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Sansweet S, Jindal R, Gupta R. Food allergy issues among consumers: a comprehensive review. Front Nutr 2024; 11:1380056. [PMID: 38595790 PMCID: PMC11002200 DOI: 10.3389/fnut.2024.1380056] [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: 02/01/2024] [Accepted: 02/23/2024] [Indexed: 04/11/2024] Open
Abstract
Food Allergy (FA) is a growing global public health concern. In the United States alone, 8% of children and 11% of adults have a convincing FA (symptoms consistent with an IgE-mediated reaction to a specific allergen). Given the significant prevalence of this condition, the objective of this mini-review is to illustrate the many dimensions of life that are impacted among those with FA. Summarizing findings from a breadth of current literature, we present how FA affects social, psychological, and economic-related quality of life. With this informative review, we endeavor to bring increased awareness to these issues and help cultivate a better future for individuals with FA.
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Affiliation(s)
- Samantha Sansweet
- Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ria Jindal
- Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ruchi Gupta
- Center for Food Allergy and Asthma Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
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Ingrassia JP, Buontempo MG, Alhanshali L, Akoh CC, Glick S, Shapiro J, Lo Sicco K. The financial burden of alopecia: a survey study. Int J Womens Dermatol 2023; 9:e118. [PMID: 37915401 PMCID: PMC10615414 DOI: 10.1097/jw9.0000000000000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Jenne P. Ingrassia
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
- Department of Undergraduate Medical Education, School of Medicine, New York Medical College, Valhalla, New York
| | - Michael G. Buontempo
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
- Department of Dermatology, Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Lina Alhanshali
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
- Department of Undergraduate Medical Education, SUNY Downstate School of Medicine, Brooklyn, New York
| | - Christine C. Akoh
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Sharon Glick
- Department of Undergraduate Medical Education, SUNY Downstate School of Medicine, Brooklyn, New York
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
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Warren CM, Aktas ON, Manalo LJ, Bartell TR, Gupta RS. The epidemiology of multifood allergy in the United States: A population-based study. Ann Allergy Asthma Immunol 2023; 130:637-648.e5. [PMID: 36596337 PMCID: PMC10217773 DOI: 10.1016/j.anai.2022.12.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/01/2022] [Accepted: 12/21/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Immunoglobulin E (IgE)-mediated food allergies (FAs) are increasingly common among US children and adults. Not only can living with FA impose considerable physical health impacts, but it also imposes economic burden and can negatively affect quality of life. Limited data indicate that allergy to multiple foods (multi-FA) also may be common, but much remains unknown about its distribution and determinants. OBJECTIVE To characterize the prevalence, characteristics, determinants, psychosocial burden, and distribution of multi-FA among a large, nationally representative sample of US children and adults. METHODS A US population-based survey was administered. Estimates of multi-FA prevalence, conditional frequencies of multi-FA combinations, and associated factors were derived. Latent class analyses were conducted using 9 dichotomized indicators of specific FA prevalence, which were used to determine factors associated with latent class membership and characterize FA-related psychosocial burden within each class. RESULTS Surveys were completed for 38,408 children and 40,443 adults. Among children and adults meeting established symptom-report criteria for FA, an estimated 40% and 48% had multi-FA, respectively. Among pediatric and adult populations with convincing FAs, the lifetime reported prevalence of physician-diagnosed atopic comorbidities increased significantly as the number of reported current convincing FAs increased, as did the proportion reporting multi-FA-related health care utilization and higher perceived psychosocial burden. Latent class analyses suggested the existence of the following 4 key latent phenotypes of multi-FA: milk and egg-dominant, seafood-dominant, peanut and tree nut-dominant, and broadly multi-food allergic. CONCLUSION The US population-level burden of multi-FA is high among both children and adults, and data indicate the presence of 4 major phenotypes of multi-FA in both populations.
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Affiliation(s)
- Christopher M Warren
- Department of Preventive Medicine and Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Ozge Nur Aktas
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Rockville, Maryland
| | - Lorenzo J Manalo
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Tami R Bartell
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Ruchi S Gupta
- Department of Preventive Medicine and Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Machetanz L, Lau S, Huber D, Kirchebner J. Correlates of Social Isolation in Forensic Psychiatric Patients with Schizophrenia Spectrum Disorders: An Explorative Analysis Using Machine Learning. Int J Environ Res Public Health 2023; 20:4392. [PMID: 36901402 PMCID: PMC10002230 DOI: 10.3390/ijerph20054392] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The detrimental effects of social isolation on physical and mental health are well known. Social isolation is also known to be associated with criminal behavior, thus burdening not only the affected individual but society in general. Forensic psychiatric patients with schizophrenia spectrum disorders (SSD) are at a particularly high risk for lacking social integration and support due to their involvement with the criminal justice system and their severe mental illness. The present study aims to exploratively evaluate factors associated with social isolation in a unique sample of forensic psychiatric patients with SSD using supervised machine learning (ML) in a sample of 370 inpatients. Out of >500 possible predictor variables, 5 emerged as most influential in the ML model: attention disorder, alogia, crime motivated by ego disturbances, total PANSS score, and a history of negative symptoms. With a balanced accuracy of 69% and an AUC of 0.74, the model showed a substantial performance in differentiating between patients with and without social isolation. The findings show that social isolation in forensic psychiatric patients with SSD is mainly influenced by factors related to illness and psychopathology instead of factors related to the committed offences, e.g., the severity of the crime.
