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Alves M, Skuza K, Coloni-Terrapon C, Lê Van K, Wenger D, Rexhaj S. Perspectives of family caregivers, health professionals, and support providers on partnership issues in adult psychiatry. Rech Soins Infirm 2024; 154:13-28. [PMID: 38182537 DOI: 10.3917/rsi.154.0013] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Context Family caregivers play an essential role in the continuity of care for patients with mental health problems. However, the lack of consideration for their role and difficulties in their collaboration with health professionals impact their involvement. Objective The purpose of this study is to identify the issues underlying the family-professional partnership. Method A qualitative and exploratory study is used to collect data from providers of support services, family caregivers of patients with psychiatric disorders, and mental health professionals. Semi-structured interviews and focus groups conducted from October 2017 to August 2018 were analyzed to determine key issues surrounding this partnership. Results A total of thirty-two family caregivers, nine healthcare professionals, and eleven providers participated in the study. The central concerns related to the partnership are information, continuity of care, and the relationship between patients, family members, and professionals. The relational dimension appears to be an important element for all three groups of participants, who nevertheless point out difficulties with regard to their positioning in this tripartite relationship. Discussion/Conclusion In the context of the current healthcare system, the concept of partnership creates obstacles to family caregivers being able to contribute their expertise while feeling recognized by the other actors.
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Affiliation(s)
- Martina Alves
- Infirmière spécialiste clinique, M.Sc, Hôpital du Valais, pôle de psychiatrie et psychothérapie, Monthey, Suisse
| | - Krzysztof Skuza
- Psychosociologue, Ph.D, Haute école de Santé Vaud HESAV, Haute école spécialisée de Suisse occidentale HES-SO, Lausanne, Suisse
| | - Claire Coloni-Terrapon
- Maître d’enseignement, M.Sc, Haute école de Santé Fribourg, Haute école spécialisée de Suisse occidentale HES-SO, Fribourg, Institut et Haute école de la Santé La Source, Haute école spécialisée de Suisse occidentale HES-SO, Lausanne, Suisse
| | - Kim Lê Van
- Sociologue, Ph.D, Haute école de Santé Vaud HESAV, Haute école spécialisée de Suisse occidentale HES-SO, Lausanne, Suisse
| | - Daniel Wenger
- Infirmier clinicien spécialisé, M.Sc, Institut et Haute école de la Santé La Source, Haute école spécialisée de Suisse occidentale HES-SO, Lausanne, Suisse
| | - Shyhrete Rexhaj
- Infirmière, Ph.D, Institut et Haute école de la Santé La Source, Haute école spécialisée de Suisse occidentale HES-SO, Lausanne, Suisse
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Korogod N, Skuza K, Bangerter G, Opsommer E. Physiological effects of Therapeutic Body Wraps in healthy volunteers: An observational study. Arch Psychiatr Nurs 2022; 41:114-123. [PMID: 36428039 DOI: 10.1016/j.apnu.2022.07.020] [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: 02/07/2022] [Revised: 05/30/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The clinical management of severe anxiety is challenging. Along with specific medication, several nonpharmacological treatments exist, among which the Therapeutic Body Wraps (TBW). While TBW is clinically known to be efficient, the absence of objective physiological measurements raised some debates about its harmlessness. AIMS This observational study investigated TBW in healthy volunteers. METHODS Measurements were done in 26 participants, who experienced TBW, which consisted of tightly wrapping the body in one layer of wet cold sheets and several warm blankets. These were compared to 13 participants, who rested in supine position. RESULTS Our results showed increase in the trunk skin temperature by the end of TBW similar to rest. Somatosensory perception as assessed with quantitative sensory testing was stable after both TBW and rest. The heart and breath rates decreased both during TBW and rest. It was accompanied by increase in heart rate variability parameters and decrease in salivary cortisol levels. DISCUSSION Our data indicate anxiolytic effect of TBW in healthy participants. IMPLICATIONS FOR PRACTICE The TBW is harmless and might be used in patients, who are unable to relax by themselves and/or without anxiolytic medication. Further studies are necessary to investigate physiological response to TBW in clinical population.
