Need For Psychological Care Research Articles

Psychological Impact on Maxillofacial Trauma Patients - An Observational Study.

Facial disfigurement due to trauma is very common as the face is a prominent part of the body and is susceptible to injuries. A protocol for the diagnosis and intervention for psychological problems of trauma patients should be implemented in the Indian hospitals as they lack policies for assessing the mental status of such patients. This study was conducted to analyze and determine the psychological implications and need for mental health services of maxillofacial trauma patients. Fifty patients with maxillofacial trauma above 18 years of age were included in this study. The assessment was done using the Hospital Anxiety and Depression Scale (HADS) and Trauma Screening Questionnaire (TSQ), which are considered as the standard tools for assessment of psychological disorders post-trauma. We observed psychological stress in 84% of the patients at the baseline, which reduced to 24% after one month at the first follow-up visit and further reduced to 22% at the second follow-up visit. The reduction in the percentage from the first to the second follow-up visit was less significant. However, the change in HADS and TSQ scores was found to be significant, suggesting that the intensity of trauma decreases with the time-lapse. Anxiety, depression, and post-traumatic stress are prevalent in patients with maxillofacial trauma, which may lead to impaired day-to-day life. Our results suggest that there is a need for psychological care in patients with maxillofacial trauma.

Is type of depressive symptoms associated with patient-perceived need for professional psychological care in depressed individuals with diabetes?

AimsThe objective of this study is to investigate whether type of depressive symptoms (i.e. cognitive-affective or somatic) is related to a patient-perceived need for professional psychological care in individuals with diabetes.MethodsIn total 2266 participants were recruited as part of the screening procedure for a multi-center randomized controlled trial on the treatment of depressive symptoms among individuals with diabetes. Individuals were invited to complete Beck Depression Inventory-II (BDI-II). Patients with elevated depressive symptoms (BDI-II ≥14) were interviewed about their psychological care need. Based on their care needs patients were categorized into: unmet need, no need, met need and unclear need. These groups were compared on type of depressive symptoms, as categorized into cognitive-affective symptoms and somatic symptoms.Results568 eligible individuals had elevated depressive symptoms, of whom 519 were reached. Among these depressed individuals, 19.7% (102 of 519) had an unmet need for psychological care. Participants with an unmet need were younger (p<0.001) and had higher total depression scores compared to the group with no need (p<0.001). They also scored higher on cognitive-affective symptoms (p<0.001), whereas somatic symptoms did not significantly differ (p = 0.232). Logistic regression revealed that cognitive-affective symptoms predicted an unmet need (p = 0.001). However, overall predictive capacity of type of depressive symptoms on care needs was weak.ConclusionsCognitive-affective symptoms of depression—but not somatic symptoms—were associated with an unmet need for psychological care among depressed individuals with diabetes. Future research is needed to reveal better predictors explaining the discrepancy between distress and low care needs in order to optimize screening procedures.

Factors contributing to the recognition of anxiety and depression in general practice

BackgroundAdequate recognition of anxiety and depression by general practitioners (GPs) can be improved. Research on factors that are associated with recognition is limited and shows mixed results. The aim of this study was to explore which patient and GP characteristics are associated with recognition of anxiety and depression.MethodsWe performed a secondary analysis on data from 444 patients who were recruited for a randomized trial. Recognition of anxiety and depression was defined in terms of information in the medical records, in patients who screened positive on the extended Kessler 10 (EK-10). A total of 10 patient and GP characteristics, measured at baseline, were tested and included in a multilevel regression model to examine their impact on recognition.ResultsPatients who reported a perceived need for psychological care (OR = 2.54, 95% CI 1.60–4.03) and those with higher 4DSQ distress scores (OR = 1.03; 95% CI 1.00–1.07) were more likely to be recognized. In addition, patients’ anxiety or depression was less likely to be recognized when GPs were less confident in their abilities to identify depression (OR = 0.97; 95% CI 0.95–0.99). Patients’ age, chronic medical condition, somatisation, severity of anxiety and depression, and functional status were not associated with the recognition of anxiety and depression.ConclusionsThere is room for improvement of the recognition of anxiety and depression. Quality improvement activities that focus on increasing GPs’ confidence in the ability to identify symptoms of distress, anxiety and depression, as part of care according to guidelines, may improve recognition.