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Knoth RL, Gupta S, Perkowski K, Costantino H, Inyart B, Ashka L, Clapp K. Understanding the Association between Red Blood Cell Transfusion Utilization and Humanistic and Economic Burden in Patients with β-Thalassemia from the Patients' Perspective. J Clin Med 2023; 12:jcm12020414. [PMID: 36675342 PMCID: PMC9861260 DOI: 10.3390/jcm12020414] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023] Open
Abstract
We assessed the humanistic and economic burden of chronic red blood cell (RBC) transfusions on patients with β-thalassemia. This cross-sectional, US-based study included adults (≥18 years) who self-reported a β-thalassemia physician diagnosis and had received ≥1 RBC transfusion in the past 6 months. The outcomes included the Functional Assessment of Cancer Therapy-Anemia (FACT-An), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and ad hoc questions about treatment experience, side effects, direct/indirect costs, and psychological burden. Overall, 100 patients completed the survey, of whom 70% experienced "moderate" to "extremely high" burden due to RBC transfusions, 81% reported iron overload, 42% reported compromised social lives. The mean FACT-An score was 132 (higher score indicates better outcomes; 0-188). Mean scores were 33/52 for fatigue and 20/28 for anemia symptoms in the previous 7 days. Health-related quality of life (HRQoL) temporarily improved after RBC transfusion, although patients continued to experience mild-to-severe depression and anxiety, substantial direct costs, compromised employment, and suboptimal quality of life. Over 6 months, patients dedicated a mean of 173 h to transfusion requirements and incurred out-of-pocket costs of USD 2239 for transfusions and USD 896 for additional care costs. These findings highlight the need for new treatment options to improve patient HRQoL and economic outcomes.
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Affiliation(s)
- Russell L Knoth
- Bristol Myers Squibb, 100 Nassau Park Blvd #300, Princeton, NJ 08540, USA
| | - Shaloo Gupta
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Kacper Perkowski
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Halley Costantino
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Brian Inyart
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Lauren Ashka
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
| | - Kelly Clapp
- Cerner Enviza, an Oracle Company, 51 Valley Stream Pkwy, Malvern, PA 19355, USA
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Schuchter T, Mayer K, Glarcher M. Veränderungen in anhaltenden Extremsituationen. Procare 2022; 27:44-48. [PMID: 36712463 PMCID: PMC9875164 DOI: 10.1007/s00735-022-1644-2] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background The Covid-19 virus caused increased challenges for nursing professionals. Objectives This study aims to explore psychosocial stress in the work environment of nursing staff resulting from the pandemic within an Austrian hospital. In addition, differences in the experience between nurses and nursing assistants, in leadership and management positions, as well as between wards with (suspected) Covid-19 positive patients and wards without Covid-19 patients will be recorded. Design and Methods In a mixed-method study, a web-based survey was conducted using the Copenhagen Psychosocial Questionnaire (COPSOQ). The qualitative data was collected with four open questions. The results were analysed descriptively and inferentially with a one-way analysis of variance and the Mann-Whitney-U test. The qualitative data were analysed using content analysis. Results A total of 104 participants completed the survey. The results show that there is a burden on nursing professionals (p = 0.03) within the area of emotional and quantitative demands (p < 0.01), but no differences between the individual nursing groups emerged. Leadership and management positions report less stress than the rest of the nursing staff (p ≤ 0.05). When distinguishing between Covid-19 (suspected) wards and non-Covid-19 wards, two scales (demands for hiding emotions % possibilities for development) were statistically significant (p ≤ 0.04). Conclusion The results of this study illustrate the psychosocial burden of the Covid-19 pandemic on nurses with different characteristics and are in line with current research. Further studies should address the impact of the burden on nursing practice.
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Tomaszewska K, Majchrowicz B, Delong M. Impact of SARS-CoV-2 Pandemic on Psychosocial Burden and Job Satisfaction of Long-Term Care Nurses in Poland. Int J Environ Res Public Health 2022; 19:3555. [PMID: 35329241 DOI: 10.3390/ijerph19063555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 02/05/2023]
Abstract
Psychosocial consequences of the coronavirus pandemic are severe for health care workers due to their higher levels of exposure. Nurses often experience tremendous psychological pressure as a result of their workload in a high-risk environment. The purpose of this study was to determine the impact of the SARS-CoV-2 pandemic on the psychosocial burden and job satisfaction of nurses employed in long-term care. One hundred thirty-eight nurses employed in long-term care participated in the study. The respondents were 96.4% female and 3.6% male. The mean age of the respondents was 53.99 (standard deviation-4.01). The study was conducted between February and June 2021. The research tool was a standardized psychosocial risk scale questionnaire, which is a scientifically validated diagnostic tool with high reliability and accuracy coefficients. The primary tests used during the statistical analyses were non-parametric Mann-Whitney U (for two samples) and Kruskal-Wallis (for more than two samples) tests for assessing differences. During these analyses, in addition to standard statistical significance, appropriate p-values were calculated using the Monte Carlo method. Correlations between ordinal or quantitative variables were made using Spearman's rho coefficient. The results obtained allow us to conclude that the respondents rated the characteristics present in the workplace that constitute psychosocial risks at an average level. Emotional commitment and continuance-type commitment to the respondents' job position were also at a medium level. Respondents' self-rated ability to work for nurses employed in long-term care during the SARS-CoV-2 pandemic and commitment to patient care was high at 4.0 and 4.18, with a maximum of 5 points.
