Illness-related Factors Research Articles

Antipsychotic treatment of psychotic disorders in forensic psychiatry: Patients' perception of coercion and its predictors

BackgroundDespite the major encroachment of coercive measures on the fundamental rights of affected forensic psychiatric patients, there is relatively few research done in this field. Considering the relevance of this subject for psychiatric care and the recent changes of the legal basis of coercive treatment in Germany, more studies are needed. The present study examines forensic psychiatric inpatients' perception of coercion regarding the prescribed antipsychotic medication and factors associated with the perception of coercion. Material and methodsPatients with schizophrenia, schizotypal and delusional disorders in two forensic psychiatric institutions in Southern Germany were interviewed about their experience of coercion related to antipsychotic medication. Due to a lack of appropriate psychometric scales, the perception of coercion regarding antipsychotic medication was assessed using an adapted version of the MacArthur Admission Experience Survey (aAES). The influence of sociodemographic and illness-related factors, of the attitude towards medication, insight into illness and symptom severity on the extent to which patients felt coerced to take the prescribed medication was analyzed. Two Visual Analog Scales, the Drug Attitude Inventory DAI-10, the Positive and Negative Syndrome Scale PANSS, the Fragebogen zur Krankheitseinsicht (Questionnaire about insight into illness) FKE-10 and the Coercion Experience Scale CES were used as psychometric scales. Results50% of all patients eligible for the study gave their written consent. 70% of all participants had experienced coercive measures between admission and time of data assessment. The DAI-10 and the aAES correlated moderately, a high level of insight into illness being correlated to less perceived coercion. The FKE-10 and the aAES correlated moderately as well, a high level of insight into illness being correlated to less perceived coercion. The severity of symptoms (PANSS score) and the level of perceived coercion (aAES score) correlated weakly, participants with more severe symptoms perceived more coercion than those with less marked symptoms. A linear regression model showed that to what extent patients felt coerced to take the prescribed antipsychotic medication was mainly influenced by their attitude towards medication and the degree of insight into illness, to a lesser extent by symptom severity (R2 = 0.565, p < 0.001). Sociodemographic factors were not related to the extent to which patients felt coerced to take the antipsychotic medication. ConclusionsPredictors of the experience of coercion related to the prescribed antipsychotic medication of forensic psychiatric inpatients with schizophrenia and related disorders are not so much sociodemographic or illness-related factors as education or past medical history, but rather potentially influenceable variables such as insight into illness or attitude towards medication.

Modifiable correlates of illness perceptions in adults with chronic somatic conditions: A systematic review.

When individuals become ill, they want to understand and give meaning to their illness. The interpretation of this illness experience, or illness perception, is influenced by a range of individual, contextual, and cultural factors. Some of these factors may be modifiable by nursing interventions. The purpose of this systematic review was to investigate which modifiable factors were correlated with illness perceptions across studies of adults with different chronic somatic diseases. Using search terms tailored to each of four electronic databases, studies retrieved were reviewed by two independent evaluators, and each relevant article was assessed for methodological quality. Results were standardized by calculating correlation coefficients. Fifteen papers on illness perceptions in a variety of chronic diseases met the inclusion criteria. All used standardized measures of illness perceptions. We identified five groups of modifiable correlates of illness perceptions: illness-related factors, psychosocial factors, medication beliefs, information provision and satisfaction with information received, and quality of care. Our findings add to the knowledge of modifiable factors correlated with illness perceptions, including the importance of illness-related factors and psychosocial factors such as anxiety and depression. Knowledge of these correlates can facilitate understanding of patients' illness perceptions and might be useful in tailoring patient education programs.