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Affiliation(s)
- Natalya Korogod
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland.
| | - Krzysztof Skuza
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Gilles Bangerter
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Emmanuelle Opsommer
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland
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Monteiro S, Fournier M, Favrod J, Drainville AL, Plessis L, Freudiger S, Skuza K, Tripalo C, Franck N, Lebas MC, Deloyer J, Wilquin H, Golay P, Rexhaj S. Ability to Care for an Ill Loved One During the First COVID-19 Lockdown: Mediators of Informal Caregivers' Stress in Europe. Front Psychiatry 2022; 13:852712. [PMID: 35492725 PMCID: PMC9039127 DOI: 10.3389/fpsyt.2022.852712] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
Informal caregivers are overlooked, healthcare actors. They are at particular risk of distress and suffer from poor mental health. This study aimed to investigate the perceived stress and modulating factors during the first COVID-19 lockdown in Europe, regardless of the illness that care recipients suffer from. Sociodemographic data, coping resources, and perceived stress level using the Perceived Stress Scale (PSS-10) questionnaire were assessed using a web-based survey in Switzerland, France, and Belgium with 232 informal caregivers. Mediation analyses were used to identify the factors that modulate stress. Higher perceived stress among informal caregivers was associated with a younger age for the care recipient, family relationship with the care recipient, cohabitation, and female sex of the informal caregiver. These associations were partially mediated by the fear of getting ill (age, cohabitation), the conviction that lockdowns had a negative impact on health (age, kinship), and the perceived deterioration of the care recipient's health (gender). The fear of losing the ability to cope with caregiving tasks due to an illness (COVID-19 and/or other) and the negative impact of the lockdown on care recipients' health, particularly on the mental health of young care recipients, increased the stress of informal caregivers. Our results emphasize the importance of informal caregiving support to prevent heightened stress in lockdown conditions, regardless of care recipient illness or kinship.
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Affiliation(s)
- Shadya Monteiro
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Margot Fournier
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Anne-Laure Drainville
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Léa Plessis
- Aix Marseille Université, LPCPP, Aix-en-Provence, France
| | - Sylvie Freudiger
- AVASAD, Association Vaudoise d'Aide et de Soins à Domicile Route de Chavannes, Lausanne, Lausanne, Switzerland
| | - Krzysztof Skuza
- HESAV, School of Health Sciences, HES-SO University of Applied Sciences Western Switzerland, Switzerland
| | - Charlene Tripalo
- Service de Psychiatrie Générale, Psychiatry Department, CHUV, Lausanne, Switzerland
| | - Nicolas Franck
- Pôle Centre Rive Gauche et Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Centre Hospitalier Le Vinatier, UMR 5229, CNRS, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie-Clotilde Lebas
- Département des Sciences de la Santé Publique et de la Motricité, Haute Ecole de la Province de Namur, Namur, Belgium
| | | | - Hélène Wilquin
- Aix Marseille Université, LPCPP, Aix-en-Provence, France
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Skuza K, Dubois J, Bangerter G. "It's the First Time I Feel as One". Patients' Experience of Therapeutic Body Wraps in Swiss Public Adult Inpatient Psychiatric Wards. Arch Psychiatr Nurs 2017; 31:359-364. [PMID: 28693871 DOI: 10.1016/j.apnu.2017.04.005] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/22/2017] [Accepted: 04/09/2017] [Indexed: 11/30/2022]
Abstract
Many patients suffering from serious mental illness experience severe anxiety, and those with psychosis often report feeling that their bodies are falling apart. Expert opinions reported relational benefits and tranquilizing effects of therapeutic body wraps (TBWs). Yet this adjunct nursing therapy has rarely been studied and the existing knowledge is limited to single clinical cases reported from clinicians' perspectives. This study reports on seven adult patients, whose independent accounts of TBWs were audio-recorded, transcribed and cross-analyzed. It sheds light on a commonly underestimated need among many severely ill psychiatric patients to have their anxiety addressed on a bodily level.