Эмоциональное состояние и стратегии совладания подростков с онкогематологическими заболеваниями

The article presents data on the study of emotional state characteristics and coping strategies of adolescents in the stressful situation of oncohematological diseases treatment. Two equalized by socio-demographic and clinical parameters groups of patients 11-18 were examined. The experimental group consisted of 28 adolescents undergoing treatment with hemopoietic stem cell transplantation (HSCT) (M = 14.25, SD = 2.20, M: 57.1%, F: 42.9%). The control group consisted of 30 adolescents undergoing chemotherapy (M = 13.71, SD = 2.12, M: 53.3%, F: 46.7%). The psychological state of adolescents in the course of treatment by НSCТ, in comparison with the state of adolescents of the control group, which is characterized by a significantly higher level of distress and anxiety. Significant differences in the use of coping strategies with stress in patients of the two groups were obtained. Adolescents of the experimental group use a less extensive repertoire of productive coping strategies, often use such an ineffective strategy as "discharge" These differences may be associated with less availability, as well as an increase in depletion of various coping resources under special treatment conditions by the НSCТ. The results of the study confirmed that НSCТ is objectively and subjectively more stressful, which indicates the need for additional monitoring of both the psychological state and the need for psychological care for patients in this group, the development of specialized programs for psychological support for transplantation.

Disaster nursing skills, knowledge and attitudes required in earthquake relief: Implications for nursing education.

Globally, nurses becoming more aware of getting better prepared for disaster relief, but in China, disaster nursing knowledge, courses and research are still limited. China has long been prone to disasters, but disaster nursing education and training is in its infancy. This study explored the skills, knowledge and attitudes required by registered nurses from across China who worked in the aftermath of three large earthquakes to try to determine future disaster nursing education requirements. The Questionnaire of Nurses' Disaster Nursing Skills at Earthquake Sites, assessing nursing skills, knowledge and attitudes, was distributed to 139 registered nurses in 38 hospitals in 13 provinces across China who had worked in one or more earthquake disaster zones. Descriptive statistics were used for quantitative data, and content analysis for qualitative data. Eighty-nine questionnaires were returned, a response rate of 68.3%. No respondent had ever received specific disaster nursing training prior to their post-earthquake nursing. Skills most often used by respondents were haemostasis bandaging, fixation, manual handling, observation and monitoring, debridement and dressing, and mass casualty transportation. Respondents identified that the most important groups of skills required were cardiopulmonary resuscitation; haemostasis, bandaging, fixation, and manual handling; and emergency management. They emphasized the need for psychological care of victims as well as that of fellow health workers. No respondent had ever received disaster nursing training prior to engagement at the earthquake disaster sites. All believed that there were important gaps in their knowledge and skills, and supported disaster nursing courses in the future. China urgently needs to develop disaster nursing courses, with the support of nurse leaders, educationalists and government, to implement training using an all hazards approach in accordance with international best practice and trainees' background clinical experience and knowledge.

Psychological Wellbeing of Saudi Patients Diagnosed with Chronic Illnesses

Patients’ psychosocial status interferes with their ability to manage their physical needs independently affecting health care outcomes. The purpose of this study was to investigate the psychological wellbeing of patients diagnosed with chronic illnesses in Saudi Arabia. A cross sectional survey using 412 patients diagnosed with chronic illnesses has been used to collected data in regards to depressive symptoms, psychological distress and life satisfaction. 17.5% of the patients reported that they had moderate to severe depressive symptoms, and about 50% of them had high level of life satisfaction, moderate level of psychological distress. There were significant association between patients’ age and depression (r = .17, p = .003), while no significant correlation with life satisfaction and psychological distress (p > .05). Positive and significant correlation found between period of diagnosis and life satisfaction (r = .16, p = .010), and negative and significant correlations with psychological distress (r = -.13, p = .029). Also patients were different in the level of life satisfaction relation to medical diagnoses (F5412 = 2.74, p = .019). Patients with chronic illness are in need for psychological care, and periodic psychological screening is one step toward maintaining their psychological wellbeing.