Prevalence of Sexual Dysfunction in Females with and Without Schizophrenia

INTRODUCTION- Schizophrenia is an illness that may influence every aspect of the person’s life. Rates of female sexual dysfunction (FSD) in schizophrenia the rates reported have been between 30 and 80%. The aim was to identify attribution (locus of control) and sexual dysfunction among female with schizophrenic disorder and females without schizophrenia and to study and to compare the sexual dysfunction and attribution in schizophrenic and non-schizophrenic women. METHODS- This was a cross sectional, hospital-based study and was approved by the Institutional Ethics Committee of SRM Medical college and health sciences. Women between the ages of 21 to 45 years, diagnosed with schizophrenia by ICD 10 criteria (World Health Organization, 1992) attending the outpatient services, who were under remission, and were in marital relationship for at least six months were approached for the study. Schizophrenia was assessed using PANSS while sexual dysfunction in females was assessed using female sexual functioning index. Sexual attribution was assessed by using Rotter’s locus of control. RESULTS- 45 women belonging to cases had sexual dysfunction as assessed by FSFI whilst 13 had had scored for sexual dysfunction is the control group. 5 in the cases and 37 in controls did not have sexual dysfunction. X2 test was carried out and the difference was very highly statistically significant at 0.001level. A very high frequency of sexual dysfunction in this group calls for added focus in to this aspect for a better quality of life for the patient. The relationship between locus of control, sexual dysfunction as assessed by FSFI and PANSS scores where higher scores denote a severe form of illness were subjected to co-relation analysis. Locus of control is identified to be external when the scores are higher than the cut-off point. CONCLUSION-Sexual dysfunction is one of the aspects which affect the overall quality of life and needs to be studied on a larger sample and the relationship between illness related, treatment related and environment related factors need to be studied. Individual disturbances in the various aspects of sexual dysfunction also need to be studied.

Aggression Management Education for Acute Care Nurses: What’s the Evidence?

Aggression Management Education for Acute Care Nurses: What’s the Evidence?

Predictors of patient-related benefit, burden and feeling safe in relation to hospital admissions in palliative care: A cross-sectional survey

Background: Research exploring patient experience of palliative care in the hospital setting has previously been limited to negative aspects of care. However, recent studies have shown that patients with palliative care needs experience benefits being in hospital. Little is known about how experiences of benefit and burden vary according to socio-demographic and illness-related factors and how these experiences influence patient preferences to return to hospital. Aim: To identify factors influencing experiences of benefit and burden and the predictors associated with a preference to return to hospital in palliative care. Design: Cross-sectional design using a questionnaire survey. Setting/participants: In total, 116 hospital inpatients admitted with palliative care needs in an urban hospital in New Zealand. Recruitment was from an oncology ward, four general medical wards and a respiratory ward. Results: Those living in more deprived areas experienced more benefit being in hospital (F(4, 109) = 3.15, p = 0.017), while younger people (F(4, 109) = 4.44, p = 0.00) and those from Asian or Pacific cultures (F(2, 111) = 7.78, p = 0.000) experienced more burden. Those with a non-cancer diagnosis felt less safe in hospital (p = 0.04). ‘Feeling safe’ was a significant (B = 0.14, p = 0.03) predictor for a preference to return to hospital. Conclusion: Deprivation, diagnosis, age and ethnicity influenced experiences of benefit and burden in hospital. ‘Feeling safe’ was a significant predictor for a preference to return to hospital. Further research is needed to understand why certain patient factors influence experiences of hospitalisation and how ‘feeling safe’ can be replicated in other care environments.

Determinants and incidence of depression in multiple sclerosis: A prospective cohort study

ObjectiveTo estimate the incidence and explore potential determinants of incidence of depression in MS. MethodsA prospective cohort study used a sample of 192 patients from the southern Alberta MS clinic registry. Participants completed baseline risk factor assessment questionnaires using either online, mail or telephone surveys, and completed the Patient Health Questionnaire every 2weeks for 6months to assess depressive symptoms in real time. Risk factors assessed included biopsychosocial variables such as socioeconomic status, illness-related factors, childhood risk factors, psychosocial factors, and health behaviors. Cox proportional hazard models were fit to estimate predictors of incidence. Results2-week incidence of depression for females was 0.019 (95% CI 0.013–0.029) and for males was 0.044 (0.026–0.074). Strongest predictor of depression incidence risk included fatigue impact, low mobility, resiliency, self-esteem, self-efficacy, and coping style. ConclusionDepression in MS exhibits a risk factor profile similar to that of depression in the general population, with the additional impact of MS illness-related factors. Potentially modifiable risk factors, such as coping with stress and resiliency, present opportunities for focus of further research in depression in MS treatment and prevention efforts. Some differences in determinants of incidence were found compared to the prevalence risk factors, highlighting the danger of using cross-sectional data to make assumptions about risk. For example, the finding that depression incidence was higher for men is opposite to the higher depression prevalence estimates found for women as well as the consensus in the literature.

Psychological factors and psychosocial interventions for cancer related pain.

