Management Of Psychological Distress Research Articles

Management of psychological distress by non-specialists in conflict-affected areas

Management of psychological distress by non-specialists in conflict-affected areas

P341 Identification and management of psychological distress after stoma surgery: a qualitative study of patients and healthcare professionals

P341 Identification and management of psychological distress after stoma surgery: a qualitative study of patients and healthcare professionals

Examining Factors Related to Health-Related Quality of Life in People With Parkinson's Disease.

Parkinson's disease (PD) results in a range of dysfunctions and disabilities as it progresses to later stages. All these not only affect a patient's physical well-being but also emotional, social, and spiritual well-being. To tailor interventions that can address these concerns, this study aimed to examine the impacts of PD on their health-related quality of life (HRQOL). A cross-sectional study with 123 PD patients. Measures included the following: Hospital Anxiety and Depression Scale, Unified PD Rating Scale-Motor Examination, Hoehn and Yahr Stage, PD Questionnaire-8. Associating factors of HRQOL was examined using stepwise linear regression. Psychological distress and functional impairment are significantly associated with the HRQOL of the PD population. Psychological distress is associated most to the variance of HRQOL (42.4%). Considering that PD is chronic, rehabilitation programs should be applied to address not just functional but also psychosocial needs of PD patients. Early recognition and management of psychological distress in PD patients is indispensable to promote their HRQOL.

Effectiveness of a brief psycho-oncology training program for general nurses: a preliminary study.

Many nurses are not confident in management of psychological distress in cancer patients. We developed a brief psycho-oncology training program for general nurses, and explored the usefulness of the program preliminary. Seventy-two nurses in 17 designated cancer hospitals received a 4-h program comprising an e-learning lecture on assessment and management of normal psychological responses to cancer and an onsite workshop, including a role-play exercise and group work. Primary outcomes were changes in self-reported confidence, knowledge and attitudes toward caring for patients with normal psychological response between pre-training and post-training. All outcomes, excepting several aspects of attitude, were significantly improved after training (P < 0.05). Intervention acceptability was good as no participants dropped out and all participants considered the program useful in clinical practice. Further consideration is required to clarify whether the cancer care provided by nurses who received psycho-oncology training is effective to ameliorate psychological distress in cancer patients.

Connecting through chaos: escape behaviour among sex-working adolescents in Aotearoa New Zealand

ABSTRACTUnderage sex work (USW) has been shown to adversely affect adolescents’ physical and psychological wellbeing; however, little is known about the lives of sex-working adolescents or their needs for services. This study involved semi-structured interviews with eight adolescents who began sex work between the ages of 12 and 16. It was found that caregivers’ characteristics, attachment disruption and early trauma intersected with participants’ wider social environments, specifically with their peer relationships and limited access to services, to create a culture of chaos and avoidant coping. These combined factors constitute significant barriers to service access, and require considered navigation of relational and environmental barriers as well as appropriate management of psychological distress and trauma symptoms to enable effective engagement with services.

Recognition and management of psychological distress in HF

Background: Evidence suggests psychological distress is common in people with heart failure (HF) and associated with adverse clinical and quality of life outcomes. Recent national guidelines highlight that there is a need to improve psychological care in HF. Purpose: This retrospective study of 11 917 clinic letters written by specialist heart failure nurses (SHFNs) contained within 2488 patient files aimed to benchmark documented recognition and management of psychological distress in HF patients by SHFNs in 11 NHS Scotland health boards. Conclusions: The study indicated SHFN case note documentation of recognition and management of psychological distress in HF fell dramatically short of clinical guidelines. Few people with HF are recognised as having associated psychological distress and fewer still are accessing evidence-based interventions. Clinical implications: Improvement to the documentation, identification and management of psychological distress in people with HF by SHFNs should be supported by training delivered by accredited psychology practitioners. There is a need for services to have clinical pathways in place to support any increases in identification of psychological distress in HF.

Psychological factors associated with response to treatment in rheumatoid arthritis.

