Psychosocial Area Research Articles

Quality of Life in Patients Diagnosed with Type 2 Diabetes

Introduction: Since the beginning of the new millennium, type 2 diabetes (T2D) in Mexico is the first cause of death in women and the second cause of mortality among men.1 The T2D is a chronic degenerative disease in which blood glucose is elevated2 and that over time; this excess causes a state known as glucotoxicity, which is the pathophysiological basis of diabetes and its complications.3,4 The T2D is complex and leads to physical, economic, and emotional stress that has a direct or indirect impact on the quality of life of patients.5 Objective: To determine the quality of life in patients with T2D, using the “Escala de Calidad de Vida Relacionada con la Salud” (ESCAVIRS). Methodology: A convenience sample of 60 participants was selected with the following inclusion criteria: diagnosis of diabetes according to the American Diabetes Association criteria, both genders, more than 6 months of evolution, and over 45 years of age. The sample was collected from a clinic and private medical offce (“Casa de Salud” [Cuautlancingo, Puebla] and private medical offce located in the “Independencia” neighborhood [Puebla, Puebla]); where the ESCAVIRS was applied during the period May to June 2023. Results: 60 patients were examined, 45 (75%) were female and 15 (25%) were male. 45 patients (75%) have some degree of overweigh/obesity, only 25% of the population is of normal weight, 50% of the patients were overweight and 25% obese. In the ESCAVIRS physical area, the most notable points were: diffculty at work 66% of the cases (28% often, 38% sometimes), diffculty walking 70% (22% often, 48% sometimes), diffculty sleeping 77% (72% often, 5% sometimes). In the psychosocial area, low self-esteem is observed when diagnosed with the disease and is reflected in emotional aspects such as depression, sadness, anger, and worry. In this study, about the area of medical interaction, the deterioration of the doctor-patient and nurse-patient relationship, most of the patients rated this area well. Finally, in the sexual area and the relationship, it was evident in the study that there is a loss of sexual interest, which contributes to poor sexual and relationship dysfunction. Conclusion: The evaluated areas of ESCAVIRS show that patients with T2D treated in these two clinics have a mild degree of deterioration in their quality of life, especially focused on the psychological and physical area.

Development and empirical testing of a questionnaire-based algorithm to evaluate physical and psychosocial health status in performing artists / Entwicklung und empirische Testung eines fragebogenbasierten Algorithmus zur Erhebung des körperlichen und psychosozialen Gesundheitszustands darstellender Künstlerinnen und Künstler

Abstract Background Health care providers like physiotherapists should address the needs of performing artists for a specific health care derived from physical and psychosocial (performance-related) complaints. The aims of this study were (1) to compose an algorithm including subjective outcome measures in order to suggest how to evaluate the physical and psychosocial health status of performing artists in its complexity in a manner as targeted and detailed as possible, and (2) to test the feasibility of applying this algorithm. Methods Questionnaires regarding different health dimensions were searched and assembled to an algorithm. The survey was applied to performing artists in order to test feasibility. The respective questionnaires were scored and interpreted in comparison to cut-off values. Results Performing-art-specific and body-region-specific standardized questionnaires in German with the highest possible psychometric quality were selected. The algorithm covers a series of questionnaires on health-related quality of life, complaints in physical matters—especially musculoskeletal and voice-specific—and in the psychosocial area. Based on specific predefined decision criteria the artist was guided individually through the survey. This was illustrated by the participants' flow through the survey. Profiles of physical and psychosocial complaints for subgroups of 103 participants were built based on multiple scores and showed problems in both dimensions. Discussion It is possible to illustrate the physical and psychosocial health status of performing artists in a multidimensional way using the novel algorithm. It could be used both for groups and individuals to build complaint profiles for research and clinical purposes.

Stress, Resilience, Burnout and Study Hours in Physical Education Pre-Service Teachers-An Explanatory Model about Gender.