The present paper is aimed at briefly presenting psychological factors involved in cancer related pain and what psychosocial interventions are efficient in reducing it. Cancer related pain is a complex experience and the most integrative and recommended approach is the biopsychosocial model. It has been proved that chronic pain is more strongly related to psychological factors than to treatment or illness related factors. Psychological factors influencing pain experience can be intuitively grouped starting with awareness of pain (i.e., attentional factor), then with evaluation of pain (i.e., cognitive factors) which is leading to feelings (i.e., emotional factors), and behaviours (i.e., coping strategies) regarding pain. Psychosocial interventions (i.e., skill based and education based interventions) have strong evidence that is effective in reducing cancer related pain.

Psychosocial, Demographic, and Illness-Related Factors Associated With Acute Traumatic Stress Responses in Parents of Children With a Serious Illness or Injury.

This study investigated factors associated with acute stress symptoms in parents of seriously ill children across a range of illnesses and treatment settings within a pediatric hospital setting. It was hypothesized that psychosocial variables would be more strongly associated with acute stress responses than demographic and child illness variables. Participants were 115 mothers and 56 fathers of children treated within the oncology, cardiology, and intensive care departments of a pediatric hospital. Acute stress, psychosocial, demographic, and medical data were collected within the first 4 weeks of the child's hospital admission. A robust hierarchical regression model revealed that psychosocial factors significantly explained 36.8% of the variance in parent acute stress responses (p < .001); demographic variables significantly added a further 4.5% (p = .022), but illness-related factors did not contribute to the model. Findings support the implementation of a general psychosocial screening approach for parents across the wider hospital system, and that psychosocial risk factors may be targeted in interventions across different illnesses and treatment settings to improve parent outcomes.

Determinants of duration of untreated psychosis among first-episode psychosis patients in Denmark: A nationwide register-based study

BackgroundInformation on determinants of duration of untreated psychosis (DUP) is still needed to inform campaigns targeting people with first episode psychosis (FEP). This nation-wide study analysed the association between demographic factors (age, sex, ethnicity, marital status, and geographic area), premorbid and illness-related factors (global functional level, substance misuse, and contact to police), healthcare factors (referral source and first FEP contact) and DUP. MethodThe study population of 1266 patients aged 15–25years diagnosed with FEP (ICD10 F20.0‐F20.99) was drawn from the Danish National Indicator Project during 2009–2011. The study population was combined with data from national administrative registers. A multinomial regression model was estimated to analyse the impact of demographic, premorbid and illness-related, and healthcare factors on DUP. ResultsOne third of the population had a DUP below 6months. DUP longer than 12months was associated with older age at onset, being female, having cannabis misuse, and living in peripheral municipalities. Being charged by the criminal authorities during one year before FEP was associated with a DUP over 6months. ConclusionDUP is related to a number of demographic, premorbid and healthcare factors. These findings suggest that future information campaigns should focus on increasing the awareness of early signs of psychosis not only among mental health professionals but also other professionals in contact with adolescents such as the police. It may also be useful to consider how to target information campaigns towards persons living in peripheral areas.

Deviation from expected cognitive ability across psychotic disorders

Patients with schizophrenia show a deficit in cognitive ability compared to estimated premorbid and familial intellectual abilities. However, the degree to which this pattern holds across psychotic disorders and is familial is unclear. The present study examined deviation from expected cognitive level in schizophrenia, schizoaffective disorder, and psychotic bipolar disorder probands and their first-degree relatives. Using a norm-based regression approach, parental education and WRAT-IV Reading scores (both significant predictors of cognitive level in the healthy control group) were used to predict global neuropsychological function as measured by the composite score from the Brief Assessment of Cognition in Schizophrenia (BACS) test in probands and relatives. When compared to healthy control group, psychotic probands showed a significant gap between observed and predicted BACS composite scores and a greater likelihood of robust cognitive decline. This effect was not seen in unaffected relatives. While BACS and WRAT-IV Reading scores were themselves highly familial, the decline in cognitive function from expectation had lower estimates of familiality. Thus, illness-related factors such as epigenetic, treatment, or pathophysiological factors may be important causes of illness related decline in cognitive abilities across psychotic disorders. This is consistent with the markedly greater level of cognitive impairment seen in affected individuals compared to their unaffected family members.