This paper presents a comprehensive review of research relating psychological domains with response to therapy in patients with rheumatoid arthritis. A holistic approach to the disease was adopted by incorporating not only disease activity but also dimensions of the impact of disease on patients' lives. Psychological distress, including depression and anxiety, is common among patients with rheumatoid arthritis and has a significant negative impact on response to therapy and on patients' abilities to cope with chronic illness. Evidence regarding the influence of positive psychological dimensions such as acceptance, optimism, and adaptive coping strategies is scarce. The mechanisms involved in these interactions are incompletely understood, although changes in neuro-endocrine-immune pathways, which are common to depression and rheumatoid arthritis, seem to play a central role. Indirect psychological influences on therapeutic efficacy and long-term effectiveness include a myriad of factors such as adherence, placebo effects, cognition, coping strategies, and family and social support. Data suggest that recognition and appropriate management of psychological distress may improve response to treatment and significantly reduce disease burden.

La gestion de la souffrance par le psychologue clinicien. Étude des impacts et des stratégies de coping

We focus in this study on strategies used by clinical psychologists to cope with their own or patient psychological distress in the framework of help relationship. A self-administered form was sent to listings of professionals by e-mail. The sample is made of 187 French clinical psychologists. To cope with patients’ suffering, psychologists use mostly avoidance coping style. And the strategies they prefer are “supervision”, “personal therapy” and “speaking with colleagues” (problem focused coping strategies). To cope with their own distress, which has a lot of negative impacts on help relationship, psychologists have most frequently a problem focused coping style but their favourite strategy is to “lighten their schedules”. And almost a quarter of the sample presents a significant level of distress. In conclusion, results show that psychological distress management by psychologists is an important question with a lot of ethical questions.

COMPASS collaborative research Strand 2: The development and evaluation of complex interventions for psychological distress in cancer patients

AimsTo provide the basis for the development of active components of complex interventions for distress and rigorous evaluation of process measures and patient outcomes. A staged co-ordinated approach was adopted,...

Evaluation of a training programme to teach a guided self-help psychological intervention to hospice staff

A recent trial demonstrated that a brief guided self-help intervention reduces anxiety in palliative patients. This study investigated whether training palliative nurses to deliver a guided self-help intervention would improve their routine management of psychological distress. A randomized controlled cluster trial compared a team of nurses who attended training (n=5) with a team allocated to a no-training control condition (n=5) on self-reported behaviour and confidence in addressing psychological distress. Ratings of patient psychological distress at routine clinical assessments were also examined pre- and post-training to assess the impact of training on patient distress. As predicted, patients cared for by the trained team demonstrated a significantly greater reduction in distress post-training than patients cared for by the untrained team. However, there was no significant difference in self-reported behaviour and confidence. These findings suggest that brief workshop-based training improves clinical outcomes on psychological distress and may be a means to increase the accessibility of effective psychological interventions in palliative care.

The Effect of Meditation on Psychological Distress among Buddhist Monks and Nuns

This study aimed to ascertain whether there is an association between meditation and psychological distress. Within a cohort of meditating Monks and Nuns who have accomplished varying levels of skill in the art of meditation, we studied whether there are varying degrees of psychological distress, and if so, whether this correlates to how advanced the meditators are. In this cross-sectional study, Monks and Nuns were recruited from monasteries, nunneries, and volunteer centres throughout Dharamshala, Northern India. A total of 331 Monks and Nuns participated. Psychological distress was measured using the GHQ-12, and the expertise on meditation was assessed through the number of years practising meditation and the maximum length of time held in concentration in one sitting. A dose response association was found with more years meditating associated with increasingly lower GHQ scores. There was 0.21 points drop in GHQ scores for every year meditating (p = 0.001). This study shows that Monks and Nuns who are more advanced in practicing meditation show fewer signs of psychological distress than Monks and Nuns who are less advanced in the art of meditation. The practice of meditation may have therapeutic value in the management of psychological distress, and could be offered as a non-pharmacological treatment alternative in patients with anxiety and depression. This is a preliminary study with limitations. More robust evidence is needed before we can confidently establish a causal link between meditation and psychological wellbeing. Our findings should, however, encourage further research in this area to generate better evidence for the health benefits of what is a long established practice in Buddhist communities.

