Mental Health Status Of Patients Research Articles

Effect of the psychological intervention on the physical and mental health of patients with myopia undergoing Femtosecond Laser and Excimer Laser in Situ Keratomileusis

Objective To study the physical and mental health status of patients with myopia so as to provide evidence for psychological care and explore the effect of psychological intervention on the patients with myopia.Methods Totals of 141 patients (251 eyes ),before diagnosed,six months after surgery,were investigated with Cornell Medical Index ( CMI ).Myopic patients received targeted psychological care before,during and after surgery.The findings of all items ( A-R items),psychological items ( M - R key items),A-R 18 items were compared.Results The frequency of psychosomatic symptoms of patients in all items ( A - R items) and psychological items ( M-R items) of return visit was significantly lower than that of the first visit [A-R:(19.82±7.43) vs (25.06±10.08); M-R:(6.32 ±2.75) vs (7.73 ±2.94);P＜0.01].Among A -R 18 items,item A (eyes and ears),G (nervous system),L (used to),O (anxiety),P (sensitive) of first visit was higher than that of the return visit,and the difference was statistically significant [ A:(6.62 ±6.03) vs (2.14±1.86),G:(0.49 ±0.50) vs (0.29 ±0.13),L:(1.21±0.42) vs (0.96 ±0.08),0:(1.25±1.03) vs(0.62±0.70),P:(1.63±0.92) vs(0.59±1.01);P＜0.001].Conclusions Patients show different preoperative psychological quality in their first visit and have poor psychological defense mechanisms.So,the psychological care should be strengthened in first visit,preoperative,during operative and postoperative period and more attention should be paid to their physical and mental health.Psychological intervention can improve the life quality of myopia patients with FL - LASIK treatment. Key words: Nursing; Myopia; FL - LASIK; Physical and mental health

Studv on the mental health status for 260 patients with breast cancer

Objective To explore the mental health status of patients with breast cancer and social support on their influence. Methods 260 cases of patient with breast cancer were investigated by using the questionnaire of demographic characteristics and symptom check list 90 (SCL-90) and social support rating scale (SSRS). Results Breast cancer patients ' mental health condition was worse than normal healthy people and their mood changes were obviously observed. Breast cancer patients achieved good social support.However, the urban patients with breast cancer got better social support than the rural patients and the difference were statistically significant (t =7.91, P =0.000). SCL-90 total score and its factors such as forced symptoms, sensitive interpersonal relationship, depression, anxiety, hostile, terror, paranoid,psychoticism,were negatively related with the social support (r =-0.278,-0.259,-0.165,-0.294,-0.215,-0.177,-0.175,-0.167,-0.219,all P ＜ 0.05).Conclusion The social support influences breast cancer patients' mental health,therefore,the patients with breast cancer should be given a better social support in order to improve the psychological health level and improve recovery. Key words: Breast neoplasms; Mental health; Social support; Data collection

The relevance of Nash equilibrium to psychiatric disorders

In game theory, the word 'game' is used to describe any interdependence between interacting parties, and the Nash equilibrium is a prominent tool for analysing such interactions. I argue that the concept of the Nash equilibrium may also be used in non-gaming contexts. An individual is in a Nash equilibrium if his or her beliefs are consistent with his or her actions. Given that discordance between beliefs and behaviour is a typical cause of psychiatric disorders, individuals who are not in a Nash equilibrium are likely to be affected by such disorders. In this regard, the concept of the Nash equilibrium could aptly be introduced into the medical practitioner's vocabulary for describing a patient's mental health status.

Routine outcome monitoring and feedback on physical or mental health status: evidence and theory

Routine Outcome Monitoring (ROM) is an important quality tool for measuring outcome of treatment in health care. The objective of this article is to summarize the evidence base that supports the provision of feedback on ROM results to (mental) health care professionals and patients. Also, some relevant theoretical aspects are considered. Literature study (Pubmed, Medline, PsychINFO, Embase Psychiatry, 1975-2009) concerning randomized controlled trials (RTC's) of ROM and feedback on physical or mental health status of patients of all ages. Main search terms were routine outcome monitoring/measurement, feedback, health status measurement, patient reported outcome measures. Included were 52 RCT's concerning ROM and feedback with adult or older patients: of these seven RCT's were exclusively focused on physical health and 45 RCT's (also) on the mental health of the patient, although not always in a mental health care setting or as primary outcome measure. There appears to be a positive impact of ROM on diagnosis and monitoring of treatment, and on communication between patient and therapist. Other results were less clear. There were no published RCT's on this topic with children or adolescents. ROM appears especially effective for the monitoring of patients who are not doing well in therapy. Further research into this topic and the clinical-and cost-effectiveness of ROM is recommended, especially in mental health care for both adults and children. Also, more theory-driven research is needed with relevant conceptualizations such as Feedback Intervention Theory, Therapeutic Assessment.