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Affiliation(s)
- Krzysztof Skuza
- HESAV School of Health Sciences, University of Applied Arts and Sciences of Western Switzerland, Av. de Beaumont 21, 1011 Lausanne, Switzerland.
| | - Julie Dubois
- Foundation of Nant Psychiatric Hospital, Corsier-sur-Vevey, Switzerland.
| | - Gilles Bangerter
- HESAV School of Health Sciences, University of Applied Arts and Sciences of Western Switzerland, Av. de Beaumont 21, 1011 Lausanne, Switzerland.
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Opsommer E, Dubois J, Bangerter G, Panchaud R, Martin D, Skuza K. Therapeutic Body Wraps in Swiss public adult acute inpatient wards. A retrospective descriptive cohort study. J Psychiatr Ment Health Nurs 2016; 23:207-16. [PMID: 27126065 DOI: 10.1111/jpm.12304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Accepted: 03/23/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Various expert opinions reported relational benefits and tranquilizing effects of therapeutic body wraps (TBW) in adults experiencing high anxiety in the context of psychosis. Yet, this tranquilizing effect was never investigated in larger samples and in the context of modern psychopharmacology. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to establish descriptive statistics of this mind-body therapy in French-speaking Switzerland where TBWs are routinely used in two public psychiatric hospitals. It brings knowledge on patients nowadays treated with TBW. Moreover, it opens a new area of investigation on the potential of this nursing technique, which may contribute to reduce anxiolytic medication in severely ill patients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study sheds light on a clinical practice in mental health nursing and upon nurses' specific contribution to psychiatric clinic. It investigates a potential for TBWs to reduce the use of anxiolytic medications by patients who agreed to have TBW as part of their treatment. It may help to inform the mental health nursing practice. ABSTRACT Introduction Many patients suffering from serious mental illness experience severe anxiety and those with psychosis often report the feeling of their bodies falling apart. While it is believed that these patients benefit from therapeutic body wraps (TBWs), the use of this adjunct therapy has rarely been studied in adult patients. Aims The aim of this study was to obtain descriptive statistics on the clinical, social-demographic and institutional reality of TBW therapy in Swiss public adult inpatient wards. Methods Retrospective data related to a cohort of 172 adult inpatients were retrieved from records of two public hospitals. Correlations between TBW and the prescriptions of lorazepam were explored. Results TBWs were primarily used for patients diagnosed with either schizophrenia, schizotypal, delusional and other non-mood psychotic disorders or mood disorders. Patients had, on average, four psychiatric hospitalizations, and in 30% of the cases, TBWs were offered during the first hospitalization. Moreover, TBWs were mostly practiced by nurses. Body wraps were potentially associated with a reduction in both anxiolytic and neuroleptic drugs. Discussion/Implication for practice Based on our results, TBW might contribute to the clinical management of anxiety by nurses. The efficacy of TWB regarding anxiety has yet to be investigated in a randomized controlled trial.
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Affiliation(s)
- E Opsommer
- School of Health Sciences, University of Applied Arts and Sciences of Western Switzerland, Lausanne, Switzerland
| | - J Dubois
- Foundation of Nant Psychiatric Hospital, Corsier-sur-Vevey, Switzerland
| | - G Bangerter
- School of Health Sciences, University of Applied Arts and Sciences of Western Switzerland, Lausanne, Switzerland
| | - R Panchaud
- Foundation of Nant Psychiatric Hospital, Corsier-sur-Vevey, Switzerland
| | - D Martin
- School of Health Sciences, University of Applied Arts and Sciences of Western Switzerland, Lausanne, Switzerland
| | - K Skuza
- School of Health Sciences, University of Applied Arts and Sciences of Western Switzerland, Lausanne, Switzerland
