Psychological Care Of Patients Research Articles

The psychological care of patients undergoing an evisceration of the eye

This paper examines the need for patients undergoing evisceration surgery to remove their eye to receive psychological support. The removal of an eye has serious consequences on various aspects of a patient's personal and family life, yet despite this there is a notable lack of literature and research relating to the physical, psychological and emotional care of patients undergoing this life-changing treatment. Patients are often listed for surgery in a busy, under staffed outpatient setting with no nurse present and if surgery is required immediately, due to severe pain or trauma, the patient may not receive pre assessment. As a result there may be little opportunity for the patient to come to terms with their altered body image which can have devastating effects on their recovery. An in-depth literature review identifies the lack of literature in this complex area of nursing, however, it offers insight to the reader with clear recommendations for practice. Hehir (2000 ) states that the psychological aspect of disfigurement is highlighted as one of the main concerns of patients undergoing removal of an eye. Indeed this study indicates that an ocular plastic specialist nurse to provide psychological support for these patients at all stages of their journey would be beneficial, as would ophthalmic ward nurses receiving basic counselling training. Such nurses would help patients to come to terms with their altered body image, offering support at all times.

NURSING PROBLEMS IN A PATIENT WITH CANCER OF THE CERVICAL SPINAL CORD

Neoplastic lesions of the cervical spinal cord, are much less frequently than intracranial tumors.Aim of this study was to present the most important nursing problems, which can meet with the nurse taking care of the quadriplegicpatient with paralysis. Presented case study patient treated surgically for tumors of the cervical spinal cord.Patient care discussed completely immobilized, only passing a care nursing staff. In the process of care should pay particular attention to:the prevention of cardiovascular and respiratory disorders, prevention of decubitus changes, preventing inflammation of the bladder and preventpulmonary embolism.It is very important to include early physical rehabilitation and psychological care of patients and their families.

FC18-03 - Internet addiction as comorbid disorder in patients with a substance-related disorder: results from a survey in german inpatient clinics

IntroductionInternet Addiction (IA) is discussed as a serious health problem. Epidemiologic investigations show prevalence rates of 3% of internet users that fulfil criteria for IA. Reported symptoms like tolerance, withdrawal, and craving resemble those of substance-related disorders. Although there is no final agreement on the classification of IA, it has often been referred to as a non-substance-related addiction fostering current issues on the next revision of DSM (Holden, 2010).ObjectivesAlthough IA has been investigated in epidemiologic studies there is no research of its prevalence in patients in treatment because of a substance-related disorder. Regarding similarities between IA and substance-related disorders, theories suggest increased prevalence of comorbid IA in these patients.AimsThis study focused on the identification of prevalence of comorbid IA among patients with a primary substance-related disorder in different in-patient clinics across Germany.MethodsSponsored by the German Federal Ministry of Health 1826 patients were screened with a diagnostic inventory for IA. For further description additional questionnaires were given assessing aspects of personality (NEO-FFI) and psychopathology (SCL-90R, BDI-II).Results4.1% of the patients fulfilled criteria of IA. In these most common primary diagnoses were pathological gambling and dependency of cannabis. Concerning personality IA-subsample showed increased neuroticism and introversion. Highest symptom burden was found in depression and social insecurity.ConclusionsAmong patients with substance-related disorder prevalence of IA is more common than in healthy samples. Results recommend separate screening for IA in inpatient clinics for substance-related disorders to guarantee full psychological care for patients with IA.

To explore the effect of psychological relaxation techniques in surgical patients psychological care

Objective To summarize psychological care experience, and explore decompression with the psychology of a variety of relaxation techniques in patients undergoing elective surgery and the effect of psychological intervention. Methods There were 80 cases randomly selected patients about an operation, experimental group of 40 patients before surgery, while health education intervention for stress relaxation techniques. The control group of 40 patients was received routine preoperative care, they were investigated by self - rating anxiety scale, 0 ～ 10 numerical rating scale, patient satisfaction survey questionnaire, etc. Results Intervention in the first two groups was no significant difference between parameters (P＞0.05). After treated with the appropriate method of mental relaxation, the SAS, NRS scores of experimental group were decreased and patients'satisfaction was increased, quality of sleep was improved and sleep aid drugs was reduced,the ( P＜0.05 or P＜0.01). Conclusions The treatment of relaxation techniques can increase perioperative patients'comfort and the effect of psychological care, not only improve the quality of care, but also help to promote changes in the pattern of modern medicine to people's health care as the holistic health models. Key words: Relaxation techniques; Surgical operation; Psychological care; Perioperative period

Does multidisciplinary care enhance the management of advanced breast cancer?: evaluation of advanced breast cancer multidisciplinary team meetings.