A systematic review on the factors affecting effective communication between registered nurses and oncology adult patients in an inpatient setting.

Effective nurse-patient communication is essential in the development of therapeutic relationships and meeting the cognitive and affective needs of oncology patients. However, the emotional load in cancer nursing has made communication additionally challenging. This review aimed to establish the best available evidence regarding the factors affecting effective communication between registered nurses and adult oncology patients in inpatient setting. Types of participants This review considered studies that included registered nurses and inpatient oncology adults who were more than 21 years of age. This review considered studies carried out in inpatient settings, regardless of ward specialty, whilst active or palliative cancer treatments were administered.Phenomena of interest This review considered the factors affecting effective communication between registered nurses and inpatient oncology adults.Types of studies This review considered both quantitative (randomized controlled trials, non-randomized controlled trials, before and after studies, cohort observational, descriptive survey and mixed method studies) and qualitative (including, but not limited to, phenomenology, grounded theory and ethnography) research studies on the factors affecting effective communication between registered nurses and inpatient oncology adults.Search strategy The search strategy aimed to find studies published in English language and not limited by year of publication. A three-step search strategy was utilized in each component of this review. The grey literature was not included in this review. Quantitative data were extracted using standardized data extraction tools adapted from the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Qualitative data were extracted using the standardized data extraction tool from the Joanna Briggs Institute-Qualitative Assessment and Review Instrument (JBI-QARI). Quantitative data were presented in a narrative summary. Qualitative findings were categorised using JBI-QARI tool to generate synthesised findings. One quantitative, two mixed method and four qualitative studies were included in this review. Combined findings of the narrative summary and meta-synthesis identified promoting and inhibiting factors in the characteristics of nurses, patients, and the environment. Promoting factors in nurses included genuineness, competency and supportive facilitation skills. However, the role of post-basic training in improving communication remained inconsistent. In patients, active participation in their own care and information-seeking behaviour promoted nurse-patient communication. Conversely, inhibiting factors in nurses included task orientation, fear of own death and low self-awareness of own verbal behaviours. Nurses also communicated less effectively during psychological assessments and emotionally-charged situations. For patients, their unwillingness to discuss the disease/feelings, their preference to seek emotional support from family and friends and the use of implicit cues inhibited effective communication. Environmentally, a supportive ward environment increased the use of facilitative behaviour in nurses, whereas the existence of conflict among staff increased the use of blocking behaviours. Cultural norms in the Chinese society also inhibited nurse-patient communication. Within the constraints of the study and the few quality papers available, it appears that personal characteristics of patients and nurses are the key influencing factors of effective nurse-patient communication in the oncology setting. Very little evidence exists on the role of environment in effective nurse-patient communication, particularly within an Asian setting. Using evidence from the quantitative component of the review, nurses need to focus on the mental health status of patients admitted with a recurrence of cancer. Education programs can be implemented to inform nurses about the challenges in communication and develop strategies to counter these obstacles. Using evidence from the qualitative component of the review, nurses should build rapport and encourage active patient participation in their care in order to enhance patient disclosure. Nurses should also be mindful of patients' psychological readiness to communicate and respect their preference as to whom they wish to share their thoughts/emotions with. Institutions need to design ward structures (ward culture and nurses' workload) that support and/or encourage nurses to be person-oriented and take responsibility for providing holistic care to patients. Both the quantitative and qualitative components of the review indicated the need to improve nurses' communication skills and their receptivity to patient cues. An explorative descriptive study on the effect of the Asian culture on the effective communication in the oncology setting is required to add to the small amount of knowledge in this area. Descriptive or mixed method studies to ascertain the effect of the patient's age and place within the oncology treatment cycle are also warranted. The lack of evidence on the effectiveness of post-basic communication courses would be best gathered by a descriptive study, followed by a before-and-after randomised controlled trial to test different education programs.