SU27. Cognitive Remediation, Cognitive Behavioral Therapy, and Occupational Outcome in Schizophrenia Spectrum Disorders: A 2-Year Follow-up Study

Background: Neurocognitive impairment is prominent in schizophrenia and significantly related to low occupational attainment and poor occupational outcomes (August et al, 2012). Vocational rehabilitation (VR) is frequently implemented to counteract high unemployment rates. Individuals with schizophrenia however face numerous challenges such as neurocognitive impairments and psychotic symptoms. Hence, augmenting VR to address illness-related factors may optimize occupational outcomes. The aim of this study was to examine the effects of Cognitive Remediation (CR)-augmented compared to Cognitive Behavioral Therapy (CBT)-augmented VR on neurocognition and occupational functioning over a 2-year period. Methods: One hundred and thirty-one participants underwent assessments at baseline, post-treatment (after 10 months), and follow-up (2 years after randomization). Performance on the MATRICS Consensus Cognitive Battery (MCCB), occupational status, and number of hours worked per week were recorded at all assessment points. Results: Both intervention groups improved on several neurocognitive domains, improvements were however in favor of the CR group with significant intervention-by-time interactions for working memory (P = .009) and the composite score (P = .03). There was a significant increase in number of participants working (79% vs 80% at post-treatment and 68% vs 58% at follow-up in CBT and CR, respectively) and hours worked throughout the project period, with no between-group differences. CBT participants were working 11.6 hours a week at post-treatment and 14 hours at follow-up, whereas CR participants worked 10.6 hours at post-treatment and 11.3 hours a week at follow-up. Separate multiple regression analyses with hours worked as criterion was not significant for CBT (P = .13), but for CR (P = .03) with education (P = .03) and positive change in Working Memory (P = .02) as significant predictors. Entering the composite change score as predictor instead of separate domains produced a significant model for CR (P = .02). Significant predictors were age (P = .04) and change in the composite score (P = .007). Conclusion: CR-augmented VR improved several neurocognitive domains, particularly Working Memory, which was central in the CR program as well as the MCCB Composite Score. Neurocognitive improvements may also be partially explained by additional strategy learning and bridging to work settings provided in the CR program perhaps reducing interference caused by neurocognitive impairments and leading to more sufficient allocation of neurocognitive resources in turn aiding in transfer of learning to vocational settings which consequently may have helped optimize occupational functioning. The major implication of these findings is that the combined effect of VR, organized collaboration between services and CBT/CR enabled a significant proportion of the participants to attain work and to increase the number of hours worked in the study.

Factors influencing mother–child communication about fathers with neurobehavioural sequelae after brain injury

ABSTRACTObjective: The present study clarified factors related to mother–child communication openness when fathers suffer neurobehavioural sequelae after stroke or traumatic brain injury.Research design: A cross-sectional study using self-report anonymous questionnaires was conducted.Methods and procedures: Forty-one mothers with 6–22-year-old children participated. The questionnaire examined personal factors (mother’s psychological distress), social/family factors (family support functioning), illness-related factors (father’s time at home and neurobehavioural sequelae severity) and mother’s perceived level of open communication. Multiple regression was used to analyse factors related to mother–child communication openness.Results: Mother–child open communication was explained by family support functioning (β = 0.449), father’s time at home (β = –0.325) and mother’s psychological distress (β = –0.303). Neurobehavioural sequelae severity was not associated with mother–child open communication.Conclusions: Personal, social/family and illness-related factors were related to mother–child communication about paternal illness. Professionals should promote optimal family support functioning, connect families with external resources and assess families’ interaction processes.

Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul.

There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

Impact of quality of life (QoL) on glycemic control (HbA1c) among adolescents and emerging adults with long-duration type 1 diabetes: A prospective cohort-study.