To assess the contribution of the advanced breast cancer (ABC) multidisciplinary team meetings (MDMs) to patient care and clinical outcomes. Members of ABC MDMs at two health services completed questionnaires in November 2007. The questionnaire asked about the performance of the MDMs and their contribution to improvement in patient care in five domains: medical management, psychosocial care, palliative care, care in the community, and benefits for team members. A final section covered the perceived value and importance of the MDM in patient management. Descriptive statistics (frequencies, mean, and standard deviation) were used to summarize the performance, improvement, and importance scores. A total of 27 multidisciplinary team members (73%) completed the questionnaire. The MDM performed best in medical management (mean performance score out of 5 [M] = 3.78) and palliative care (M = 3.77). These were also the areas that were most improved through the MDM. Benefits to team members and care in the community (both M = 3.05) ranked lowest by both measures. The MDM provided the most benefit for patient management in the areas of "awareness of services available" (M = 4.32), "efficiency of referrals" (M = 4.27) and "supportive care for patients" (M = 4.27). "Awareness of services available," "psychological care for patients," and "continuity of care" were considered the most important (M = 4.64). The study provides evidence that MDMs make an important contribution to the logistical and medical management of patients with advanced breast cancer.

Hemorrhagic stroke patients because of postoperative bleeding and nursing intervention

Objective To summarize the treatment of hemorrhagic stroke patients because of bleeding during re-analysis and nursing interventions of prevention of postoperative bleeding in these patients the best care method. Methods from January 2008 to December 2009 were treated 96 cases of hemorrhagic stroke patients were randomly divided into two groups, intervention group were given general nursing interventions in the control group received routine care of Neurosurgery, The postoperative rebleeding postoperative hypertension and the incidence of postoperative complications. Results Postoperative bleeding in the intervention group, the incideuce of postoperative hypertension and the incidence of postoperative complications compared with the control group decreased significantly. Conclusion Postoperative blood pressure to maintain stability and to prevent increased intracranial pressure, while also making the psychological care of patients and their families and health care education and comprehensive treatment is to reduce re-bleeding of the key factors. Key words: Hemorrhagic stroke; Re-bleeding; Causes; Nursing intervention

An audit of levels of psychological support referrals for cancer patients

There is a wealth of literature concerning the psychological care of patients with cancer but little regarding its delivery and implementation. This retrospective audit reviewed the care of cancer patients (n=50) admitted to a 65-bed inpatient acute oncology unit who were referred to the liaison psychiatry team for mental health assessment. The audit covered a five-year time span and focused on ‘Key recommendation 9’ of National Institute for Health and Clinical Excellence (NICE 2004) guidance that proposed a four-level model of professional psychological assessment and intervention. The audit highlighted underprovision of and too few adequately trained professionals providing level three psychological care interventions at the inpatient unit as well as poor documentation of psychological assessments. Areas of good practice included prompt referrals to supportive care services, consistent follow-up and safe discharge systems. a bs tr ac t

Patient-Perceived Barriers to the Psychological Care of Japanese Patients with Lung Cancer

Although cancer patients frequently experience psychological distress, few cancer patients with psychological distress receive appropriate psychological care. The purpose of this study was to investigate the type and frequency of barriers to receive psychological care in patients with lung cancer. Randomly selected ambulatory patients with lung cancer participated in the study. A self-administered questionnaire developed for this study was used to assess patient-perceived barriers toward psychological care provided in a medical context. Factor analysis indicated that this scale mapped four domains; emotional communication with their physicians, psychiatric consultation, psychotropic medication and counseling. The patients' demographic factors and levels of past and current psychological distress were also assessed to reveal potential factors associated with patient-perceived barriers to psychological care. Complete data were available from 100 patients. The mean (SD) age of the patients was 65.4 (9.8) years; more than 80% were male, and 77% suffered from advanced stage lung cancer. Lack of correct information and/or misunderstanding of treatments was found to be a major barrier for all four treatment options in common. Negative opinions toward the use of psychotropics were more frequent than those toward counseling. Patients with severe psychological distress were significantly more likely to report a reluctance to undergo psychiatric consultation than those without psychological distress. Lung cancer patients commonly experienced concerns to utilize psychological care. Encouragement from physicians to discuss emotional aspects and the provision of sufficient information regarding psychological care may be useful to alleviate such concerns. Medical staff should also be aware that severe psychological distress may itself be related to a reluctance to undergo psychiatric consultation.