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Pertz M, Schlegel U, Thoma P. Sociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors. Cancers (Basel) 2022; 14:cancers14030767. [PMID: 35159034 PMCID: PMC8833643 DOI: 10.3390/cancers14030767] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/24/2022] [Accepted: 01/31/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary After years of gauging the efficacy of tumor-directed therapies primarily by means of survival, a broader perspective on therapeutic outcome also focusses on patients’ everyday functional abilities. Besides neurocognition, a matter of high clinical relevance, “social cognition” may also affect well-being and quality of life (QoL) in brain tumor patients. Abilities that enable individuals to establish and maintain social relationships are summarized under the umbrella term “sociocognitive functioning”. These abilities encompass the understanding and sharing of emotional and mental states of other individuals as well as skills to detect and resolve interpersonal problems. These sociocognitive abilities may be challenged in highly demanding life situations such as brain tumor diagnosis and treatment. Therefore, we summarize the literature on psychosocial burden and sociocognitive functioning in adult brain tumor patients. Abstract Brain tumors may represent devastating diseases and neuro-oncological research in the past solely focused on development of better treatments to achieve disease control. The efficacy of tumor-directed treatment was evaluated by progression-free and overall survival. However, as neuro-oncological treatment became more effective, preservation and improvement of quality of life (QoL) was noticed to represent an important additional outcome measure. The need to balance between aggressive tumor-directed treatment and preservation of QoL was increasingly acknowledged in brain tumor patients. QoL is comprised by many determinants; one of those may have been rather neglected so far: social cognition. Since diagnosis and treatment of brain tumors represent demanding life situations, patients may experience increased psychosocial burden and the negative consequences of illness on well-being may be buffered by intact social relationships. These skills to build and maintain supportive social relationships essentially depend on the ability to empathize with others and to recognize and appropriately address social conflicts, i.e., “sociocognitive functioning”. Therefore, sociocognitive functions may influence QoL and treatment outcome. In this article, we review the literature on psychosocial burden and sociocognitive functioning in adult brain tumor patients.
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Affiliation(s)
- Milena Pertz
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, In der Schornau 23–25, D-44892 Bochum, Germany;
- Correspondence:
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, In der Schornau 23–25, D-44892 Bochum, Germany;
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Universitätsstraße 150, D-44780 Bochum, Germany;
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von Stülpnagel CC, Augustin M, da Silva N, Schmidt L, Nippel G, Sommer R. Exploring the burden of xerosis cutis and the impact of dermatological skin care from patient's perspective. J DERMATOL TREAT 2021; 33:2482-2487. [PMID: 34547964 DOI: 10.1080/09546634.2021.1970704] [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: 10/20/2022]
Abstract
BACKGROUND Xerosis cutis is recognized as a burdensome and stressful condition of the skin, resulting in impaired health-related quality of life (HRQoL). Therefore, it should be treated as a relevant skin disease with detailed care and treatment recommendations. METHODS This cross-sectional, exploratory study aimed to examine xerosis cutis-related burden from patient's perspective and compare it with individuals without xerosis cutis. Within-group comparisons were also performed among patients with xerosis cutis associated with atopic dermatitis (AD) or not. The second aim was to assess the effect of a routinely applied basic skin care therapy in terms of burden release. RESULTS Overall, 127 participants were included in the study. Patients with xerosis cutis reported a lower quality of life (p = .041), more dysmorphic concerns (p < .001), and higher general anxiety (p = .029) than individuals without xerosis cutis. The presence of AD was associated with lower HRQoL (p = .023), more depression (p = .008) and anxiety symptoms (p = .003), and more stigmatization experiences at baseline (p < .001). CONCLUSION Patients with xerosis cutis showed higher psychosocial burden than participants without xerosis cutis. Additionally, patients with xerosis and AD had more psychosocial impairments than patients with xerosis without AD.
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Affiliation(s)
- Catharina C von Stülpnagel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Neuza da Silva
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Koch M, Gräfenstein L, Karnosky J, Schulz C, Koller M. Psychosocial Burden and Quality of Life of Lung Cancer Patients: Results of the EORTC QLQ-C30/QLQ-LC29 Questionnaire and Hornheide Screening Instrument. Cancer Manag Res 2021; 13:6191-6197. [PMID: 34393512 PMCID: PMC8357622 DOI: 10.2147/cmar.s314310] [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: 04/05/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022] Open
Abstract
Background Overall survival is the ultimate criterion for the therapy of lung cancer, but psychosocial care, which helps the patient to cope with the disease, becomes a more and more important issue in the treatment of this life-threatening disease. Methods We report the satellite project within a prospective, international, cross-cultural, multicenter study to validate the EORTC QLQ-LC29, a new designed module to assess the quality of life of lung cancer patients. The participants filled in the EORTC QLQ-C30, the recently updated lung cancer module QLQ-LC29 and the Hornheide questionnaire (HSI). Results A total of 81 patients (32 female and 49 male, mean age 65.2 years, SD = 9.7) were enrolled in this study by completing the questionnaires. Fatigue (mean 55.4, SD = 26.3) and dyspnea (mean 46.3, SD = 36.2) were the most prominent symptoms. Thirty-nine patients (48.1%) according to the HSI needed psychosocial support. When using the EORTC questionnaires as screening instrument with 50 as cut-off in contrast only 29.5% of our patients needed psychosocial support. The need for psychosocial support according to the HSI correlated most with the EORTC scales “fatigue” (38.3% overlap between the two questionnaires), “existential fear” (38.3% overlap between the two questionnaires) and worse “global quality of life” (27.2% overlap between the two questionnaires). Conclusion If psychosocial distress is at the core, the HSI is a suitable instrument for quick screening. The EORTC measures help to specify impaired quality of life areas and also cover somatic symptoms that are specific for cancer patients. Once psychosocial distress has been ascertained, clinicians should be particularly aware of specific problems regarding “fatigue”, “existential fear” and diminished “global quality of life”. Trial Registration clinicaltrials.gov, reference number NCT02745691. Registered 20 April 2016.