The process of becoming a public teacher in Spain requires a long period of preparation. This long period of preparation has an impact on the psychosocial environment of the candidates. Differences have been observed in the psychosocial area according to gender in pre-service teachers. This research aims to study the relationship between the study hours per day, stress, burnout syndrome and resilience according to gender and to study the differences in the effects according to gender using multigroup equation modeling. A multigroup structural equation analysis has been proposed according to the gender of the participants. Parametric tests were used for the descriptive analysis of the results. The sample consists of 4117 participants, 1363 males and 2754 females. The instruments used to collect the data were a self-made questionnaire, Perceived Stress Questionnaire, Connor-Davidson Resilience Scale and Maslach Burnout Inventory. All the instruments have been validated and adapted to the sample. The data reveal that there are variations in the effects of the variables according to the gender of the participants. In conclusion, it is affirmed that gender is a very important factor in coping with the competitive examination process for state-public-teaching institutions, as well as in avoiding the appearance of disruptive states generated by this preparation process.

Effectiveness of a Judo Intervention Programme on the Psychosocial Area in Secondary School Education Students.

Currently, many combat sports are pedagogically conceived as uneducational and unreliable for the development of young people. The present research aims to investigate the influence of a Judo intervention programme on the motivational climate towards sport, aggressive behaviour, emotional intelligence, and self-concept in secondary school students and to establish the relationships between them. This objective was broken down into (a) developing an explanatory model of the variables mentioned above and (b) testing the model equations through a multi-group analysis in terms of pre-test and post-test. The present study conducted a pre-post-test quasi-experimental design with a single experimental group. The sample consisted of a total of 139 adolescents (12.67 ± 1.066), 50.4% of whom were male (n = 70) and 49.6% female (n = 69). The results show that the intervention decreased all types of aggression and increased levels of emotional intelligence. An increase in social, physical and academic self-concept and decreases in the family and emotional areas were also observed. Finally, for the motivational climate, a tendency towards the ego climate to the detriment of the task climate was observed. It is concluded that the Judo intervention programme is effective in decreasing aggressive behaviour and effective in increasing levels of emotional intelligence and self-concept.

Advanced Nursing Practice als Konzept für die Versorgung von Menschen mit außerklinischer Beatmung in Deutschland: Ergebnisse einer Bedarfs- und Curriculumanalyse

IntroductionOutpatient intensive care for people on home mechanical ventilation (HMV) is a complex area of care with high demands on the nurses specialised in this field. Internationally, academic qualification as an Advanced Practice Nurse (APN) has become established in these fields of specialised care. Despite the large number of further training opportunities, there is no university qualification for home mechanical ventilation in Germany. Based on a demand- and curriculum analysis, this study therefore defines the role of an APN for home mechanical ventilation (APN-HMV). MethodsThe study structure is based on the PEPPA framework (Participatory, Evidence-based and Patient-focused Process for the Development, Implementation and Evaluation of Advanced Practice Nursing). The need for a new model of care was determined with a qualitative secondary analysis based on interviews with health care professionals (n = 87) and a curriculum analysis (n = 5). Analyses were conducted using the Hamric model with a deductive-inductive approach. Subsequently, the main problems and objectives to improve the model of care were agreed upon in the research group, and the APN-HMV role was defined. ResultsThe qualitative secondary data analysis illustrates the need for APN core competencies, especially in the psychosocial area and in family-centred care. The curriculum analysis resulted in a total of 1,375 coded segments. The focus of the curricula was on the central competency “direct clinical practice” (1,116 coded segments) and thus on ventilatory and critical care measures. Based on the results, the profile of APN-HMV could be defined. ConclusionsThe introduction of an APN-HMV can usefully complement the skill and grade mix in outpatient intensive care and counteract care problems in this highly specialised area. The study provides a basis for the development of appropriate academic programmes or advanced training courses at universities.

Multi-dimensional recording of long-term treatment of patients with schizophrenic disorders compared to patients with major depression measured with the ASSESS battery

BackgroundThe aim of the study was to validate the course and outcome of treatment in patients with schizophrenic disorders and to compare it with those of patients with depression using a multidimensional assessing approach measuring psychopathological, social and cognitive levels of functioning. MethodsWe recruited N = 86 chronically ill patients, n = 41 with schizophrenic disorders and n = 45 with depression and examined them by means of the ASSESS battery with 5 measuring points within one year. ResultsPsychopathological symptoms and cognitive functioning changed over time, but still remained. Furthermore, changes in functional ability in the psychosocial area were observed in the overall collective. The course of the patients with schizophrenic disorders differed especially from that of the patients with depression in relation to the domain personal relationships. In both groups, symptoms of the disease correlated negatively with cognition and psychosocial functioning. Cognitive deficits were associated with a reduced level of psychosocial functioning. DiscussionThe ASSESS battery proved to be a practicable measuring instrument for complex assessment of the course of the disease in patients with schizophrenic disorders as well as depression. The stable course of symptoms in both disorders as well as psychosocial differences would have to be further confirmed in long term studies to derive necessary treatment recommendations.