Diagnosis, Power and Certainty: Response to Davis

Lennard Davis’s “Biocultural Critique” of the alleged certainty of diagnosis (Davis Journal of Bioethical Inquiry 7:227−235, 2010) makes errors of fact concerning psychiatric diagnostic categories, misunderstands the role of power in the therapeutic relationship, and provides an unsubstantiated and vague alternative to the management of psychological distress via a conceptually outdated model of the relationships between physical and psychological disease and illness. This response demonstrates that diagnostic knowledge vouchsafes legitimate power to physicians, and via them relief to patients who suffer from psychological distress. The history of medicine and psychiatry demonstrates that psychiatric diagnosis shares many features with physical diagnosis, while there is also reason to believe that the two types will continue to be distinct in some respects. Diagnostic categories in psychological medicine, like those in physical medicine, are provisional, probabilistic, and often uncertain. These features do not detract from the dependence on diagnosis of therapeutic efficacy in both domains.

Symptom Experience and Quality of Life in Breast Cancer Survivors

The purposes of this study were to evaluate symptom experience and quality of life (QOL) and to identify the predictors of QOL among breast cancer survivors. A cross-sectional study was conducted on 200 disease-free breast cancer survivors at two hospitals between December 2007 and July 2008. Functional Assessment of Cancer Therapy Scale-B, Memorial Symptom Assessment Scale-short Form and The Linear Analogue Self Assessment Scale were used to assess symptom experience and QOL in these patients. Data were analyzed using the Pearson correlation, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. The mean score of QOL for breast cancer survivors was 95.81 (+/-18.02). The highest scores among physical and psychological symptoms were sexual interest and anxiety. Year since treatment completion was significantly associated with QOL in sociodemographic variables. Physical and psychological symptoms have a significant negative association with QOL. The results of the regression analyses showed that physical and psychological symptoms were statistically significant in predicting patients' QOL. Symptom experience and QOL are essential variables that should be acknowledged when delivering health care to breast cancer survivors. More attention to the reduction and management of psychological distress could improve QOL among breast cancer survivors.

General practice management of psychological distress in patients with sexually transmissible infection

This paper investigates general practitioners’ (GP) self-reported practices for psychologically distressed patients with sexually transmissible infections (STI). A cross-sectional postal survey was conducted among a 15% random sample of GP practising in New South Wales. The main outcome measures were self-reported strategies to deal with psychologically distressed STI patients, priority of counselling, and perceived need for training in counselling. The great majority (82%) of GP reported that they extended their consultation time to deal with psychologically distressed patients, whereas 49% reported being likely to refer distressed patients to a counsellor. Just over half (54%) considered counselling to be a high priority in STI care, whereas 49% acknowledged benefits of further training in counselling. Overseas medical graduates were more likely to refer patients in distress to counsellors compared with Australian graduates (odds ratio = 1.80, P = 0.008). Female and metropolitan GP were more likely to consider counselling a high priority in STI care (odds ratio = 1.56, P = 0.038; odds ratio = 1.62, P = 0.028, respectively). GP appreciate the need to deal with psychological distress of STI patients; however, referral to counselling services is not a widespread priority. Further research is needed to examine practitioners’ actual practice in caring for psychological distress among STI patients and barriers to referral for counselling.

“Can It Be That God Does Not Remember Me”: A Qualitative Study on the Psychological Distress, Suffering, and Coping of Dominican Women With Chronic Filarial Lymphedema and Elephantiasis of the Leg

The psychological states of Dominican women with chronic lymphedema and elephantiasis of the leg and the coping strategies they used to ameliorate the negative psychological effects of this condition were explored using modified precepts of grounded theory method. Qualitative data were gathered through in-depth interviewing and focus group discussions held in the Dominican Republic. Thematic results found that compounding their physical disfigurement, functional limitations, and social losses were feelings of depression, embarrassment, social isolation, and despair. Adaptive problem solving and emotion-focused coping strategies that emerged during analysis also are discussed. It is recommended that management of psychological distress should be a significant component of lymphedema management programs in developing countries.