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Affiliation(s)
- Myriam Koch
- Department of Internal Medicine 2, University Hospital Regensburg, Regensburg, Germany
| | - Laura Gräfenstein
- Center for Clinical Studies University Hospital Regensburg, Regensburg, Germany.,Hospital Wörth an der Donau, Germany
| | - Julia Karnosky
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Christian Schulz
- Department of Internal Medicine 2, University Hospital Regensburg, Regensburg, Germany
| | - Michael Koller
- Center for Clinical Studies University Hospital Regensburg, Regensburg, Germany
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Akoglu G, Yildiz I, Karaismailoğlu E, Esme P. Disease severity and poor mental health are the main predictors of stigmatization in patients with hidradenitis suppurativa. Dermatol Ther 2021; 34:e14910. [PMID: 33619860 DOI: 10.1111/dth.14910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/27/2020] [Revised: 02/06/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022]
Abstract
Hidradenitis suppurativa (HS) causes significant psychological distress in patients. We aimed to investigate the stigmatization level of HS patients and to determine the related physical, social, and psychological factors. A questionnaire with 22 questions about the physical and psychosocial problems related to HS was administered to 29 male and 34 female patients between the ages of 18 and 66 to evaluate the thoughts, emotions, attitudes, and behaviors of patients. Each patient filled Dermatology Life Quality Index, Beck Depression Inventory, Liebowitz Social Anxiety Scale, Body Image Scale, and 6-item Stigmatization Scale. Hurley classification was used to assess severity of disease. Patients with HS feel stigmatized depending on physical and psychosocial problems caused by the disease. Higher stigmatization scores correlated with higher scores of depression (r: .437, P < .001), social anxiety (r: .263, P: .03), and worse life quality (r: .522, P < .001), and body image perception (r: .696, P < .001). The degree of stigmatization was closely associated with the presence of painful lesions and disruption of socializing (P: .021 and .033, respectively). Disease severity (β: 5.12, P: .003 for moderate disease) and reporting feeling psychologically negatively affected due to HS (β: 4.26 P: .007) were the two main predictors of stigmatization in patients with HS. Cross-sectional nature of the study is the limitation. In conclusion, the stigmatization level of patients with HS is strongly related to disease severity and poor mental health.
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Affiliation(s)
- Gulsen Akoglu
- Department of Dermatology and Venereology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Irem Yildiz
- Faculty of Medicine, Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - Eda Karaismailoğlu
- Department of Medical Informatics, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Pelin Esme
- Department of Dermatology and Venereology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
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Özkesici Kurt B, İnan Doğan E, Özdemir M, Alpsoy E. Internalized stigma: One of the main factors responsible for the psychosocial burden of melasma? J Cosmet Dermatol 2020; 20:1182-1187. [PMID: 32981229 DOI: 10.1111/jocd.13697] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Internalized stigma is the acceptance of negative stereotypes about the disease created by society and withdrawing self from society with emotions such as worthlessness and shame. AIMS This study aimed to investigate the internalized stigma state of patients with melasma, and to identify the factors affecting the internalized stigma. METHODS A total of 55 melasma patients were included. The sociodemographic and clinical characteristics of the patients were recorded. Melasma Severity Index, the Turkish version of the Melasma Quality of Life Scale (MelasQoL-TR), and Internalized Stigma Scale (ISS) were used. Besides, patients answered the Perceived Health Status (PHS) and the General Health Questionnaire 12 scales (GHQ-12) surveys. RESULTS The mean ISS total score was found as 49.49 ± 13.15. Cronbach's alpha coefficient for the whole scale was calculated as 0.92 for melasma patients. There was a significant correlation between the ISS total score and MelasQoL-TR (r = 0.608, P < .001). Besides, statistically significant positive correlations were also found between the overall scores of ISS and GHQ-12 (r = 0.578, P < .001). Linear regression analysis revealed that the most important determinant of internalized stigma was MelasQoL-TR (β = 0.313, P < .001). CONCLUSIONS This study demonstrates that patients with melasma internalize the negative stereotype judgments of the society about the disease. High levels of internalized stigma are related to poor quality of life and psychological illnesses. Therefore, internalized stigma may be one of the main factors responsible for the psychosocial burden of melasma.
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Affiliation(s)
- Birgül Özkesici Kurt
- Clinic of Dermatology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | - Esra İnan Doğan
- Department of Dermatology and Venereology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
| | - Mikail Özdemir
- Osmaniye Community Health Center, Tuberculosis Dispensary, Osmaniye, Turkey
| | - Erkan Alpsoy
- Department of Dermatology and Venereolaogy, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Doser K, Andersen EW, Kenborg L, Dalton SO, Jepsen JRM, Krøyer A, Østergaard J, Hove H, Sørensen SA, Johansen C, Mulvihill J, Winther JF, Bidstrup PE. Clinical characteristics and quality of life, depression, and anxiety in adults with neurofibromatosis type 1: A nationwide study. Am J Med Genet A 2020; 182:1704-1715. [PMID: 32484306 DOI: 10.1002/ajmg.a.61627] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 10/31/2019] [Revised: 03/20/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
Neurofibromatosis type 1 (NF1) is a genetic condition characterized by numerous somatic manifestations. The psychosocial burden in adults has rarely been studied. We examined the prevalence of self-reported impairment of quality of life (QoL), symptoms of anxiety and depression and need for support, associated with disease severity and visibility. We conducted a nationwide cross-sectional study of all 467 adults with NF1 diagnosed between 1977 and 2016 at one of the two national centers for rare diseases in Denmark. A total of 244 (56% response rate) completed a questionnaire that included standard measures of QoL, symptoms of depression and anxiety, indicators of disease-related severity, visibility, and need for professional support. Associations between disease severity and visibility and psychosocial burden were analyzed in descriptive and multivariate models. We observed impaired QoL (mean = 81.3; 95% CI, 76.2; 86.4); 19% reported symptoms of depression (mean = 5.7; SD = 5.4), and 15% reported anxiety (mean = 5.1; SD = 5.2) at a clinical level. Adults with NF1 also reported requiring professional support for physical, psychological, and work-related problems. Disease severity and (partly) visibility were significantly (p < .0001) associated with psychosocial well-being and a requirement for support. This study provides new understanding of the factors associated with impaired QoL, indicating that follow-up care should be optimized into adult life.