To evaluate the impact of self-reported chronic-generic and condition-specific quality of life (QoL) on glycemic control among adolescents and emerging adults with long-duration type 1 diabetes (T1D) in a longitudinal design. The database used was a nationwide cohort study of patients with ≥10 years T1D duration at baseline in Germany. The baseline questionnaire survey was conducted in 2009-2010, the follow-up survey in 2012-2013; additional clinical data of routine care procedures were linked. QoL was assessed by the DISABKIDS chronic generic module (DCGM-12) and diabetes module (DM) with treatment and impact scales. Regression analyses were conducted for the outcome hemoglobin A1c (HbA1c) at follow up with baseline DISABKIDS scores as predictors and sociodemographic and health-related covariates. At baseline, the included 560 patients had a mean age of 15.9 (SD 2.3) years, a diabetes duration of 13.0 (2.0) years, and an HbA1c of 67 (14.2) mmol/mol. Mean follow-up time was 3.0 (0.6) years. Univariate analyses indicated associations between baseline QoL scores and HbA1c at follow-up (β[DCGM-12] = -0.174 (SE 0.038), β[DM treatment] = -0.100 (0.022), β[DM impact] = -0.177 (0.030), p < .001). The associations remained significant after adjustment for sociodemographic and illness-related factors, but dissolved (p > .60) when additionally adjusting for baseline HbA1c. In patients with poor baseline HbA1c (>75 mmol/mol), significant associations were observed between DCGM-12 and DM impact scores and follow-up HbA1c (β[DCGM-12] = -0.144 (0.062), p = .021; β[DM impact] = -0.139 (0.048), p = .004). QoL was inversely associated with HbA1c after 3 years in the course of T1D only in patients poorly controlled at baseline.

Preventing involuntary admissions: special needs for distinct patient groups

BackgroundCoercive measures in psychiatry are a controversial topic and raise ethical, legal and clinical issues. Involuntary admission of patients is a long-lasting problem and indicates a problematic pathway to care situations within the community, largely because personal freedom is fundamentally covered by the UN declaration of human rights and the German constitution.MethodsIn this study, a survey on a large and comprehensive population of psychiatric in-patients in the eastern part of North Rhine-Westphalia, Germany, was carried out for the years 2004–2009, including 230.678 treatment cases. The data were collected from the dataset transferred to health insurance automatically, which, since 2004 is available in an electronic form. In addition, a wide variety of information on treatment, sociodemographic and illness-related factors were collected and analysed. Data were collected retrospectively and analyses were calculated using statistical software (IBM SPSS Statistics 19.0®). Quantitative data are presented as mean and standard deviation. Due to the unequal group sizes, group differences were calculated by means of Chi-square tests or independent sample t tests. A Bonferroni correction was applied to control for multiple comparisons.ResultsWe found an over-representation of involuntary admissions in young men (<21 years) suffering from schizophrenia and in female patients aged over 60 with a diagnosis of dementia. Most of our results are concordant with the previous literature. Also admission in hours out of regular out-patient services elevated the risk.ConclusionThe main conclusion from these findings is a need for a fortification of ambulatory treatment offers, e.g. sociopsychiatric services or ward round at home for early diagnosis and intervention. Further prospective studyies are needed.

24-Hour protein, arginine and citrulline metabolism in fed critically ill children – A stable isotope tracer study

The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4-8h) time period and extrapolate results to 24-h. However, 24-hmeasurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-happearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children. In eight critically ill children, admitted to the pediatric (n=4) or cardiovascular (n=4) intensive care unit, aged 0-10 years, receiving continuous (par)enteral nutrition with protein intake 1.0-3.7g/kg/day, a 24-hstable isotope tracer protocol was carried out. L-[ring-2H5]-phenylalanine, L-[3,3-2H2]-tyrosine, L-[5,5,5-2H3]-leucine, L-[guanido-15N2]-arginine and L-[5-13C-3,3,4,4-2H4]-citrulline were infused intravenously and L-[15N]-phenylalanine and L-[1-13C]leucine enterally. Arterial blood was sampled every hour. Coefficients of variation, representing intra-individual variability, of the amino acid appearances of phenylalanine, tyrosine, leucine, arginine and citrulline were high, on average 14-19% for intravenous tracers and 23-26% for enteral tracers. No evident circadian rhythm was present. The pattern and overall 24-hlevel of whole body protein balance differed per individual. In continuously fed stable critically ill children, the amino acid appearances of phenylalanine, tyrosine, leucine, arginine and citrulline show high variability. This should be kept in mind when performing stable isotope studies in this population. There was no apparent circadian rhythm. NCT01511354 on clinicaltrials.gov.

Clinical Practice Guidelines for Management of Schizophrenia.

Clinical Practice Guidelines for Management of Schizophrenia.