Abstract 11843: Association of Individual- And Neighborhood-Level Factors With Racial and Ethnic Differences in Cardiovascular Health During Early Pregnancy

Introduction: Individual and neighborhood-level factors are associated with racial and ethnic differences in cardiovascular health (CVH). To identify strategies to improve maternal health, we determined the relative contributions of these factors to racial and ethnic differences in early pregnancy CVH. Methods: We included pregnant individuals from nuMoM2b, a multicenter cohort who self-identified as Hispanic, non-Hispanic Black (NHB), or non-Hispanic White (NHW). We applied a Blinder-Oaxaca decomposition to evaluate the extent to which socioeconomic and psychosocial factors, discrimination experiences, and area deprivation index statistically explain racial and ethnic differences in CVH (0-8 points, based on body mass index, blood pressure, diabetes, and smoking status) in the first trimester. This method utilizes a counterfactual approach to estimate the mean change in CVH in the Hispanic and NHB groups if covariates were set to the mean in the referent group (NHW). We calculated the percent explained by each factor by dividing the predicted mean change by the total CVH difference between groups*100. Results: Of 5,695 pregnant individuals, 12.3% were Hispanic, 8.9% NHB and 78.8% NHW. Mean CVH scores were 6.4 for Hispanic, 6.0 for NHB and 6.6 for NHB individuals. After adjusting for age and immigrant status, mean CVH scores were lower (worse) by 0.83 (95% CI 0.51-1.04) points in NHB individuals and 0.49 (95% CI 0.28-0.60) points in Hispanic individuals compared with NHW individuals. Differences in social and psychologic factors explained 87% of NHB-NHW differences and 71% of Hispanic-NHW differences in CVH scores (FIGURE) ; socioeconomic factors explained the greatest difference in CVH between groups. Conclusions: Individual- and neighborhood-level social and psychologic factors statistically explained a clinically meaningful difference in CVH among racial and ethnic groups, which may inform strategies to optimize health in pregnant individuals.

Desafios da terapia ocupacional em saúde mental: reflexões a partir de uma experiência docente

Abstract Reflecting on occupational therapy in mental health from an academic practice while utilizing a critical qualitative approach allows one to identify professional challenges in the daily live contexts of individuals and groups. Prioritizing the clinical context to care has conditioned integral and continuous processes. Occupational therapy in mental health must also transit the daily contexts in which people participate in occupations. This article reflects on occupational therapy challenges in mental health care from academic practice. These reflections are based on the use of qualitative analysis techniques used by two educators in the psychosocial area between 2013 and 2020, among which are included the documentary revision and analysis of the normative and conceptual framework, field journal, documents of systematization of experiences, participant observation and academic spaces for discussion. It allows us to observe that occupational therapy in mental health in Colombia has been structured mainly in clinical contexts, with a resolutive approach. It frequently responds to individual needs related to symptoms associated with prevalent disorders; this institutionalization of the practices limits the continuity of the processes. It is necessary to recognize the current reflections in which occupational therapists are valued professionals who promote the analysis and interaction between systems, contexts, people, populations, and occupations. This dynamic would allow responding to current policy approaches, comprehensive care, and social inclusion. The profession must contemplate subjective occupational needs in daily life contexts, making use of occupation as a tool for autonomy and social inclusion.