Personality Disorders are Not Associated With Nonrecovery in Patients With Traffic-Related Minor Musculoskeletal Injuries

Personality disorders (PDs) have been suggested to be one of the determinants that might influence recovery after injuries but has rarely been measured. This study describes the occurrence of PDs among patients with minor traffic-related musculoskeletal injuries and relates these disorders to nonrecovery 12 months after the injury. This is a single-center, prospective, cohort study. We included patients with minor traffic-related musculoskeletal injuries at a general hospital in Stockholm, Sweden, with a catchment area of 0.6 million people. Structured Clinical Interview II screen questionnaire was used to measure PD. Outcome measure were self-reported recovery at 12 months (yes/no). Fifty-one percent of all patients (102 of 200) had at least one PD, and 20% had at least two. The proportion of nonrecovered was 50% (51 of 102) among those with one or more PD compared with 39% (38 of 98) among those without any PD (p = 0.12). Patients with a Cluster A (paranoid, schizoid, and schitzotypal) or Cluster B (borderline, histrionic, narcissistic, and antisocial) PD were associated with nonrecovery. When compared with patients without any PD, patients with a Cluster A or Cluster B PD had an increased risk of nonrecovery (OR: 2.5; 95% CI: 1.0 -5.9 and OR: 2.1; 95% CI: 1.2-3.8, respectively). However, after adjusting for mental health factors at the time of the injury, these associations were no longer significant. PDs are common among patients with minor traffic-related musculoskeletal injuries. Our study does not support the view that PDs are associated with nonrecovery. The patient's mental health status at the time of the crash seems to be more important for nonrecovery than a PD.

Self-Image and Quality of life of Dermatology Patients

The problems of self-image among patients with dermal problems have been seldom explored. As dermal diseases detrimentally affect well-being, functioning and adaptation of dermatology patients, they may decrease the level of self-acceptance. Self-image, on the other hand, may significantly affect the own mental health status and quality of life (QoL) in that group of patients. The aim of our research was to assess mental health status and quality of life of patients with dermal problems in respect of the level of their self-acceptance. The participants were patients of the Occupational Diseases Outpatient Clinic and the Occupational and Environmental Allergy Centre of the Nofer Institute of Occupational Medicine (NIOM). In total, 112 patients were examined, including 37 with diagnosed urticaria, 50 with allergic contact dermatitis and 25 with atopic dermatitis. General Health Questionnaire (GHQ) was used to assess patients' mental health, a Polish version of Dermatology Life Quality Index (DLQI) was employed for the assessment of their life quality, while Self-Acceptance Scale (SAS) served to obtain patients' self-image. There were statistically significant differences in the assessment of mental health and quality of life, depending on the level of self-acceptance. People with high self-acceptance are characterised by better mental health condition than those with low self-acceptance (t=4.8; p=0.00). The patients with negative self-image (compared to those with positive self-image) deem also their quality of life to be poor (t=3.1; p=0.00). A relationship has been found to exist both between mental health condition and the subjective assessment of life quality, and self-image. Thus, both patient's mental health status and his/her self image constitute major determinants of the quality of life that are worth to be monitored in dermatology patients. Their treatment procedure should include also psychological consulting or psychotherapy.

A Mental Health Program for Ground Zero Rescue and Recovery Workers: Cases and Observations

A Mental Health Program for Ground Zero Rescue and Recovery Workers: Cases and Observations

General physical and mental health status in patients with moderate to severe plaque psoriasis receiving 48 weeks of adalimumab therapy

General physical and mental health status in patients with moderate to severe plaque psoriasis receiving 48 weeks of adalimumab therapy

Factors which predict physical and mental health status in patients with amyotrophic lateral sclerosis over time

OBJECTIVES: To determine which factors are predictive of physical and mental health one year after a first measurement of health status in amyotrophic lateral sclerosis (ALS) patients.METHODS: The Physical Component Summary (PCS) score and the Mental Component Summary (MCS) score of the SF‐36 were used as the main outcome measures in patients enrolled in the European ALS Health Profile Study (ALS‐HPS). Correlation and stepwise regression procedures were used to determine the relationship between patients' physical and mental health status at follow‐up with baseline measures.RESULTS: A total of 1118 patients were recruited into the ALS‐HPS, of which 918 (82.11%) returned fully or partially completed baseline and follow‐up surveys. PCS scores declined over time. No significant changes were reported for the MCS scores over time for patients with ALS. Baseline scores were found to be significant predictors of patients' health status over time.CONCLUSIONS: Overall, patients' physical health status at the time of recruitment was the major predictor of the physical health status at both first and second follow‐up time assessments. The same relationship was found between baseline and follow‐up mental health status. The study also confirms the appropriateness of the use of the SF‐36 in ALS patients.