Depressive Symptoms Among Adolescent Students in Greek High Schools.

Depressive symptoms in adolescence have been a subject of considerable controversy in terms of their nature, severity and identification. Therefore, the objective of this study was to examine the presence of depressive symptoms in Greek adolescent high school students and to explore the relationship between depressive symptoms and sociodemographic characteristics. For that purpose, a cross-sectional study design was conducted in two public schools in Megalopolis, Greece, from April 2012 to July 2012, using a self-administered questionnaire based on DSM-IV. The target population involved 222 high school students and the response rate was 74.75%. Data was analyzed using trend χ2 test, student’s t-test and bivariate analysis. The analysis of survey data was conducted using the SPSS (19.0). Main findings demonstrate that 3.6% had symptoms of major depressive episode. Furthermore, depressive symptoms were significantly higher in girls, while statistically significant relationships were found between students’ physical (P<0.01) and mental health (P<0.008), students’ experiences in school (P<0.02), students’ experiences with friends (P<0.008) and the frequency of depressive symptoms. Overall, the study results reveal that depressive symptoms can occur in adolescents. Early diagnosis, as well as the need for psychological care at adolescence is necessary for the prevention of major depressive disorders.

Psychosocial Health Status of Patients Diagnosed with Chronic Illnesses in Jordan

Background: The comorbidity between chronic physical conditions and psychosocial health consequences is becoming a research interest for researchers in the field. The purpose of this study was to investigate the psychosocial health status of patients diagnosed with chronic illnesses in Jordan. Methods: A cross sectional survey using 806 patients diagnosed with chronic illnesses has been used to collect data in regards to depressive symptoms, psychological distress, coping, optimism, life satisfaction, and perceive social support. Results: 17.5% of the patients reported that they had moderate to severe depressive symptoms, and about 50% of them had high level of optimism and life satisfaction, moderate level of effectiveness of coping skills, psychological distress, and perceived social support from family, friends and others. There were significant association between patients’ age and their scores on perception of social support from family, friends and others, life satisfaction, and psychological distress (p > 0.05). While, male and female patients were different in their depressive symptoms (t = －2.57, p = 0.01), perceived social support from others (t = －2.06, p = 0.04), and optimism (t = 2.29, p = 0.02). Also, patients had differences in their depressive symptoms, perceived social support from friends, others and friends, optimism, life satisfaction, and psychological distress related to their medical diagnoses (p < 0.05). Conclusion: Patients with chronic illness are in need for psychological care, and periodic psychological screening is one step toward maintaining their psychological wellbeing.

The therapeutic community impulse: what makes it grow?

PurposeThis paper seeks to provide a history and a prehistory of the therapeutic community movement, and a series of questions still debated in the field.Design/methodology/approachThe paper discusses the factors which favour the creation of therapeutic communities, drawing on Winnicott's views on democracy and the history of therapeutic community innovations. Some key factors are identified and their implications discussed.FindingsThe paper suggests that the therapeutic community impulse takes root where a number of individuals, with what Winnicott has called the “democratic tendency”, come together in response to a community's need for psychological care and support, and this can happen anywhere.Originality/valueThe paper offers a history and a prehistory of the therapeutic community movement, and draws out some of the implications for the future development of therapeutic communities and the nurturing of the therapeutic community impulse.