Clinical supervision and education via videoconference: a feasibility project

Clinical supervision and education was provided to a total of 20 psycho-oncology staff by videoconference. Monthly group sessions, with 3-5 participants, were held via multipoint videoconference at a bandwidth of 256 kbit/s. Sessions consisted of a one-hour educational presentation followed by one-hour of case discussion. In addition, participants were offered individual telephone supervision each month. Participants completed evaluations before and after the project, and following each group session. They were asked to rate their confidence in dealing with a range of problems. There were significant increases in self-reported confidence in the areas covered by the educational component, e.g. assessing and treating pain in people with cancer (P<0.01). In addition, self-assessment of overall effectiveness in current management of psychological distress from pre- to post-evaluation increased by 25%. Participants indicated that attending the educational sessions increased their knowledge (mean = 7.3 out of 10). With regard to telephone supervision, most (80%) were very or extremely satisfied. The feedback indicated that remote supervision was well received and that participants were keen to continue their involvement.

Associated and predictive factors of sleep disturbance in advanced cancer patients

Little attention has been paid to sleep disturbance experienced by advanced cancer patients. The purpose of the present study was to investigate longitudinal change in sleep disturbance and to identify factors that associated with and predicted sleep disturbance among 209 consecutive terminally ill cancer patients. Patients were assessed twice for sleep disturbance by one item of the structured clinical interview for assessing depression, once at the time of their registration with a palliative care unit (PCU) (baseline) and again at the time of their PCU admission (follow-up), and possible associated medical and psychosocial factors were evaluated. The proportions of patients with obvious sleep disturbance at baseline and follow-up were 15.3 and 25.9%, respectively. Sixty-seven percent of the subjects showed some sleep status changes, including both aggravation and improvement, between baseline and follow-up. Being younger, having diarrhea and living alone were significantly associated with sleep disturbance at baseline, and the increase of psychological distress was the only significant predictive factor for sleep disturbance at follow-up. These findings suggest that psychological distress is a possible key cause of sleep disturbance and management of psychological distress may be one promising strategy for prevention of sleep disturbance among advanced cancer patients.

Psychological distress, loneliness and disability in old age

With the growth in the number of older people, an increase of mental health problems might be expected. Reducing the amount of suffering and dependence due to poor mental health in old age is a priority requiring a good understanding of the determinants of psychological distress. The objectives were: (a) to measure the prevalence of psychological distress and loneliness in old men and women, living in the community, (b) to clarify the association between psychological distress, health and other explanatory variables and (c) to determine relationship between loneliness and psychological distress. We performed a cross-sectional study of 999 people aged 65+. The variables studied were psychological distress (GHQ-12) and self-reported loneliness. The prevalence of psychological distress was 20%. Illness and disability are related to psychological distress in old age; the feeling of loneliness is the single most important predictor of psychological distress, and not knowing neighbours increases the probability of depression. Attempts to improve detection and management of psychological distress in sick older people, in those who appear isolated and express loneliness should be evaluated.

Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study.

There is evidence of an interaction between psychological factors and activity of inflammatory bowel disease (IBD). We examined the influence of depressive mood and associated anxiety on the course of IBD over a period of 18 months in a cohort of patients after an episode of active disease. In this prospective, longitudinal, observational study, 60 patients (37 women and 23 men) with clinically inactive IBD (Crohn disease, n = 47, 78%; ulcerative colitis, n = 13, 22%) were enrolled after a flare of disease. Psychological status, health-related quality of life (HRQOL), and disease activity were evaluated at baseline and then every 3 months for a period of 18 months by means of clinical and biological parameters, the Beck Depression Inventory (BDI), the Spielberger State-Trait Anxiety Inventory, the Inflammatory Bowel Disease Questionnaire, the Perceived Stress Questionnaire, and the Rating Form of Inflammatory Bowel Disease Patients Concerns. At baseline, depression (BDI > or = 13 points) was found in 17 of 60 (28%) patients. Thirty-two patients (59%) experienced at least one relapse during the 18 months of follow-up. Regression analysis showed a significant correlation between BDI scores at baseline and the total number of relapses after 12 (p <.01) and 18 months (p <.01) of follow-up. Furthermore, depression scores at baseline correlated with the time until the first recurrence of the disease (p <.05). Anxiety and low HRQOL were also related with more frequent relapses during follow-up (p <.05 and p <.01, respectively). Psychological factors such as a depressive mood associated with anxiety and impaired HRQOL may exert a negative influence on the course of IBD. Therefore, assessment and management of psychological distress should be included in clinical treatment of patients with IBD.

The management of psychological distress in terminal illness

The management of psychological distress in terminal illness