia. We evaluated the effects of this program on measures of divergent thinking (e.g., fluency measures), negative symptoms, and social functioning. After the training program, participants in the divergent thinking program had significantly greater improvements on measures of idea fluency, negative symptoms, and interpersonal relations than the participants in the control program. These results suggest that interventions for divergent thinking in patients with schizophrenia may lead to improvements in patients' social functioning. In recent years, intrinsic motivation has become a focus of attention as a critical mechanism for explaining the relationship between neurocognition and psychosocial functioning in patients with schizophrenia. Divergent thinking is thought to be relevant to spontaneity and intrinsic motivation. The training program for divergent thinking deficits may have achieved its effects on negative symptoms and social functioning through an improvement in spontaneity and intrinsic motivation. The potential of the cognitive training program to enhance patients' quality of life is discussed.

Inventory and analysis of definitions of social participation found in the aging literature: proposed taxonomy of social activities

Social participation is a key determinant of successful and healthy aging and therefore an important emerging intervention goal for health professionals. Despite the interest shown in the concept of social participation over the last decade, there is no agreement on its definition and underlying dimensions. This paper provides an inventory and content analysis of definitions of social participation in older adults. Based on these results, a taxonomy of social activities is proposed. Four databases (Medline, CINAHL, AgeLine and PsycInfo) were searched with relevant keywords (Aging OR Ageing OR Elderly OR Older OR Seniors AND Community involvement/participation OR Social engagement/involvement/participation) resulting in the identification of 43 definitions. Using content analysis, definitions were deconstructed as a function of who, how, what, where, with whom, when, and why dimensions. Then, using activity analysis, we explored the typical contexts, demands and potential meanings of activities (main dimension). Content analysis showed that social participation definitions (n = 43) mostly focused on the person's involvement in activities providing interactions with others in society or the community. Depending on the main goal of these social activities, six proximal to distal levels of involvement of the individual with others were identified: 1) doing an activity in preparation for connecting with others, 2) being with others, 3) interacting with others without doing a specific activity with them, 4) doing an activity with others, 5) helping others, and 6) contributing to society. These levels are discussed in a continuum that can help distinguish social participation (levels 3 through 6) from parallel but different concepts such as participation (levels 1 through 6) and social engagement (levels 5 and 6). This taxonomy might be useful in pinpointing the focus of future investigations and clarifying dimensions specific to social participation.

[Relationships between participation in community activities and psychosocial and physical health of community-dwelling elderly]

OBJECTIVE

The aim of this study was to clarify relationships between participation in community activities and psychosocial and physical health of community-dwelling elderly.

METHODS

The participants of the present study were 413 people selected on the basis of a random 1/3 extraction of people aged 65 or older and living in a rural community in Miyagi prefecture. The baseline survey was conducted in February 2008. One year later, we conducted a follow-up survey to clarify how participation in community activities influenced the elderly. Finally, we analyzed data for 218 people, focusing on influences on psychosocial and physical health using the logistic regression model. The state of community activity was treated as a dependent variable, and mental and physical health indicators were assessed as the independent variables.

RESULTS

Of the elderly sample, 63 persons were found to be frequent participants in community activities, 60 were infrequent participants, and 95 did not participate. The frequently participating individuals displayed significantly better results for declines in depression (OR = 0.34, 95% CI: 0.13-0.89), and social participation (OR = 0.12, 95% CI: 0.05-0.29), as well as the TMIG index of competence (OR = 0.26, 95% CI: 0.08-0.78) as compared with those who did not participate.

CONCLUSION

These results suggest that community activities prevent deterioration of mental health, improve social health, and maintain higher-level functional capacity among community-dwelling elderly individuals.