Conflicting perceptions between health care professionals and patients on the psychological morbidity following miscarriage

Miscarriage is common and may result in significant psychological morbidity for women. Recent research has revealed that health care professionals often tend to neglect this factor. This negligence may lead to delayed diagnosis and appropriate care. To assess health care professionals' and patients' attitudes towards the psychological impact of miscarriage. A prospective, cross-sectional survey of nearly 3000 subjects was conducted. Of these, 1269 were health care professionals and 1519 were pregnant women or their spouses. Their perceptions of the psychological impact of miscarriage, in comparison with postnatal depression were studied. RESULTS Health care professionals were less aware of the psychological impact of miscarriage compared with postnatal depression (91.9 vs 98.4%, P = 0.02). Furthermore, they believed that the psychological impact of miscarriage was less than that of postnatal depression (79.9 vs 88.9%, P < 0.001). However, more patients believed that psychological impact after miscarriage can seriously affect women (59.0 vs for health care professionals 38.3%, P < 0.001). A higher proportion of patients compared with health care professionals (85.2 vs 74.3%, P < 0.001) believed that routine psychological support should be provided after miscarriage, but few agreed that primary health professionals were the most suitable people to provide this care although most health care professionals thought this to be appropriate (9.1 vs 59.7%, P < 0.001). Health care professionals should be more aware of the psychological morbidity associated with miscarriage and also be sensitive to a currently unmet need for psychological care.

Diez años de psicología clínica infantil y de adultos en un centro privado

In this article shows the result of ten years of work ¡n clinical psychology for children and adults from a narrative perspective. We have stressed from the beginning, the growth in activity and acceptance by users of the need for psychological care. This process we have experienced and looking back we raised this study to determine the evolution of our work, both in techniques and in the results. We describe here the analysis of data obtained from the 595 subjects who have entered into the study, whose results indicate that the therapeutic process is carried satisfactory. CITE AS:Berzosa Grande, M.P. &amp; Rinconada Lorenzo, M.P. (2010). Diez años de psicología clínica infantil y de adultos en un centro privado. Apuntes de Psicología, 28, 31-50.

Prospective analysis of depression and psychological distress before and after surgical resection of lung cancer

The psychological effects of surgery have received little attention in patients with lung cancer, so it is unclear how much psychological support is required by these patients. This study was done to assess the mental state of patients with lung cancer before and after surgery and to determine their need for psychological care. A group of 165 patients with lung cancer scheduled for surgical treatment were included in this study. They were asked to complete the Profile of Mood States questionnaire before surgery and on discharge after completion of treatment. The data on mood from the questionnaires were analyzed. Tension-anxiety improved significantly after surgery, whereas the fatigue score increased significantly. The scores for depression-dejection and confusion were elevated before surgery and were unchanged afterward. Patients with lung cancer were depressed before surgery and remained depressed after their operations, although postoperative tension-anxiety diminished. These results indicate that lung cancer patients need psychological support to alleviate depression during the perioperative period.

Evaluation of the home help service and its impact on the informal caregiver's burden of dependent elders

This study looks at the objective and subjective characteristics of home respite service provision and its impact on the informal care burden of dependent elders. A sample of 296 dependent people and their informal caregivers was randomly selected among users and non-users of the Home Help Service (HHS) in an autonomous Spanish region (Comunidad Valenciana). An experimental design was used and a field study was carrying out that collected information on sociodemographic variables of the dependent person and his/her caregiver, HHS characteristics and the assessment of the services delivered by this resource as well as the informal caregivers'burden. The results show that the services of this resource are very limited, with low cover and frequency, and they do not address the real dependency needs in specific activities of daily living. However, users and caregivers are satisfied with this care and experience a higher quality of life since it was implemented, although the HHS does not alleviate informal caregivers' stress. These data show the need to extend the services delivered by the HHS and the duration of care, address the caregiver's need for psychological care, and look at potentially modifiable variables in the care context when designing prevention and psychosocial intervention programmes to lessen the informal caregiver's burden.

The contribution of psychologists to specialist palliative care.

Current approaches to multidisciplinary working in specialist palliative care generally acknowledge the need for psychological care and the contribution of specialist psychological services. Embedded within an integrated approach to care, there has long been a recognition of the psychological needs of patients and their informal caregivers, although there has been less consensus on how these needs should be addressed. Confusion appears to exist regarding the boundaries between psychological support and psychological interventions, and which members of the multidisciplinary team are best qualified to provide them. This article aims to explore the contribution of psychologists and psychological services to specialist palliative care. It offers a conceptual model to help categorize psychological care in hospices and specialist palliative care services. It seeks to help define the boundaries between general psychological support and care that may be offered by nurses and other health care professionals, and the specialist expertise of psychologists.

