Psychosocial Implications Research Articles

Defining "successful" treatment outcomes in adolescent idiopathic scoliosis: a scoping review.

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis that affects children aged 10-18years old, manifesting in a three-dimensional spinal deformity. This study aimed to explore outcome measures used in defining AIS treatment success. Particularly, analyzing the extent of qualitative and quantitative (radiographic and quality of life domains) measures to evaluate AIS and whether AIS treatment approaches (surgical, bracing and physiotherapy) influences outcomes used as proxies of treatment success. EMBASE and MEDLINE databases were used to conduct a systematic scoping review with 654 search queries. 158 papers met the inclusion criteria and were screened for data extraction. Extractable variables included: study characteristics, study participant characteristics, type of study, type of intervention approach and outcome measures. All 158 studies measured quantitative outcomes. 61.38% of papers used radiographic outcomes whilst 38.62% of papers used quantitative quality of life outcomes to evaluate treatment success. Irrespective of treatment intervention utilized, the type of quantitative outcome measure recorded were similar in proportion. Moreover, of the radiographic outcome measures, the subcategory Cobb angle was predominantly used across all intervention approaches. For quantitative quality of life measures, questionnaires investigating multiple domains such as SRS were primarily used as proxies of AIS treatment success across all intervention approaches. This study identified that no articles employed qualitative measures of describing the psychosocial implications of AIS in defining treatment success. Although quantitative measures have merit in clinical diagnoses and management, there is increasing value in using qualitative methods such as thematic analysis in guiding clinicians to develop a biopsychosocial approach for patient care.

Physical and psychological wellbeing among Australian and New Zealand patients seeking fertility treatment during COVID-19

ABSTRACT Background Worldwide, COVID-19 has disrupted the provision of fertility treatment and patients’ reproductive plans, resulting in heightened stress for many people seeking to form or expand their families. Aims Our study explored health behaviour changes and psychosocial implications of COVID-19 in patients accessing fertility treatment in Australia and New Zealand. Materials and Methods Sixty participants (58 female; 2 male) completed an online cross-sectional survey about demographics, fertility history and treatment, changes to physical and mental health status, and perceived support. Participant responses were summarised using descriptive statistics. Results Patients indicated that COVID-19 had adversely impacted their fertility treatment experience, including interruptions to treatment owing to fertility clinic closure (70%) and fears about conceiving (68.3%). Patients reported negative health behaviour changes, including a reduction in sleep quality (40%), reduced exercise (40%), weight gain (56.7%) and increases in symptoms of depression (38.3%), anxiety (75%), stress (78.3%) and loneliness (38.3%). Whilst most participants agreed their fertility clinic clearly communicated policy about COVID-19 service changes, including information about availability and/or restrictions, approximately 55% reported being offered nil to very little professional psychological support. When provided professional support, this was most commonly via fertility doctors and nurses (48.3%) compared to counsellors (3.3%). Conclusions(s) Commensurate with findings from larger international cohorts, this study highlights the negative impact of COVID-19 on health behaviours and psychological wellbeing. Moreover, given the ever-changing landscape of COVID-19, our study underscores the importance of promoting and utilising fertility clinic counselling services to enhance patient psychological care during this unprecedented pandemic.

The experiences of nurses who were involved in the COVID-19 contact tracing and tracking activities in Bulawayo, Zimbabwe

Background: The COVID-19 pandemic had a significant impact on the healthcare systems worldwide. For countries to contain the spread of COVID-19 and to mitigate its impact, contact tracing was adopted as one of the COVID-19 response strategies. The objective of this study was to explore and describe the experiences of nurses who were involved in the COVID-19 contact tracing and tracking activities in Bulawayo, Zimbabwe. Methods: A descriptive phenomenological design was utilised in this study. Data was collected telephonically using in-depth individual interviews between the 28th of December 2020 and 25th February 2021. Twelve participants comprising of two males and ten females with experience in contact tracing were purposively sampled and interviewed telephonically to get lived experiences. The number of females and males who were purposefully sampled depended on the proportion of this participants in the setting. Analysis followed the seven steps by Colaizzi strategies. Results: The study findings demonstrated that the participants experienced challenges as they implemented contact tracing activities. Four themes on contact tracing emerged: follow-up and contact-tracing activities; support systems; psychosocial implications; and witnessed patients’ experiences. Fourteen sub-themes were identified: negative perceptions of the re-assigned roles; unintended outcomes; delayed COVID-19 test results; increased workload; provision of personal protective equipment; training and orientation on COVID-19; meals for providers involved in contact tracing; we want to be heard and listened to; anxiety and fear; stress; emotionally challenging moments; unable to provide a service; witnessed discomfort; and stigma and discrimination. Conclusions: Contact tracing is key in the response to the COVID-19 pandemic. The strategy has proven to be complex, with increased workload, which is emotionally draining – hence the need for an effective support system for staff conducting contact-tracing activities.

Post-Inflammatory Hypopigmentation: Review of the Etiology, Clinical Manifestations, and Treatment Options.