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Rapaport R, Sills I, Patel U, Oppenheimer E, Skuza K, Horlick M, Goldstein S, Dimartino J, Saenger P. Thyrotropin-releasing hormone stimulation tests in infants. J Clin Endocrinol Metab 1993; 77:889-94. [PMID: 8408462 DOI: 10.1210/jcem.77.4.8408462] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The TSH response to TRH administration (7 micrograms/kg) was measured in 68 infants (22 premature) who had abnormal thyroid screening tests by the filter paper method and whose serum thyroid function tests were only mildly abnormal. Twenty-eight infants (12 premature) had peak TSH values of 35 mU/L or less and were considered normal (group I). Forty infants (10 premature) had peak TSH values above 35 mU/L and were considered hyperresponsive (group II). The mean age at testing, screening T4, TSH levels that prompted the testing, as well as baseline T4, T3, and free T4 at the time of TRH testing were not different between the groups. The mean (+/- SD) baseline TSH value was greater in group II (6.8 +/- 2.3 mU/L) than in group I (4.4 +/- 2.2 mU/L; P < 0.001). However, there was a great deal of overlap in the individual TSH values (group I, 0.9-10 mU/L; group II, 1.9-10.6 mU/L). Mean peak TSH levels were significantly different in the two groups (group I, 24 +/- 7.7 mU/L; group II, 60.3 +/- 26.1 mU/L; P < 0.001). During long term follow-up, all 25 group I infants available for evaluation have been confirmed as clinically and biochemically normal. No infant diagnosed as normal was later found to have evidence of hypothyroidism. Fourteen infants in group II have had evidence of thyroid dysfunction. We conclude that the TSH response to TRH stimulation is a useful tool for the evaluation of infants suspected of having primary hypothyroidism. Whether hyperresponsiveness to TRH represents a form of neonatal hypothyroidism requiring treatment remains to be determined.
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Affiliation(s)
- R Rapaport
- Division of Pediatric Endocrinology, University of Medicine and Dentistry-New Jersey Medical School, Newark
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Skuza K, Rapaport R, Fieldman R, Goldstein S, Marquis J. Recurrent acute suppurative thyroiditis. J Otolaryngol 1991; 20:126-9. [PMID: 2041062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Recurrent acute left-sided suppurative thyroiditis was observed and treated in an eight-year-old girl. Barium swallow performed after the third episode revealed the presence of a pyriform sinus fistula extending to the upper pole of the left lobe. Despite resection of the fistula, she relapsed for a fourth time. The fistula was again seen on esophagogram. A probe was left inside the tract during subsequent surgery, thus facilitating its complete removal. AST occurs most commonly as a result of the persistence of a connection between the throat and the thyroid gland which is otherwise extremely resistant to infection. AST is usually left-sided and not associated with thyroid dysfunction. Recurrences are common unless the congenital fistula is identified and completely excised.
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Affiliation(s)
- K Skuza
- Department of Pediatrics, University of Medicine and Dentistry of New Jersey Medical School, Newark
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Rapaport R, Oleske J, Ahdieh H, Skuza K, Holland BK, Passannante MR, Denny T. Effects of human growth hormone on immune functions: in vitro studies on cells of normal and growth hormone-deficient children. Life Sci 1987; 41:2319-24. [PMID: 3683079 DOI: 10.1016/0024-3205(87)90545-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We have studied the in vitro effects of human growth hormone on cell surface markers and mitogenic responses of peripheral blood lymphocytes (PBL) of normal and growth hormone-deficient children before, during and after treatment with growth hormone. Growth hormone resulted in a decrease in B cell expression but it did not affect expression of T cell subsets. Growth hormone depressed the proliferation of PBL of normal and untreated growth hormone-deficient children. The proliferative responses to phytohemagglutinin (PHA) versus PHA with growth hormone were not statistically different, though the responses of most normal and on treatment children were diminished by the addition of growth hormone. PBL derived from growth hormone-deficient children during treatment with human growth hormone exhibited significantly greater spontaneous proliferation then the PBL of normal children. Growth hormone further significantly enhanced their proliferation. PHA and PHA with growth hormone resulted in significantly greater proliferation of these patients' PBL when compared to those of normal children. We demonstrated that human growth hormone had substantial in vitro effects on immune functions. These effects, some of which depend on the treatment status of the children, may need to be considered in the clinical use of human growth hormone.
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Affiliation(s)
- R Rapaport
- UMDNJ-New Jersey Medical School, Department of Pediatrics, Newark 07103
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