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Affiliation(s)
- Karoline Doser
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Line Kenborg
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research and Center for Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services Capital Region Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Anja Krøyer
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - John Østergaard
- Center for Rare Disease, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Hove
- The RAREDIS Database, Center for Rare Diseases, Copenhagen University Hospital and Aarhus University, Copenhagen, Denmark
| | - Sven Asger Sørensen
- Department of Neurogenetics, Institute of Cellular and Molecular Medicine, The Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Christoffer Johansen
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Oncology Clinic, Finsen Center, Copenhagen, Denmark
| | - John Mulvihill
- Department of Pediatrics, University of Oklahoma, Norman, Oklahoma, USA
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Faculty of Health, Department of Clinical Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Knebel C, Menzemer J, Pohlig F, Herschbach P, Burgkart R, Obermeier A, von Eisenhart-Rothe R, Mühlhofer HML. Peri-Prosthetic Joint Infection of the Knee Causes High Levels of Psychosocial Distress: A Prospective Cohort Study. Surg Infect (Larchmt) 2020; 21:877-883. [PMID: 32282286 DOI: 10.1089/sur.2019.368] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 12/18/2022] Open
Abstract
Background: Peri-prosthetic joint infection (PJI) is a major complication of knee arthroplasty that can cause long-term disability. In addition to its physical impact, there is a clear psychological burden that has not been measured yet. We hypothesized that the psychosocial burden of PJI can be assessed quantitatively using standardized questionnaires and may be correlated with treatment stage. Methods: Thirty-one patients were enrolled in this longitudinal prospective cohort study from August 2015 to November 2016. Participants had clinically established knee PJI after primary total knee replacement in osteoarthritis according to the Musculoskeletal Infection Society criteria and underwent a standardized two-stage protocol. After explantation of the prosthesis and implantation of a polymethylmethacrylate knee spacer, patients were treated with organism-specific intravenous antibiotics for two weeks, followed by oral antibiotics for four weeks; and then reimplantation was performed in all cases. Psychometrically validated standardized questionnaires were used to measure psychosocial stress via self-assessment at four time points: (1) Before explantation of the prosthesis; (2) after explantation; (3) after the antibiotic treatment before reimplantation; and (4) three months after reimplantation (follow-up). The Patient Health Questionnaire (PHQ)-4, Short Form (SF)-12 (including PSK and KSK), Questions about Life Satisfaction (FLZM) and Fear of Progression (PA-F-KF) (titles and abbreviations in German) scores were interpreted according to cut-off values for depression, fear of progression, anxiety, and quality of life. Results: Eighteen patients (58.1%) showed a PHQ-4 score above the cut-off value for depression at least once, with the highest score before reimplantation (time point 3). On the SF-12, the mean subtest mental scale (PSK) score was 42.6 (± 14.5), and the mean subtest physical scale (KSK) score was 26.9 (± 7.5) over the four time points, which was significantly lower than that of the general German population (PSK 53.1, KSK 44.0; p < 0.05). The SF-12 scores did not change significantly over time. On the FLZ, health was least satisfactory, followed by recreational activities and work. On the PA-F-KF, patients had the greatest fear of being dependent on outside help, drastic medical interventions, and infection progression. The mean PA-F-KF value was 31.24 (± 9.60; values ≥34 are regarded as critical). Conclusion: Peri-prosthetic joint infection is a measurable, relevant psychosocial stressor for patients. Their quality of life and fear of the disease progressing are comparable to those of oncology patients. Routine screening should be conducted to identify affected patients early for appropriate treatment, improving long-term outcomes. Orthopaedic surgeons who treat patients with PJI should initiate by psychologists as well in order to maintain the patient's long-term quality of life.
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Affiliation(s)
- Carolin Knebel
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Jennifer Menzemer
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Florian Pohlig
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Peter Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Comprehensive Cancer Center Munich, Munich
| | - Rainer Burgkart
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Andreas Obermeier
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Rüdiger von Eisenhart-Rothe
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
| | - Heinrich M L Mühlhofer
- Klinikum rechts der Isar, Clinic for Orthopaedic and Sportorthopaedic, Technical University of Munich, School of Medicine, Munich, Germany
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Abstract
Midwives and Nurses in Early Childhood Intervention: The Benefit of Additional Qualification Abstract. BACKGROUND Early childhood interventions are locally and regionally organized support services for families from pregnancy until the end of the third year of life. The interventions promote diverse measures to enhance parental skills in order to improve developmental and living circumstances. Midwives and nurses with additional qualification support burdened families in early childhood intervention. METHOD Within a retrospective survey (standardized interviews, CAPI) mothers' (N = 298) perspective of the benefit of the home visiting support is assessed. Data from two groups were compared: (1) mothers in the care of a midwife or nurse with additional qualification (GruppeGFK + Quali) and (2) mothers cared for by a midwife or nurse without additional qualification (GruppeGFK). RESULTS (1) Families with weighted levels of psychosocial burdens reported an enhanced need for help. (2) Midwives and nurses with additional qualification support more frequently families with high levels of psychosocial burdens. (3) Mothers with care of midwives and nurses with additional qualification reported this support as more useful in relation to every day demands than mothers with regular care after birth (questionnaire for evaluation of the received support: GruppeGFK + Quali: mean = 2.57; GruppeGFK : mean = 1.97; t (121) = 2.799, p = .003). CONCLUSION The study complements results of national and international studies showing that families with high levels of psychosocial burdens accept home visiting support. Furthermore, this support seems to be useful. An increase of the offer and the additional qualification is recommended for improving the developmental and living conditions of families with psychosocial burdens.