Factors which predict physical and mental health status in patients with amyotrophic lateral sclerosis over time.

To determine which factors are predictive of physical and mental health one year after a first measurement of health status in amyotrophic lateral sclerosis (ALS) patients. The Physical Component Summary (PCS) score and the Mental Component Summary (MCS) score of the SF-36 were used as the main outcome measures in patients enrolled in the European ALS Health Profile Study (ALS-HPS). Correlation and stepwise regression procedures were used to determine the relationship between patients' physical and mental health status at follow-up with baseline measures. A total of 1118 patients were recruited into the ALS-HPS, of which 918 (82.11%) returned fully or partially completed baseline and follow-up surveys. PCS scores declined over time. No significant changes were reported for the MCS scores over time for patients with ALS. Baseline scores were found to be significant predictors of patients' health status over time. Overall, patients' physical health status at the time of recruitment was the major predictor of the physical health status at both first and second follow-up time assessments. The same relationship was found between baseline and follow-up mental health status. The study also confirms the appropriateness of the use of the SF-36 in ALS patients.

Impact of fatigue on the quality of life of patients with primary biliary cirrhosis.

Fatigue is a frustrating symptom frequently reported by patients with primary biliary cirrhosis (PBC), but it is still poorly understood and not well evaluated. Our aim was to determine its importance and its impact on the quality of life and mental health status of patients with PBC. Patients with PBC (103 women and 13 men with a mean age of 52.6 yr) completed self-report questionnaires to evaluate the impact of fatigue on their quality of life (Fatigue Impact Scale, FIS), the perception of their own mental health (Symptom Check list-90-R, SCL), and depression (Beck Depression Inventory, BDI). A cohort of age-matched healthy blood donors served as controls. Fatigue was present in 99 patients (85.3%) and was the worst or one of the worst symptoms in about half of them. In PBC patients, the mean FIS and SCL indexes were significantly increased, compared to healthy controls (1.49 +/- 1.11 vs 0.6 +/- 0.6 and 0.72 +/- 0.55 vs 0.36 +/- 0.35, respectively). Unexpectedly, 52 patients (44.8%) could be classified as having depression (BDI score > 10). Significant correlations were found between the FIS and SCL indexes, between the FIS index and the BDI score, as well as between the BDI score and the SCL index. Finally, fatigue was not related to the disease severity parameters, that is, clinical, biochemical, metabolic, and pathological. Fatigue is a frequent and disabling complaint that impairs the quality of life of PBC patients and their perception of their own mental health, which may be associated with an unexpected depressive condition. In addition, the FIS questionnaire can be considered as a useful tool to assess fatigue in PBC patients and may be used in the evaluation of specific treatments aimed at reducing this complaint in such patients.

Impact of fatigue on the quality of life of patients with primary biliary cirrhosis

OBJECTIVE: Fatigue is a frustrating symptom frequently reported by patients with primary biliary cirrhosis (PBC), but it is still poorly understood and not well evaluated. Our aim was to determine its importance and its impact on the quality of life and mental health status of patients with PBC. METHODS: Patients with PBC (103 women and 13 men with a mean age of 52.6 yr) completed self-report questionnaires to evaluate the impact of fatigue on their quality of life (Fatigue Impact Scale, FIS), the perception of their own mental health (Symptom Check list-90-R, SCL), and depression (Beck Depression Inventory, BDI). A cohort of age-matched healthy blood donors served as controls. RESULTS: Fatigue was present in 99 patients (85.3%) and was the worst or one of the worst symptoms in about half of them. In PBC patients, the mean FIS and SCL indexes were significantly increased, compared to healthy controls (1.49 ± 1.11 vs 0.6 ± 0.6 and 0.72 ± 0.55 vs 0.36 ± 0.35, respectively). Unexpectedly, 52 patients (44.8%) could be classified as having depression (BDI score >10). Significant correlations were found between the FIS and SCL indexes, between the FIS index and the BDI score, as well as between the BDI score and the SCL index. Finally, fatigue was not related to the disease severity parameters, that is, clinical, biochemical, metabolic, and pathological. CONCLUSIONS: Fatigue is a frequent and disabling complaint that impairs the quality of life of PBC patients and their perception of their own mental health, which may be associated with an unexpected depressive condition. In addition, the FIS questionnaire can be considered as a useful tool to assess fatigue in PBC patients and may be used in the evaluation of specific treatments aimed at reducing this complaint in such patients.