Transtibial amputees from the Vietnam War. Twenty-eight-year follow-up.

The long-term functional outcome following lower-extremity amputation is not well documented. I ascertained the functional outcome and health status of patients who had sustained a unilateral transtibial amputation as a result of a battlefield injury. The records of 123 patients who had been treated at Valley Forge Army General Hospital during the Vietnam War for a diagnosis of isolated transtibial amputation due to a battlefield injury were reviewed. Group 1 had an isolated transtibial amputation, and Group 2 had at least one other major injury (another major long-bone fracture of the lower extremity, burns covering >20% of the body surface area, or a chest, abdominal, face, or head wound) in addition to the transtibial amputation. Seventy-two (59%) of the patients were enrolled in the study: twenty-eight were in Group 1 and forty-four, in Group 2. Data were collected about employment status, marital status, whether the patient had children, and use of psychological support services. The Short Form-36 (SF-36) health survey was used to compare Group 1 and Group 2, individually and combined, with age and gender-matched controls. Scaled scores for the two groups (control and amputation) were compared with use of the Student t test (two-tailed). Tripping a land mine or booby trap caused 65% of the injuries. The average age at the time of follow-up was forty-eight years. The average time to follow-up was twenty-eight years. Only the prevalence of the use of psychological support services differed significantly between Groups 1 and 2 (21% compared with 50%; p = 0.015). The results of the SF-36 health survey for Groups 1 and 2 were 81.6 and 58.2, respectively, for physical function, 82.7 and 33.1 for role physical, 81.4 and 50.9 for bodily pain, 74.1 and 58.7 for general health, 67.1 and 51.5 for vitality, 89.1 and 70.4 for social function, 88.1 and 56.0 for role emotional, and 79.5 and 64.0 for mental health. The average scaled scores for Group 1 were similar to those for the age and gender-matched controls, but the scores for Group 2 were significantly lower (p < or = 0.001) than those for the age and gender-matched controls in all categories. Group-1 patients led relatively normal lives after sustaining a transtibial amputation in battle. The addition of another major injury (Group 2) appears to have significant long-term consequences with regard to SF-36 scores and the need for psychological care.

Radiotherapy: Impact of Quality of Life and Need for Psychological Care: Results of a Longitudinal Study

Background: In the framework of a prospective longitudinal study, the quality of life (QoL) and support requirements of patients from a university hospital department of radiotherapy were evaluated for the first time by means of established psychodiagnostic questionnaires. Patients and Methods: At first, 732 patients were screened, of whom 446 (60.9%) fulfilled the criteria for inclusion; 39.1% did not (refusals 21.0%, low Karnofsky performance status 6.6%, management problems 3.4%, language barriers 3.0%, cognitive restrictions 2.6%, death 2.5%). Disease-specific aspects of QoL (Functional Assessment of Cancer Treatment – General, FACT-G) and moderating variables [Social Support Scale (SSS), Disease Coping (FKV), Self-Assessment Depression Scale (SDS), and Self-Defined Care Requirements (BB)] were self-rated by patients with different tumor types before radiotherapy (T1), after radiotherapy (T2), and 6 weeks after the end of radiotherapy (T3). We studied 265 patients (157 male, 108 female; median age 58.6 years) with complete data of three time points. Results: In general, QoL of patients decreased significantly over all time points in all subscales. Social support was rated high and remained constant throughout the treatment. Apparent coping mechanisms were active problem-oriented coping, leisure activities, and self-support. The patients’ depression proved to be an important and constant factor without significant changes. The support requirement is characterized by the need for more medical information and dialogue with a physician. Conclusions: Early specific support from personnel with radiotherapeutic skills, during the disease-coping process as well as during rehabilitation, should be a permanent component of an integrated radiooncological treatment schedule.

Family history of breast cancer: what do women understand and recall about their genetic risk?

The current study has two aims: (1) to look at people's recall of risk information after genetic counselling and (2) to determine the impact of receiving an audiotape of the...