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Affiliation(s)
- Sara Scharmanski
- 1 Nationales Zentrum Frühe Hilfen (NZFH), 7-1Bundeszentrale für gesundheitliche Aufklärung (BZgA), Köln
| | - Ilona Renner
- 1 Nationales Zentrum Frühe Hilfen (NZFH), 7-1Bundeszentrale für gesundheitliche Aufklärung (BZgA), Köln
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Marron SE, Tomas-Aragones L, Navarro-Lopez J, Gieler U, Kupfer J, Dalgard FJ, Lien L, Finlay AY, Poot F, Linder D, Szepietowski JC, Misery L, Jemec GBE, Romanov D, Sampogna F, Szabo C, Altunay IK, Spillekom-van Koulil S, Balieva F, Ali FM, Halvorsen JA, Marijuan PC. The psychosocial burden of hand eczema: Data from a European dermatological multicentre study. Contact Dermatitis 2018; 78:406-412. [PMID: 29464713 DOI: 10.1111/cod.12973] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 03/14/2017] [Revised: 12/31/2017] [Accepted: 01/03/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema. OBJECTIVES The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities. MATERIALS AND METHODS Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema. RESULTS Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P = .02), and for depression (median = 4.0) than controls (3.0, P < .001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P = .038, P < .001, and P < .001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68). DISCUSSION This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.
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Affiliation(s)
- Servando E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | - Lucia Tomas-Aragones
- Department of Psychology, University of Zaragoza, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | - Jorge Navarro-Lopez
- Bioinformation Group, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | - Uwe Gieler
- Department of Dermatology, Justus Liebig University, Giessen, Germany
| | - Jörg Kupfer
- Institute of Medical Psychology, Justus Liebig University, Giessen, Germany
| | - Florence J Dalgard
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Andrew Y Finlay
- Department of Dermatology and Wound Healing, Cardiff University School of Medicine, Cardiff, UK
| | - Françoise Poot
- Department of Dermatology, ULB Hospital ERASME, Brussels, Belgium
| | - Dennis Linder
- Section of Biostatistics, University of Oslo, Oslo, Norway
| | | | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Dmitry Romanov
- Department of Psychiatry and Psychosomatics, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, Rome, Italy
| | - Csanad Szabo
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Ilknur K Altunay
- Department of Dermatology, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey
| | | | - Flora Balieva
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
| | - Faraz M Ali
- Department of Dermatology and Wound Healing, Cardiff University School of Medicine, Cardiff, UK
| | - Jon A Halvorsen
- Department of Dermatology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pedro C Marijuan
- Bioinformation Group, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
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Grassi L, Mezzich JE, Nanni MG, Riba MB, Sabato S, Caruso R. A person-centred approach in medicine to reduce the psychosocial and existential burden of chronic and life-threatening medical illness. Int Rev Psychiatry 2017; 29:377-388. [PMID: 28783462 DOI: 10.1080/09540261.2017.1294558] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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] [Indexed: 12/20/2022]
Abstract
The psychiatric, psychosocial, and existential/spiritual pain determined by chronic medical disorders, especially if in advanced stages, have been repeatedly underlined. The right to approach patients as persons, rather than symptoms of organs to be repaired, has also been reported, from Paul Tournier to Karl Jaspers, in opposition and contrast with the technically-enhanced evidence-based domain of sciences that have reduced the patients to 'objects' and weakened the physician's identity deprived of its ethical value of meeting, listening, and treating subjects. The paper will discuss the main psychosocial and existential burden related to chronic and advanced medical illnesses, and the diagnostic and therapeutic implications for a dignity preserving care within a person-centred approach in medicine, examined in terms of care of the person (of the person's whole health), for the person (for the fulfilment of the person's health aspirations), by the person (with physicians extending themselves as total human beings), and with the person (working respectfully with the medically ill person).