Psychological care of patients with gynaecological cancer in French medical oncology centers: Organization and questions

Psychological care of patients with gynaecological cancer in French medical oncology centers: Organization and questions

Burnout and psychiatric morbidity among physicians engaged in end‐of‐life care for cancer patients: a cross‐sectional nationwide survey in Japan

To determine the prevalence of burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients in Japan and to explore associated factors related to end-of-life care. Questionnaires were mailed to 1436 Japanese clinical oncologists and palliative care physicians with a request to complete the Maslach Burnout Inventory (MBI), the General Health Questionnaire (GHQ-12), and to report on individual factors, including confidence in patient care. High levels of burnout and psychiatric morbidity were identified using cut-off scores of the MBI and GHQ-12. A total of 697 physicians returned the questionnaires (response rate, 49.6%). Twenty-two percent of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization, 62% had a low level of personal accomplishment, and 20% had psychiatric morbidity. Clinical oncologists showed a significantly higher psychiatric morbidity than palliative care physicians. Confidence in having sufficient time to communicate with patients was significantly associated with all the burnout subscales. A low level of personal accomplishment was relatively high among Japanese physicians compared with previous studies. Insufficient confidence in the psychological care of patients was associated with physician burnout rather than involvement in end-of-life care.

Psychological care of patients undergoing elective surgery

Psychological care of patients undergoing elective surgery

Evaluation of an action research project in ophthalmic nursing practice

This paper reports the evaluation phase of an action research project that promoted face-down posturing of patients following vitreo-retinal surgery for macular hole to enhance patient outcomes. The evaluation phase identified areas of practice needing further development from the perspectives of those involved with the care of patients. To achieve best results following surgical repair of macular hole, patients are required to posture face down for several weeks. As a consequence, patients complain of severe back and neck ache and find it difficult to persist with the posturing. Work to advance nursing practice as surgical developments occur has relevance beyond ophthalmology and the particular context of this project. The first three phases of this action research--problem identification, planning and action--have been reported in another paper. Throughout the project an action research group comprising of representatives of key stakeholders were actively involved in researching and changing practice. During the evaluation phase, a qualitative methodology was chosen. Interviews with 17 members of staff from the inpatient area were carried out to elicit their perspectives on the posturing of patients. Qualitative interviews were selected to facilitate comparison with interview data from Phase 1. Data analysis ran concurrently with data collection, so that one could inform the other. Overall, nurses and healthcare support workers felt that patients were more agreeable to posturing and after surgery began to posture more quickly. Communication was still an issue in some instances, and patients having urgent as opposed to planned surgery were found to be more difficult to prepare and the psychological care of patients still posed problems for nursing staff. The evaluation suggests that improvements in the care of this group of patients have occurred. A 10-point plan to promote face-down posturing has been developed which will be of use to practitioners in other settings. Some aspects of practice remain less well-understood, for example, the psychological care of patients.

Organization of medical and psychological care for patients with traumatic disease

Results of psychological examination of 117 patients with traumatic disease are presented. Psychological examination was performed using 16-points questionnaire by Cattel, personal questionnaire Type of relation to disease, scale of alarm by Spielberger, techniques Type of psychological protection by Plutchek and Copping-questionnaire as well as drawing test by Rosenzweig by 17, 14, 30, 90 and 180 day after trauma. Three periods of psychological reactions were determined: 1st period acute (shock) reactions (114 day); 2nd period interpersonal reactions (1490 day); 3rd period social disadaptation (90180 day). The program of psychological correction was composed and tested on the base of the revealed peculiarities. When program was completed all patients had control testing. Results showed a high efficacy of psychological correction. The problems of the organization of the psychological care for patients with traumatic disease are considered.

Psychological care of the haemodialysis patient.

The psychological care of patients at the haemodialysis unit is becoming an increasingly important aspect of the overall treatment of patients with end-stage renal failure. As more is understood and reported regarding the impact of psychological factors on physical processes it becomes crucial that good quality psychological care is delivered to patients by nurses working at the haemodialysis unit. This study aimed to look at haemodialysis patients' perceptions of their treatment to discover if a dialysis centre in Southern England might benefit from a more formal system of psychological care. The data revealed four main themes that were of particular importance to the participants of this study: The New Self, Coping, Medical Concerns and Psychological Care. Within these areas of importance, the need for good quality information, the need for a suitable dialysis environment and the importance of social and family support were evident. Although the psychological care system that was in place at the unit appeared to be working well a more formal system of care might improve the patient experience.