Cognitive remediation and occupational outcome in schizophrenia spectrum disorders: A 2 year follow-up study

Neurocognitive impairment is prominent in schizophrenia and a significant predictor of poor occupational outcomes. Vocational rehabilitation (VR) is frequently implemented to counteract high unemployment rates. Individuals with schizophrenia however face numerous challenges such as neurocognitive impairments and psychotic symptoms. Hence, augmenting VR to address illness-related factors may optimize occupational outcomes. The aim of this study was to examine the effects of Cognitive Remediation (CR) combined with VR(CR+VR) compared to techniques from Cognitive Behavioral Therapy (CBT) combined with VR(CBT+VR) on neurocognition and occupational functioning over a 2year period. A total of 131participants underwent assessment with the MATRICS Consensus Cognitive Battery (MCCB) at baseline, post treatment (after 10months) and follow-up (2years after randomization). Occupational status and number of hours worked were recorded at all assessment points. Both groups improved on several neurocognitive domains. All improvements were however in favor of the CR group. There was a significant increase in number of participants working and hours worked in both groups throughout the project period, with no between-group differences. Number of hours worked at follow-up was predicted by change in Working Memory and the Composite Score in the CR group. CR-augmented VR improved several domains, particularly Verbal Learning and Working Memory, which were central in the CR program. The combination of VR and CR or CBT thus enabled a significant proportion of participants to attain and maintain work.

Disability among Attendees with Schizophrenia in a Nigerian Hospital: Further Evidence for Integrated Rehabilitative Treatment Designs.

Evidence-based rehabilitative treatment is constrained due to limited knowledge about disability and its related factors among individuals with schizophrenia across West Africa. This study aims to investigate the pattern of disability, and the associated factors among individuals with schizophrenia. One hundred consecutively recruited consenting participants were subjected to designed questionnaire to inquire about their demographic and illness-related variables. This was followed by the administration of Structured Clinical Interview for DSM-IV-TR Axis I Disorders and Brief Psychiatric Rating Scale to confirm the diagnosis of schizophrenia and rate severity of symptoms respectively in them. In addition, the World Health Organisation Disability Assessment Scale II (WHODAS-II) was used to assess for disability in all participants. Different degrees of disability based on WHODAS-II mean score of 27.02±3.49 were noted among individuals with schizophrenia, and affectation of domains of disability like self care, getting along with others, life activities and participation in the society among others were observed. In addition, high level of disability was significantly associated with younger adults in the age group 18-44 years (P=0.007), unemployment status (P=0.003), remittance source of income (P=0.034) and ethnicity (P=0.017); conversely, less number of children (P=0.033), less amount spent on treatment (P<0.001) and lower BPRS score (P<0.001) correlated negatively with high level of disability. In spite of clinical stability following treatment, individuals with schizophrenia were disabled to varied degrees, and socioeconomic as well as illness-related factors constituted important correlates. Integration of rehabilitation along with social intervention into treatment design to reduce disability is implied, and further research is also warranted.

Associations between dyadic coping and supportive care needs: findings from a study with hematologic cancer patients and their partners.

The way couples mutually cope with hematologic cancer is likely to influence their levels of supportive care needs (SCN). Therefore, this study evaluated the levels of dyadic coping (DC) and SCN and the concurrent associations between both variables. Three hundred thirty patients with a hematologic malignancy (63% male) and their partners completed the dyadic coping inventory (DCI) and the supportive care needs survey (SCNS-SF-34-G). The levels of dyadic coping (DC) and supportive care needs (SCN) were compared with representative validation samples. Correlational analyses and actor-partner interdependence models (APIM) were calculated to estimate the association between DC and SCN. Partners' stress communication of cancer patients (as part of DC) was decreased in contrast to that of a non-cancer sample. The perception of partners' delegated DC was higher (both with a moderate effect size of g≥|0.50|). SCN of patients and partners were lower in the dimensions health system/information and physical problems/daily living in contrast to those of a cancer patients' validation sample (both with a small effect of g≥|0.20|). Higher perceptions of partners' negative DC were associated with higher SCN for both patients and partners. The same was true for patients' own stress communication and SCN, but only for the patients. Sociodemographic and illness-related factors were only partially related with the SCN of patients and partners. In order to diminish SCN of patients and partners, a possible way is to strengthen the quality of the dyadic relation. Due to its associations with elevated SCN, stress communication and negative dyadic coping behaviours may be useful targets for psychosocial interventions.