The effects of mindfulness stress reduction program on postmenopausal women's menopausal complaints and their life quality

AimThis study was carried out to define the effect of the Mindfulness Stress Reduction Program (MBSR) applied among postmenopausal women on their menopausal complaints and quality of life. Material and methodThe study was conducted with a quasi-experimental design. The sample consisted of 118 women, including 55 in the experimental group and 63 in the control group.A Personal Information Form, the Mindful Attention Awareness Scale (MAAS), the Menopausal Symptoms Rating Scale (MRS) and the Menopause Specific Quality of Life Questionnaire (MENQOL) were used to obtain the participants' data. An 8-week Mindfulness Stress Reduction Program was applied among the women in the experimental group. After the pretest, both groups completed the midtest at eight weeks and the posttests covering MAAS, MRS and MENQOL at 16 weeks. The data were analyzed by using descriptive statistics, independent-samples t-test, chi-squared test, ANOVA and Cronbach's alpha analysis. FindingsIt was observed that, in the midtest and posttest, there was a significant difference between the MRS total and psychological complaints domain scores of the women in the experimental and control groups (p < 0.05). In the midtest, there was a significant difference in the vasomotor, psychosocial, sexual domains and scale total scores between the experimental and control groups (p < 0.05). In the posttest of the women in the experimental and control groups, a significant difference was found between these groups in the MENQOL vasomotor area, psychosocial area, physical area domains and scale total scores (p < 0.05). ResultThe MBSR program reduced the menopausal symptoms and increased the quality of life of the postmenopausal women.

Propuesta de atención a alumnos con niveles de depresión en el nivel superior, en el estado de Yucatán

Objectives: Propose care strategies for students with levels of depression disorders in higher level students through the measurement of depression symptoms in higher level students and with the participation of experts in the psychosocial area, propose support measures of the cognitive model. Methodology: The research is of an exploratory and descriptive type and a non-experimental cross-sectional design (Hernández, et al, 2006), beginning with a documentary research, subsequently measuring the level of depression through instruments that detect the presence of depression in students to generate the proposal of attention and strategies according to the strongest causes to attend to students with levels of depression disorders. Contribution: In the January-June 2020 semester, the total number of registered students was 903 students. Of the total number of enrolled students, 473 students (53%) responded to the depression measurement instrument, it is important to highlight the committed participation of leaders and experts in the analysis of information for the generation of a comprehensive proposal for the care of higher level students, in the State of Yucatan

Методологічні засади дослідження феномену прокрастинації

The author proves the relevance of the study of procrastination to be a stablepersonal construct. The consequences of the increased tendency of the individualto exhibit dilatory behavioral reactions are outlined.The purpose of the article is to construct a theoretical and methodologicalbase for a comprehensive study of the phenomenon of procrastination. The mainmethods of research were theoretical analysis and modeling, which formed thebasis for determining the structure of this disposition.The results of the theoretical study of the problem indicate the necessityto interpret procrastination as a holistic concept, the influence of which is in all dimensions of the personality’s life. The analysis of the essence of the studiedconcept makes it possible to point out its multidimensionality and determinabilityby a wide range of psychological, social and physiological factors. The basis forthe creation of the model of personality of the procrastinator was the principlesof the post-nonclassical scientific paradigm, the principles of systematic,structural, continuity and biopsychosocial approach of J. Angell. Due to thecertain methodological approach, the author notes that procrastination at themacro-systemic level functions as a multidimensional integral stable personalformation, and in the subsystem sphere it is represented by psychosocial andbiological substructures.The psychosocial field of procrastination is considered as a set of individualpersonality traits that are formed and transformed by the inclusion of a personin a wide range of reference groups and the process of socialization in general.From the point of view of the author, the specified dimension of a person beingpredisposed to procrastination is manifested in his way of thinking, emotionalexperiences and peculiarities of behavior. Thus, within the psychosocial area, thecognitive-reflexive, affective-motivational and connective-regulatory levels ofprocrastinator functioning are distinguished.The biological substructure contains two components: a neurophysiological(specific features in the activity of areas of the cerebral cortex of persons beingpredisposed to delaying important cases) and psychosomatic (specific somaticdisorders associated with the individual’s procrastination tendency).Conclusion. Thus, an integral multilevel model of procrastination as a stablepersonal construct was formed, requiring further empirical verification.

Workplace-Related Interpersonal Group Psychotherapy to Improve Life at Work in Individuals With Major Depressive Disorders: A Randomized Interventional Pilot Study.