Psychological Care for Patients with Recurrent Miscarriage

An understanding of the psychological aspects of recurrent miscarriage involves an analysis of the anecdotal and research literature focused on cause, effects, and treatment. Despite methodological flaws, it is possible to derive fairly specific strategies for physicians that hold promise in mitigating the potentially damaging effects of recurrent miscarriage. The provision of psychological support should include open discussion of the emotional aspects of recurrent miscarriage, the provision of timely and detailed medical information, and referral to a mental health professional if the patient needs more support than the obstetrician/gynaecologist is comfortable providing. The role of psychotherapeutic intervention as a treatment for the pregnant patient is less clear, but there are suggested physician behaviours that have been tentatively linked with improved rates of term pregnancy. These include continuity of the treatment team throughout pregnancy, frequent office visits, reinforced and updated patient teaching, and referral to a psychotherapist who deals with pregnancy-related issues.

Psychological aspects of pre-hospital care

In the last of three articles on pre-hospital care, Tim Kilner considers the psychological care of patients and staff

Psychological aspects of congenital heart disease

AbstractOutcome following the treatment of congenital heart disease continues to improve and interest has focused on reducing morbidity as well as mortality. One important aspect of this is the psychological effect of congenital heart disease and its treatment on both children and their parents. This review addresses the extent and nature of the psychological morbidity associated with this disease, in particular the impact of the diagnosis on the management of patient and family. The etiology of the high level of psychosocial morbidity remains poorly understood. Data from the 1960s concerned with pre-school and school-age children is now of little value given the dramatic changes in the treatment of congenital heart disease, which is now predominantly in the neonatal period. While theory from developmental and pediatric psychology may be usefully applied to this area, further research is required to define effective psychological care for patients and their families.

Psychiatric aspects of bone marrow transplantation: Part I: Special issues during pre‐transplant assessment and hospitalization

AbstractBone marrow transplantation (BMT) has become an important innovative treatment for hematological malignancies, solid tumors, immunodeficiency diseases and metabolic disorders. It has evolved over the last decade from a controversial research procedure to a standard therapeutic modality, which prolongs remission of some patients and cures others. Historically, the BMT procedure is divided into several stages, each of which have accompanying emotional problems. In providing psychological care for transplant recipients, donors and families, care‐givers must be familiar with the psychological stages of the procedure, the psychological themes such as body image, rebirth and the patient's mechanisms of coping with the extreme stress of such protocols. Its complex medications, high‐dose chemotherapy, total‐body irradiation (TBI), germ‐free environment, graft‐versus‐host disease (GvHD), Broviac or Hickman line catheterization and total parenteral nutrition (TPN), can precipitate significant psychological sequelae with immediate and long‐term consequences. In response to their illness, transplant patients may also develop emotional disturbances of anxiety, depression, agitation, non‐compliance and rare suicidal thoughts. These reactions, and the occasional presence of concurrent psychiatric illness, require recognition and development of guidelines for management.This paper is the first in a series of two and will inform the reader about: (1) the biology, epidemiology, history and economics of BMT; (2) informed consent issues and the psychological/social assessment of patients and families prior to BMT; (3) the psychological care of patients during BMT; and (4) address special issues concerning donation of marrow, donor registries, family issues, children as patients and prevention of staff burn‐out. Part II of this series will review the psychosocial adjustment and quality of life of BMT patients as they convalesce and re‐enter normal daily routines. A summary is given of research into which psychosocial factors predict better post‐BMT outcome.

Clinical experiences with a semi-automated perimeter (Fieldmaster)

The perimeter Fieldmaster 101 has been applied to 178 eyes in comparison with a Tuebingen and a Goldmann perimeter. The Fieldmaster allows for a fast and relatively accurate screening test in the detection-phase of perimetry, independently of the skill of the perimetrist. This instrument missed only 2.6% of all pathological fields found by the Goldmann perimeter, and 10% of defective fields taken with the Tuebingen perimeter. In one third of the abnormal findings of the Fieldmaster the defects were even more realistic than in the plots of the Goldmann perimeter, as proven by the static and kinetic fields of the Tuebingen perimeter. The abilities of the Fieldmaster in the assessment-phase of perimetry are limited. Program-operated perimeters like the Fieldmaster are time-saving, but do not replace a perimetrist, especially in the psychological care of patients.

The psychiatrist in the terminal care unit.

The types of problems of 49 patients referred to a psychiatrist in a terminal care unit are reported and their management reviewed. The findings suggest that a psychiatrist can play a useful role in such a unit, particularly in supervising medical and nursing staff in the psychological care of patients and in helping more directly in the management of psychiatrically complicated cases.