Coexistence Of Illness Research Articles

Embodiment-based self-management for Israeli breast cancer survivors after mind-body therapy

Objective As advances in breast cancer treatment have bolstered survival rates, post-treatment self-management has become crucial for survivors’ well-being. Methods In the current qualitative research, conducted via content and form analysis of 12 in-depth interviews, the authors explored self-management strategies in the narratives of female breast cancer survivors who underwent mind-body therapy. Results Three coping models emerged: (1) an illness-focused story overshadowing the body, (2) a coexistence of illness and body stories, and (3) an embodied illness-story. These self-management models showcase a developmental sequence, reflecting the evolution of coping mechanisms. Conclusion The study underscores embodiment’s significance in fostering agency and well-being, particularly in a societal and medical context where body attention tends to be marginalized.

Functional somatic illnesses in patients with functional bowel disorders. A cross-sectional cohort study in western Saudi Arabia.

Objectives:To study the prevalence of functional gastrointestinal disorders (FGID) in Saudi patients with irritable bowel syndrome (IBS).Methods:A cross-sectional study was conducted in patients with IBS treated at a private tertiary medical center in western Saudi Arabia between 2013 and 2017. We used ROME 3 criteria with data from the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9) depression scale, and International Classification of Headache Disorders (ICHD) to assess the prevalence of psychosomatic illness. Statistical analysis of frequency and statistical correlation was performed using Chi-square.Results:The final analysis of 307 patients revealed a combined 425 diagnoses of psychosomatic illness, including diagnoses of headache in 104 patients (34%), migraine in 93 patients (30.5%), fibromyalgia in 169 patients (55%), and depression in 59 patients (19%). There was a statistically significant correlation between patients’ ages and diagnoses of joint pain and migraines.Conclusion:Fibromyalgia and headache disorders were common in this cohort of Saudi patients with IBS. This coexistence of illness is partly explained by the functional nature of these illnesses. Collective efforts to provide multidisciplinary care is needed for these patients.

Utility of Indian adaptation of Integrated Management of Childhood Illness (IMCI) algorithm

To evaluate the utility of Indian adaptation of IMCI algorithm. Children presenting to outpatient department (n=169) or casualty (n=140) among 309 cases were assessed and classified as per IMCI algorithm, the final diagnosis made after detailed evaluation and relevant investigations, served as the gold standard. The diagnostic and therapeutic agreements between the gold standard, IMCI and vertical (on the basis of primary presenting complaint) algorithms were computed. Coexistence of illness was observed in 75% of children as per IMCI algorithm. The mean (SD) number of morbidities as per the Gold standard and IMCI were 1.75 +/- 0.75 and 2.19 +/- 0.96 respectively. The referral criteria proved useful in predicting hospitalisation with high sensitivity and specificity (99.3% & 97.3%). IMCI algorithm covered majority of recorded illnesses. A total agreement with IMCI was found in 88.4% cases, while total disagreement was seen in 34.5% cases. Corresponding figures for vertical program were 88% and 18.6%. The difference was primarily due to underdiagnosis. The diagnostic discordance of IMCI and gold standard was evident for the cough category due to underdiagnosis of bronchial asthma and bronchiolitis and an overdiagnosis of pneumonia. The IMCI algorithm had a provision for preventive services of immunization (24.5% possibility of availing missed opportunity) and feeding advice. There is a sound scientific basis for adopting the IMCI approach since: (1) Co-existence of morbidities is a rule rather than exception for sick under-five children. (2) The algorithm provides good sensitivity and specificity for assessing severe illness and (3) IMCI algorithm is superior to vertical disease specific programs. It is, however, important to carefully adapt the generic IMCI algorithm to reflect the local morbidity profile.