Provision of feedback on perceived health status to health care professionals: a systematic review of its impact.

To assess the impact on the process and the outcomes of care of feeding back information on perceived health status to health care professionals in clinical practice. Systematic review of controlled trials. Search in electronic databases (MEDLINE 1966-1997), manual searches, and requests to experts in the field. Differences between intervention and control group were considered in process of care (use of health services, diagnosis, and treatment), patient outcomes (health status), and patient satisfaction. In a subgroup of 13 interventions that dealt with the provision of feedback about the patient's mental health, the impact on the process of care was subjected to meta-analysis. We identified 21 studies that satisfied the selection criteria. Eleven of 20 (55%) found significant differences (P <0.05) in at least 1 of the process indicators in favor of the intervention group. Of 11 trials that assessed patient outcomes, only 4 (36%) detected significant improvements. A similar trend but lower percentages were observed among the 8 interventions that provided general health status information. Eleven interventions that evaluated feedback information about the patient's mental health status showed a higher rate of diagnosis in the intervention group (combined odds ratio [OR]=1.91; 95% confidence interval [CI] 1.28 to 2.83). Seven of 9 studies evaluating treatment failed to show an effect on this indicator (combined OR=1.15; 95% CI 0.76 to 1.75). The provision of feedback on perceived health status to health professionals seems to have an effect on the process of care but not on patient functional or health status. This is especially true with regard to mental health status information. Nevertheless, there is still need for a more through evaluation of this type of intervention.

Economic aspects of patterns of mental health care: Cost variation by setting

The paper examines the evidence regarding the extent to which differences exist in health and mental health status of psychiatric patients treated in the specialty mental health, general medical, and informal care sectors. Differences in types of patients treated in the three sectors are important to identify since there are dramatic differences in the average costs of treatment. We use data from the Baltimore Epidemiological Catchment Area Survey to estimate a statistical model of treatment setting choice. Our results suggest that there is little support for attributing major differences in treatment costs across sectors to differences in the health and mental health status of patients.

A longitudinal analysis of psychological adaptation among survivors of cancer.

This longitudinal study examined the psychological adaptation of newly diagnosed cancer patients. Findings showed a decline in patient's mental health status over time. Initial psychological status and other psychosocial factors, and not illness-related factors, were predictive of subsequent adaptation. Two psychologically vulnerable patient groups were identified: those who remained distressed over time and those whose mental health status declined over time.

Comparison of Use of Outpatient Mental Health Services in an HMO and Fee-for-Service Plans

Whereas previous authors have used a variety of strategies to identify use of mental health services, the sensitivity of estimates to the definition of a visit has been little studied. The authors examined the sensitivity of estimates of use of outpatient mental health services in both HMO and fee-for-service plans to the method of identifying outpatient mental health visits. The HMO and fee-for-service plans had identical benefits (i.e., free care). Data were from the Rand Health Insurance Study. Mental health visits were identified using two definitions: presence of a mental health diagnosis or procedure; and presence of a mental health procedure, diagnosis, or prescription for psychotropic medication in the absence of physical disorders requiring such medications. The major policy conclusions about lower levels of use in the HMO compared to fee-for-service plans were insensitive to the definition of a visit. Nevertheless, estimates of use of general medical providers were higher when psychotropic medications were included in the definition of a mental health visit; this sensitivity to definition was significantly greater for fee-for-service than HMO participants (P less than 0.05). Further, conclusions about the comparability of enrollment mental health status of patients treated by general medical providers in HMO and fee-for-service plans were somewhat sensitive to the definition of a visit.