ObjectivesIndividuals suffering from major depressive disorder (MDD) often report workplace-related stress as the major cause of their disorder. Accordingly, workplace-related stress was established as a fifth psychosocial problem area of Interpersonal Psychotherapy (workplace-related Interpersonal Psychotherapy, W-IPT). The aim of the study was to investigate the influence of W-IPT on depressive symptoms and on workplace-related issues in individuals with MDD compared to a treatment-as-usual (TAU) condition.MethodsA total of 27 individuals with MDD (mean age = 43 years, 48% males) were randomly assigned either to eight weekly group sessions of W-IPT or to the TAU condition. At baseline, 8 weeks later at the end of the intervention, and 20 weeks later at follow-up, the Hamilton Rating Scale for Depression was conducted. In addition, the participants completed the Beck Depression Inventory, the Work Ability Index (WAI), the Return to Work Attitude (RTW-SE), and the Insomnia Severity Index (ISI).ResultsSymptoms of depression in experts' ratings as well as in self-rated ratings decreased over time, but more so in the W-IPT condition compared to the TAU condition [experts rating: large effect size (d = 1.25) and self-assessment: large effect sizes (d = 0.94)]. The subjective ability to work (WAI) [medium effect size (d = 0.68)], self-efficacy to returning to work RTW-SE [medium effect size (d = 0.57)], and subjective symptoms of insomnia (ISI) [large effect size (d = 1.15)] increased over time, but again more so in the W-IPT condition compared to the TAU condition. The effects of the intervention remained stable from the end of the intervention to follow-up.ConclusionsThe pattern of results of this pilot study suggests that a newly established fifth IPT focus on workplace-related stress appeared to be particularly efficient in individuals with MDD due to work-related stress in reducing depressive symptoms and reducing sleep complaints as well as in improving occupational outcomes.

Sistematización de la intervención realizada en un proceso de restablecimiento de derechos desde el enfoque en interlegalidad, adelantado por la Comisaría de Familia de Totoró y el Cabildo Indígena de Novirao

El presente artículo científico describe la sistematización de experiencias de un proceso de restablecimiento de derechos que las autoridades -indígena y ordinaria- adelantaron en favor de una mujer en condición de discapacidad, comunera del cabildo indígena de Novirao del municipio de Totoró, Cauca, quien presuntamente fue víctima de abuso sexual intrafamiliar.&#x0D; Dicho proceso de restablecimiento incluía directamente a la presunta víctima, pero debido a que la situación se dio al interior del sistema familiar, las autoridades tradicional y administrativa y los profesionales del área psicosocial, por medio de un proceso de interlegalidad, determinaron que la familia debía involucrarse en los trámites y acciones de intervención, principalmente para ser acompañada y orientada.&#x0D; Mediante el proceso de sistematización se logró identificar que, gracias a la articulación de la autoridad indígena y ordinaria, la usuaria continuó con su vida, finalizó su embarazo y posteriormente se encargó de la crianza de su hija, producto del presunto abuso sexual. Asimismo, se evidenció que aunque la familia se desestabilizó al conocer los presuntos hechos, por medio del acompañamiento y orientación psicosocial recuperaron el equilibrio y dinámica familiar, abordando el sistema familiar de forma integral, teniendo en cuenta el aspecto sociocultural.

CN66 - Assessment of emotional discomfort of oncological patients in the first nursing visit at Donostia University Hospital

BackgroundA cancer diagnosis often causes an emotional impact with signs of anxiety, uncertainty and subjective discomfort. It´s necessary to identify and assess emotional discomfort to offer quality treatment articulated around the patient and his / her demand. The design of a questionnaire that is easy to use and understand, allows the detection of patients susceptible to referral to the Psycho-oncology Unit (POU). Methods- Prepare a PAQ that includes: Evaluation of emotional distress assisted by visual analogue scales (VAS); Modified Gijón scale (sociofamilar assessment scale); previous use of psychoactive drugs - Include PAQ in the first nursing visit - Quick referral to POU - Interview with psycho-oncology nurse - Valuation, diagnosis and treatment planning by POU - Data recording - Data analysis. ResultsPatients with a positive PAQ are referred to the POU where the liaison nurse performs an interview with the patient and / or family. The nurse collects data on psychobiography, oncological disease, psychic sphere, frequent affections, previous contacts with psychologists / psychiatrists and treatments with psychoactive drugs. The POU will offer the patient the most appropriate resource for their needs (Psychotherapy, Psychopharmaceuticals, and Social Work Service). ConclusionsThe inclusion of the PAQ in the first visit of nursing allows the detection and early treatment of disorders in the psychosocial area. We achieve an optimal use of resources, a greater adherence to the proposed oncological treatment, alleviate problems that are found throughout the oncological treatment and improve the quality of life of our patients by reducing emotional discomfort. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Self-management of diabetes in Sub-Saharan Africa: a systematic review