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Affiliation(s)
- Luigi Grassi
- a Department of Biomedical and Specialty Surgical Sciences, School of Medicine , Institute of Psychiatry, University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care Integrated Department of Mental Health and Addictive Behavior , University Hospital and Health Authorities , Ferrara , Italy
| | - Juan E Mezzich
- c Icahn School of Medicine at Mount Sinai, International College of Person-Centered Medicine , New York City , NY , USA
| | - Maria Giulia Nanni
- a Department of Biomedical and Specialty Surgical Sciences, School of Medicine , Institute of Psychiatry, University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care Integrated Department of Mental Health and Addictive Behavior , University Hospital and Health Authorities , Ferrara , Italy
| | - Michelle B Riba
- d Integrated Medical and Psychiatric Services Department of Psychiatry , University of Michigan Comprehensive Depression Center , Ann Arbor , MI , USA.,e PsychOncology Program, University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA
| | - Silvana Sabato
- a Department of Biomedical and Specialty Surgical Sciences, School of Medicine , Institute of Psychiatry, University of Ferrara , Ferrara , Italy
| | - Rosangela Caruso
- a Department of Biomedical and Specialty Surgical Sciences, School of Medicine , Institute of Psychiatry, University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care Integrated Department of Mental Health and Addictive Behavior , University Hospital and Health Authorities , Ferrara , Italy
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18
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Buchhold B, Wiesmann U, Bahlmann J, Lutze S, Eggert C, Arnold A, Daeschlein G, Jünger M, Hannich HJ. Psychosocial burden and desire for support in outpatients with skin cancer. J Dtsch Dermatol Ges 2016; 14:405-15. [PMID: 27027752 DOI: 10.1111/ddg.12767] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND An important basis for adequate psycho-oncological and psychosocial care of cancer patients is the regular assessment of their psychosocial distress and thus their need for care. For this purpose, there are numerous questionnaires available. The objective of the present study was to assess whether distressed patients require professional support and which screening instrument outpatients with skin cancer prefer. PATIENTS AND METHODS In a cross-sectional survey, we asked outpatients with skin cancer to fill out three questionnaires assessing psychosocial stress, and to indicate which one they considered most adequate. Patients were offered the following three instruments: Hornheide Questionnaire (27 items), Hornheide Screening Instrument (7 items), and the Distress Thermometer. In addition, we inquired about the patients' desire for support. RESULTS (1) Comparing subjective distress and patients' declared desire for support revealed a marked divergence. While one-third of the 137 patients were identified as being in need of care, only 11.5% of the sample requested such support. (2) 63.7% of patients chose the long version of the Hornheide Questionnaire. CONCLUSIONS In addition to their psychosocial burden, patients' desire for support should be assessed. Moreover, apart from screening tools, other ways to provide access to psychosocial care should be considered.
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Affiliation(s)
- Britta Buchhold
- Institute for Medical Psychology, Greifswald University Hospital, Greifswald, Germany
| | - Ulrich Wiesmann
- Institute for Medical Psychology, Greifswald University Hospital, Greifswald, Germany
| | - Johannes Bahlmann
- Department of Psychiatry and Psychotherapy, Greifswald University Hospital, Greifswald, Germany.,HELIOS Hanse Hospital Stralsund, Stralsund, Germany
| | - Stine Lutze
- Department of Dermatology, Greifswald University Hospital, Greifswald, Germany
| | - Claudia Eggert
- Department of Dermatology, Greifswald University Hospital, Greifswald, Germany
| | - Andreas Arnold
- Department of Dermatology, Greifswald University Hospital, Greifswald, Germany
| | - Georg Daeschlein
- Department of Dermatology, Greifswald University Hospital, Greifswald, Germany
| | - Michael Jünger
- Department of Dermatology, Greifswald University Hospital, Greifswald, Germany
| | - Hans-Joachim Hannich
- Institute for Medical Psychology, Greifswald University Hospital, Greifswald, Germany
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Barnard K, Crabtree V, Adolfsson P, Davies M, Kerr D, Kraus A, Gianferante D, Bevilacqua E, Serbedzija G. Impact of Type 1 Diabetes Technology on Family Members/Significant Others of People With Diabetes. J Diabetes Sci Technol 2016; 10:824-30. [PMID: 27118728 PMCID: PMC4928241 DOI: 10.1177/1932296816645365] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim was to explore the impact of diabetes-related technology to ensure that such devices are used in a way that returns maximum benefit from a medical and psychological perspective. METHOD Spouses and caregivers of people with type 1 diabetes were invited to complete an online questionnaire about their experiences with diabetes technologies used by their family members. Participants were recruited via the Glu online community website. Questions explored impact on daily living, frequency and severity of hypoglycemia, and diabetes-related distress. RESULTS In all, 100 parents/caregivers and 74 partners participated in this survey. Average (mean) duration of living with a person with type 1 diabetes was 16 years (SD = 13) for partners, with duration of diabetes for children being 4.2 ± 3.2 years. Average duration of current therapy was 8.3 ± 7.3 years for adults and 3.4 ± 2.9 years for children. Of the participants, 86% partners and 82% parents/caregivers reported diabetes technology had made it easier for their family members to achieve blood glucose targets. Compared to partners, parents/caregivers reported more negative emotions (P < .001) and decreased well-being (P < .001) related to their family members type 1 diabetes. Diabetes-related distress was common, as was sleep disturbance associated with device alarms and fear of hypoglycemia. Reduced frequency and severity of hypoglycemia related to device use was reported by approximately half of participants. CONCLUSION There is little doubt about the medical benefit of diabetes technologies and their uptake is increasing but some downsides were reported. Barriers to uptake of technologies lie beyond the mechanics of diabetes management. Supporting users in using diabetes technology to achieve the best possible glycemic control, in the context of their own life, is crucial. Furthermore, understanding these issues with input from the type 1 diabetes community including family members and caregivers will help innovation and design of new technology.