Health-related quality of life and classroom participation of deaf and hard-of-hearing students in general schools

A group of deaf and hard-of-hearing (D/HH) students at mainstream schools (N = 212) was investigated in a questionnaire-based survey using the Inventory of Life Quality of Children and Youth (ILC) and the Classroom Participation Questionnaire. The ILC data for the D/HH sample are for the most part comparable with the data from a normative hearing sample. Item-total correlations showed that the domains of school and social activities with peers were more important for the Health-Related Quality of Life (HRQoL) of the D/HH students than for that of the hearing students. The results also reveal differences in the HRQoL levels of the two samples, with the D/HH sample having higher scores for school experiences, physical and mental health, and overall HRQoL, though the effect sizes for the differences are small to moderate. Specific characteristics of the D/HH sample may be responsible for this result. There are also relationships between quality of life and perceived classroom participation in certain domains: Students who perceive classroom participation as satisfying have higher scores for quality of life in school, social contact with peers, and mental health. This also applied to the scores for global assessment and a summarized quality of life indicator.

[Efficacy of the social mobilization and the social participation in dengue control measures]

INTRODUCTION

Dengue is a public health problem. However, the efficacy of typical control programs is not well-established.

OBJECTIVE

The efficacy of social mobilization was assessed for its role in public empowerment in the improvement of dengue control measures.

MATERIALS AND METHODS

A community trial was conducted in Comuna Norte, a section of the city of Bucaramanga,Santander. Four high-incidence neighborhoods were selected--two received empowerment training and two served as controls. During 1,968 home visits, information was collected concerning knowledge and practices of dengue control, and information was provided concerning dengue and mosquito larval habitats of the vector. At local schools, dengue control information was provided for 2,455 students. The intervention included training of 155 community leaders and tracking of prevention and control activities. Findings were compared between post-intervention and controls by χ² test, with a significance level of p<0.05.

RESULTS

At the home visits, 80.7% of respondents were female. with a mean age of 39.1 and 5.8 years schooling. In comparing the intervention neighborhoods with the controls, differences in knowledge about dengue were as follows: symptoms of bodily pain (χ²=21.0, p<0.001) and abdominal pain (χ²=5.1, p=0.024), reproduction cycle of the mosquito vector (χ²=11.5, p<0.001), knowledge of mosquitos characteristics (χ²=7.1, p=0.008). In washing practices batteries (χ²=7.2, p=0.007), spraying (χ²=7.0, p<0.008), use of bednets (χ²=49.8, p<0.001), consulting a physician (χ²=8.2, p=0.004), participate in meetings (χ²=29.6, p<0.001), prevention methods (χ²=10.4, p=0.013), willingness to lead anti-mosquito campaigns (χ²=6.8, p= 0.009) and to get help for programs (χ²=5.8, p=0.016). There was a decrease in the proportion of households with larvae from 20.0% to 15.9% in both groups. The difference in prevalence of dengue one year after initiation of the program was not significant--4.8% in the intervention group and 6.7% in control (χ²=3.4, p=0.065).

CONCLUSION

The social mobilization was effective for improving actions of empowerment, control, but not dengue prevention.

Social capital and the decline in HIV transmission - A case study in three villages in the Kagera region of Tanzania

We present data from an exploratory case study characterising the social capital in three case villages situated in areas of varying HIV prevalence in the Kagera region of Tanzania. Focus group discussions and key informant interviews revealed a range of experiences by community members, leaders of organisations and social groups. We found that the formation of social groups during the early 1990s was partly a result of poverty and the many deaths caused by AIDS. They built on a tradition to support those in need and provided social and economic support to members by providing loans. Their strict rules of conduct helped to create new norms, values and trust, important for HIV prevention. Members of different networks ultimately became role models for healthy protective behaviour. Formal organisations also worked together with social groups to facilitate networking and to provide avenues for exchange of information. We conclude that social capital contributed in changing HIV related risk behaviour that supported a decline of HIV infection in the high prevalence zone and maintained a low prevalence in the other zones.