BackgroundThe prevalence of diabetes in sub-Saharan Africa has increased rapidly over the last years. Self-management is a key element for the proper management, but strategies are currently lacking in this context. This systematic review aims to describe the level of self-management among persons living with type 2 diabetes mellitus in sub-Saharan Africa.MethodRelevant databases including PubMed, Web of Science and Google Scholar were searched up to September 2016. Studies reporting self-management behavior of people with type 2 diabetes mellitus and living in sub-Saharan Africa were included.ResultsA total of 550 abstracts and 109 full-text articles were assessed. Forty-three studies, mainly observational, met the inclusion criteria. The studies showed that patients rarely self-monitored their glucose levels, had low frequency/duration of physical activity, moderately adhered to recommended dietary and medication behavior, had poor level of knowledge regarding diabetes related complications and sought traditional or herbal medicines beside of their biomedical treatment. The analysis also revealed a lack of studies on psychosocial aspects.ConclusionExcept for the psychosocial area, there is a good amount of recent studies on self-management behavior of type 2 diabetes mellitus sub-Saharan Africa. These studies indicate that self-management in sub-Saharan Africa is poor and therefore a serious threat to the health of individuals and the health systems capacity.

Effect of Rehabilitation on Fatigue Level in Patients with Multiple Sclerosis.

BackgroundThe objective of this study was to evaluate the effect of a rehabilitation program in changing the perception of fatigue in patients with multiple sclerosis.Material/MethodsThe study involved 65 respondents/patients with clinically confirmed multiple sclerosis (54 women, 11 men, average age 46.49 years). The evaluation of the effects of fatigue on the physical, psychological, and psychosocial aspects of life was assessed using the Modified Fatigue Impact Scale (MFIS). To test the effectiveness of the neurorehabilitation program, we enrolled 2 groups: the experimental group (EG, n=32, 29 women, 3 men, Expanded Disability Status Scale (EDSS) 4.8 average, SD±1.77, min. 1.5 max 8.0) participated in the intervention and rehabilitation program over a period of 12 weeks and the control group (CG, n=33, 25 women, 8 men. EDSS average 5.12±1.74 SD, min. 2.0 max. 8.0). Each group of patients was divided into 3 sub-groups according to the severity of EDSS: a) 1–3.5, b) 4–6, and c) 6.5–8. For the statistical evaluation of the significance of the observed changes, the MANOVA/ANOVA model was used.ResultsBetween the input and output assessment of the MFIS individual areas questionnaire between the EG and the CG, there existed a statistically significant in the physical area (p<0.000), psychological area (p<0.000), and psychosocial area (p=0.002).ConclusionsOur results support the importance of an active approach in patients with multiple sclerosis using individualized rehabilitation intervention programs.

Psychosocial care in the Department of Pediatric Hematology and Oncology of public hospitals in Argentina.

Blood diseases and cancer are part of a group of rare conditions in pediatrics. In general, cancer treatments are prolonged (months or years), so psychosocial support has been introduced to provide comprehensive care to these patients. To explore psychosocial care provided at the public hospitals of Argentina to children and adolescents with cancer. Population and Methods. An electronic questionnaire was sent to the heads of the Departments of Hematology and Oncology, Mental Health, and Social Services of 27 public hospitals providing care to pediatric patients with cancer. The survey included questions related to psychosocial care provided to this group of patients. Answers were collected and processed in the 2013-2014 period. Of the total number of health care providers contacted, 62.6% (47/75) completed the questionnaire. As per hematologist-oncologists, the three specialties complied with the recommendations made by the International Society of Pediatric Oncology to a greater extent than that reported by the psychosocial area. Such difference was repeatedly observed in all answers. The standards that were observed more consistently were continuation of education and care of healthy siblings. The health care providers from the three specialties indicated that they lacked formal mechanisms to detect failures in treatment adherence in an early manner, although treatment withdrawal interventions were systematized. Providers from the psychosocial area indicated that human resources were lacking and perceived little interdisciplinary work. This study reported partial adherence to the standards recommended by the International Society of Pediatric Oncology. The assessment made by hematologists-oncologists was different from that made by health care providers from the psychosocial area.