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Affiliation(s)
- Katharine Barnard
- Faculty of Health & Social Science, Bournemouth University, Bournemouth, UK
| | | | - Peter Adolfsson
- Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Hospital of Halland, Kungsbacka, Sweden
| | | | - David Kerr
- William Sansum Diabetes Center, Santa Barbara, CA, USA
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Bugaj TJ, Mücksch C, Schmid C, Junne F, Erschens R, Herzog W, Nikendei C. Peer-led Stress Prevention Seminars in the First Year of Medical School--A Project Report. GMS J Med Educ 2016; 33:Doc3. [PMID: 26958651 PMCID: PMC4766929 DOI: 10.3205/zma001002] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 11/17/2015] [Accepted: 11/25/2015] [Indexed: 05/13/2023]
Abstract
INTRODUCTION From the beginning of the first year of medical studies, increased psychological stress and elevated burnout prevalence rates can be registered compared to sample populations. Characterized by learning "on an equal footing", the principle of peer-assisted learning (PAL) is widely used in medical education. This report aims to showcase the development and evaluation of peer-led stress prevention seminars for first year medical students after one year of implementation. PROJECT DESCRIPTION With each of the three sessions lasting 90 min., the stress prevention seminars took place in small groups (6-10 students) in the period from November 2013 to January 2014 and from November 2014 to December 2014 at the Medical Faculty of Heidelberg. Led by trained peers, the seminar content ranged from psycho-educational elements, i.e. time management strategy development and test anxiety assistance, to relaxation techniques. All seminar sessions were evaluated via questionnaire. All questions were answered on a Likert scale ranging from 1 to 7 (1=strongly agree; 7=strongly disagree). RESULTS 75 students consented to participate in seminars (65% female; aged 20.5±3.3 years). The series of seminars was averagely given the school grade of 1.2±0.4 (1=very good to 6=unsatisfactory) in WS 2013/14 and 1.5±0.5 in the following year and the peer tutors' competence was evaluated as very high (1.4 to 1.5 approval rate on the Likert scale). DISCUSSION The seminar sessions' importance to the students is underlined by their very positive evaluations. This offer seems to have benefited students especially during the demanding transitional phase at the start of their studies. Both the implementation of the preventive measure at an early stage as well as the use of PAL seem to have proven effective. CONCLUSION PAL seems to be effective in the field of stress prevention. However, specific efficacy studies are still lacking.
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Affiliation(s)
- Till Johannes Bugaj
- University Hospital of Heidelberg, Department of General Internal and Psychosomatic Medicine, Heidelberg, Germany
| | - Christine Mücksch
- University Hospital of Heidelberg, Department of General Internal and Psychosomatic Medicine, Heidelberg, Germany
| | - Carolin Schmid
- University Hospital of Heidelberg, Department of General Internal and Psychosomatic Medicine, Heidelberg, Germany
| | - Florian Junne
- University Hospital of Tübingen, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Rebecca Erschens
- University Hospital of Tübingen, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Wolfgang Herzog
- University Hospital of Heidelberg, Department of General Internal and Psychosomatic Medicine, Heidelberg, Germany
| | - Christoph Nikendei
- University Hospital of Heidelberg, Department of General Internal and Psychosomatic Medicine, Heidelberg, Germany
- *To whom correspondence should be addressed: Christoph Nikendei, University Hospital of Heidelberg, Department of General Internal and Psychosomatic Medicine, Thibautstraße 2, D-69115 Heidelberg, Germany, Phone: +49 (0)6221/56-3-8663, Fax: +49 (0)6221/56-5749, E-mail:
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21
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Cohen JS, Levy HP, Sloan J, Dariotis J, Biesecker BB. Depression among adults with neurofibromatosis type 1: prevalence and impact on quality of life. Clin Genet 2015; 88:425-30. [PMID: 25534182 DOI: 10.1111/cge.12551] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [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: 09/29/2014] [Revised: 11/17/2014] [Accepted: 12/10/2014] [Indexed: 11/28/2022]
Abstract
Neurofibromatosis type 1 (NF1) carries a significant psychosocial burden for affected individuals. The objective of this study was to measure the prevalence of depressive symptoms among a large sample of adults with NF1 and to quantify the impact of depressive symptoms on quality of life (QoL). This cross-sectional study used an Internet-based questionnaire to collect data from 498 adults who self-reported as having NF1. Using the Center for Epidemiologic Studies Depression (CESD) scale, 55% of all participants (61% of females and 43% of males) scored above 16, indicating a high likelihood of clinical depression. In a multivariate regression model controlling for demographics and potential confounders, depressive symptoms accounted for 32% of the variance in QoL as measured by the Quality of Life Index. This study is the largest to date and found the highest prevalence of depression compared to prior studies. Our data provide more compelling evidence that individuals with NF1 are at increased risk for psychiatric morbidity and suggest that this population should be routinely screened for depression. Because depression was found to be strongly associated with QoL and accounted for nearly one-third of the variance in QoL, it is likely that effectively treating depression may significantly enhance QoL for individuals with NF1.
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Affiliation(s)
- J S Cohen
- Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA
| | - H P Levy
- McKusick Nathans Institute of Genetic Medicine and Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Sloan
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Dariotis
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, MD, USA
| | - B B Biesecker
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
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22
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Abstract
AIM To assess the psychosocial burden and quality of life in parents of children with anorectal malformation. SUBJECTS AND METHODS This is a prospective study conducted in a tertiary care specialty hospital. Sample consisted of 50 parents (care givers), having children with anorectal malformation in the age group of 0-14 years. Data were collected through a semi structured interview with the care givers, using Zarit Burden Interview for assessing extent of burden and WHOQOL-BREF for assessing different aspects of quality of life. STATISTICAL ANALYSIS USED frequencies, percentages, mean and standard deviations were calculated for analyzing the data. RESULTS The study reveals greater psychosocial burden and poor quality of life, in terms of the psychological and environmental aspects as compared to the physical and social aspects, among the care givers. CONCLUSIONS The study found increased psychosocial burden and negative impact on the quality of life of parents, which varies with the stages of management and proper continuous counseling is recommended.
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Affiliation(s)
- Gavneet K Pruthi
- Departments of Clinical Psychology and Pediatric Surgery, Chacha Nehru Bal Chikitsalaya (affiliated to Maulana Azad Medical College), Geeta Colony, Delhi-110031, India
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