Mapping human and social dimensions of conservation opportunity for the scheduling of conservation action on private land

Abstract  Spatial prioritization techniques are applied in conservation-planning initiatives to allocate conservation resources. Although typically they are based on ecological data (e.g., species, habitats, ecological processes), increasingly they also include nonecological data, mostly on the vulnerability of valued features and economic costs of implementation. Nevertheless, the effectiveness of conservation actions implemented through conservation-planning initiatives is a function of the human and social dimensions of social-ecological systems, such as stakeholders' willingness and capacity to participate. We assessed human and social factors hypothesized to define opportunities for implementing effective conservation action by individual land managers (those responsible for making day-to-day decisions on land use) and mapped these to schedule implementation of a private land conservation program. We surveyed 48 land managers who owned 301 land parcels in the Makana Municipality of the Eastern Cape province in South Africa. Psychometric statistical and cluster analyses were applied to the interview data so as to map human and social factors of conservation opportunity across a landscape of regional conservation importance. Four groups of landowners were identified, in rank order, for a phased implementation process. Furthermore, using psychometric statistical techniques, we reduced the number of interview questions from 165 to 45, which is a preliminary step toward developing surrogates for human and social factors that can be developed rapidly and complemented with measures of conservation value, vulnerability, and economic cost to more-effectively schedule conservation actions. This work provides conservation and land management professionals direction on where and how implementation of local-scale conservation should be undertaken to ensure it is feasible.

[Social-professional status, identity, social participation and media utilization. Analysis of a complex dynamics]

This article examines the link between the domain and level of occupation, on the one hand, and use of media, including internet, on the other. It adds to this investigation an analysis of identity in its relation to media use and accessibility. It challenges the hypothesis of a strong correlation between level of occupation and use and accessibility to media. It reveals complex phenomena of social homogenization and differentiation. Data is extracted from a sample of workers who completed a questionnaire which focused on use of media.

[Psychopathology, quality of life and social functioning in dialysis treatment and kidney transplantation patients]

OBJECTIVES

Psychiatric evaluation of organ transplant candidates is now routinely proposed also in Italy. This study purposed to assess the psychological status in patients on hemo-dialysis, peritoneal dialysis and renal transplantation; moreover other purpose is to investigate the possible differences among the three groups.

MATERIALS AND METHODS

157 subjects were consecutively enrolled, to the service of U.O. Trapianti d'Organo of San Salvatore Hospital in L'Aquila (Italy), between October 2007 and August 2009; 127 were in dialysis (80.9%), of which 101 were in hemodialysis (64.3%) (HD group) and 26 in peritoneal dialysis (16.6%) (PD group) and 30 (19.1%) Kidney transplant (PT group). The subjects were examined with clinical evaluation and through the following psychometric instruments: HAM-D, HAM-A, Jalowiec Coping Scale, STAI-Y1, STAI-Y2, DISS, SF-36.

RESULTS

30% out of our sample showed the presence of some psychopathological signs and symptoms, especially depression and anxiety. At HAM-D there were no differences between HD group (6.73; DS + 5.58) and PD group (5.27, DS + 5.63); the mean value at HAM-D in PT group was 4.4 (DS + 3.16) (p < 0.05). At HAM-A there were no differences between three groups. The HD group showed an higher value at STAI-Y1 (38.61; DS + 10.64) than PD (34.95; DS + 6.75) and PT (33.89; DS + 6.14) groups (p < 0.05). The quality of life (physical role, general health, vitality and role emotional) was lower in HD and PD groups, higher in group PT. The HD e PD groups showed a higher level of disability than PT group (p < 0.05). All subjects used "positive: coping styles.

CONCLUSIONS

We consider essential to investigate the issues observed in this study, with the need to integrate psychosocial and functional needs assessment within a course of diagnosis and treatment for people who are undergoing dialysis procedures, or after waiting for a transplantation. Dialysis affects the quality of life, leading to limitations in activities and high level of disability. The PT group showed better quality of life and less impairment in functioning in the investigated areas. If the impact of psychological and/or psychiatric aid remains difficult to appraise, these results emphasize the impact of psychological status and the appropriateness of psychosocial support intervention on patients facing the transplant process or in dialysis treatments.