Psychiatric symptomatology and health-related quality of life in children with epilepsy

IntroductionThere is a limited amount of data regarding the relationship between epilepsy and psychiatric symptoms and quality of life (QoL) in children and adolescents.ObjectivesThe aim of this study was to determine the levels of depression, anxiety and attention-deficit hyperactivity disorder symptoms and health-related quality of life (HRQL) in children and adolescents with epilepsy.MethodsThe sample consisted of 75 children with epilepsy and 50 healthy controls aged 8–18 years. Questionnaires were used to evaluate the psychiatric status and HRQL of the patients.ResultsPatients had lower child-rated psychosocial and total area HRQL scores, and lower parent-rated psychosocial, physical and total area HRQL scores than the controls did. Inattention scores of the epilepsy group were significantly higher compared to controls. No significant differences were found between patients and controls in terms of anxiety and depression scores. Regarding determinants of HRQL, severity of depression and anxiety had a decreasing effect on child-rated HRQL total scores; and severity of anxiety had a decreasing effect on parent-rated HRQL total scores.ConclusionsEpilepsy is associated with poor QoL in childhood and severity of depression and anxiety are among the determinants of QoL. Clinicians should be more aware of accompanying psychiatric symptoms in epileptic patients and take the necessary precautions in the early period of the illness in an effort to improve QoL.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Deaf-blindness: Voices of mothers concerning leisure-time physical activity and coping with disability

Background: Deaf-blindness (DB) is a distinct disability because of combined impairments of hearing and visual functions, causes severe difficulties in the psychosocial area, communication, social interaction, and interaction with the environment. Leisure-time physical activities (LTPA) properly planned and executed can be beneficial in providing support and facilitating coping as strategy for managing stress in families of children with disabilities. Appropriate LTPA also influence the quality of the lives of people with DB. Our study was also based on coping theory. Objective: The purpose of this study was to examine the beliefs of mothers with regard to leisure-time physical activity of families of children with deaf-blindness, the benefits that activities can bring to families of children with DB, needs and the barriers to participation. Methods: Participants of this study were five mothers of children with DB, who were interviewed using the phenomenological tradition of qualitative inquiry. Results: Findings show six emergent themes in relation to perceived needs of children with DB: structure of life; coactive engagement; happiness and well-being; doing normal things; appropriate support and services; and appropriate communication. Conclusion: The results of the present study indicated that there are various support systems, which could facilitate participation in LTPA: (a) special schools and respite care centers; (b) special programs such as family camps or programs where children can learn basic skills needed for participation in physical activities (e.g., swimming or biking); (c) adapted equipment which can allow participation; (d) parental support groups where parents can share common experiences or religious support groups, which might be able to accept a family with a child with DB as equal member of their community; and finally (e) assistance, which could have a formal form of professionals or paraprofessionals working with persons with DB. The absence of these support systems creates barriers to participation in LTPA due to the children's lack of skills, limited accessibility and non-existence of specialized year round programs.

Ideology and mental health: analysis of the discourse of workers in the psychosocial area

This study proposes to analyze the discourse of workers in a Psychosocial Care Center regarding the operation of the ideologies which express the dimension of social practices incorporated at this service. This was a qualitative research, and the corpus was originated by transcription of semi-structured interviews, applied to 17 out of the 25 workers of a substitute service in a city in southern Brazil. The theoretical-methodological analysis of the operation of ideologies by John Thompson was used. The discourse analysis of the workers' practice shows a plurality of ideological manifestations, so that they reserve the changing practices with innovative and creative features such as the maintenance of obsolete models, hindering or even preventing these changes. In conclusion, these issues should be worked continuously in everyday services, being a major challenge to the consolidation of the psychiatric reform in Brazil.