Post-inflammatory hypopigmentation is a common acquired pigmentary disorder that is more prominent in skin of color, leading to great cosmetic and psychosocial implications. Often, a diagnosis with a pigmentary disorder can negatively impact an individual's health-related quality of life and may result in stigma. Although most cases of post-inflammatory hypopigmentation resolve spontaneously over time, a systematic diagnostic approach can help with identifying the underlying etiology and informing treatment strategies. It can be due to cutaneous inflammation, sequelae of inflammatory or infectious dermatoses, or dermatologic procedures. Therefore, a thorough understanding of the epidemiology, patient history, physical exam findings, and clinical features of post-inflammatory hypopigmentation phenomenon can explain the primary cause to providers and allow for patient education. It is also important to understand the various therapeutic approaches available and the efficacy of these options, which will inform providers to choose the appropriate therapy for patients. Although algorithms exist for classifying acquired disorders of hypopigmentation, there are no established algorithms for the diagnosis and treatment of post-inflammatory hypopigmentation, which warrants further exploration and discourse.

Evaluation of a nurse-led counselling intervention on selected outcome variables for parents of children with congenital adrenal hyperplasia.

Long-term care of children with congenital adrenal hyperplasia (CAH) has psycho-social implications for parents. Experts recommend a customized educational program for parents to facilitate their psychological adaptation and improve disease management. Such educational programs often provided by nurse counsellors are well evaluated in developed countries. There is a dearth of data on nurse-led counselling in the context of less developed countries. We aimed to evaluate the effect of a nurse-led counselling intervention on various psycho-social outcomes among parents of children with CAH. Fifty consecutive parents of children with CAH attending an outpatient clinic at a tertiary-care teaching hospital were enrolled. Parents' stress level, stigma, knowledge, practices, and treatment adherence were assessed by using Cohen's Perceived Stress Scale (PSS), DSD Stigma scale, and HILL-Bon Medication Adherence Scale (HB-MAS). Three educational counselling sessions were conducted within a month's gap, using PowerPoint presentations and a booklet. Assessment of outcomes was done at baseline and at the end of the third session. At baseline, the majority (90%) of the parents had moderate stress. Half of the parents had mild and the rest had moderate stigma. After the intervention, the majority (94%) of parents had shifted to mild levels of stress and stigma. At baseline, 86% of the parents had poor knowledge about the disease whereas post-intervention, 80% were having good knowledge. Disease management practices and treatment adherence also improved after the intervention. Nurse-led counselling was effective in reducing psycho-social problems, increasing knowledge, as well as improving practices and treatment adherence.

Quality of life in children and adolescents with alopecia areata-A systematic review.

Alopecia areata (AA) is an autoimmune-mediated non-scarring hair loss whose stigmatizing effect may have a severe psychosocial impact. AA has been reported to be correlated with bullying, reduced quality of life (QoL) and psychiatric comorbidities. The effect of AA on QoL in adult patients has been systematically reviewed and found to be detrimental. No systematic evaluation of QoL in children with AA has been performed. The aim of this review is to systematically describe QoL in the child and adolescent population affected by AA. A systematic review of multiple databases and grey literature sources was conducted. Search terms included, but were not limited to, alopecia areata and quality of life. Only studies reporting results on health-related QoL in children and adolescents were included. We evaluated the studies regarding the risk of bias, and conceptual rigour concerning the quality of life and performed a descriptive synthesis of findings. Eight studies met the inclusion criteria, encompassing 358 participants with AA and 64 healthy peers. Seven studies were quantitative using four different standardized questionnaires and scores to measure QoL. One study used a qualitative design. All studies described impairment of children and adolescents' QoL by AA. The most consistently affected QoL domain was embarrassment and self-consciousness. Further psychosocial implications of AA included bullying and limiting participation in school or spare time activities. Existing evidence indicates a substantial impact of AA on QoL in children. In daily clinical practice as well as for developing new treatments QoL in paediatric AA plays a critical role. It should be considered a key outcome in clinical research and decision-making.

Lessons learned from the first 15 years of penile transplantation and updates to the Baltimore Criteria.

Since 2006, five penis transplants have been performed worldwide. Mixed outcomes have been reported, and two of the five penile transplants have required explantation. However, the long-term outcomes have been encouraging when compliance is implemented, whether standard induction and triple therapy maintenance, or single therapy maintenance. Follow-up monitoring of transplant recipients has enabled a synthesis of technical considerations for surgical success and has shown stable leukocyte counts and renal function after a donor bone-marrow-based immunomodulatory regimen followed by tacrolimus monotherapy as long as 3 years post-transplant, as well as continuous nerve regeneration of penile allografts 3 years post-transplant. Areas of uncertainty include the ethics of donor-recipient colour mismatch, surveillance for sexually transmitted infections and how to optimize patient compliance. Questions also remain with respect to the long-term immunological sequelae of penile tissue, functional outcomes, psychosocial implications and patient selection. Patient counselling should be modified to mention the possibility of long-term improvement in nerve regeneration and sufficient renal function with single-therapy maintenance, and to build a longitudinal dialogue and partnership between the patient and the multidisciplinary care team regarding the risks of sexually transmitted infection instead of surveillance.

Discussion and Optimization of the Male Breast Cancer Patient Experience.

Breast cancer in men is rare and often overlooked as there is a misconception that it is a gendered disease that affects women only. The feminization, or "pinkification," of the disease has been socially constructed to raise awareness, improve screening, and empower women but has not addressed the occurrence of the illness in men. Men may therefore experience unique psychosocial difficulties when faced with a disease that predominantly affects women, including feelings of disbelief and embarrassment that impact their sense of self and challenge their masculinity. The lack of mammographic screening in men, lack of public awareness, and the shame that develops during the time of diagnosis can result in treatment avoidant behaviors, a delayed presentation, and worse prognosis in men. Although male breast cancer (MBC) is uncommon, the incidence is increasing; therefore, efforts should be made to enhance education for health care professionals and the general public in order to lessen the stigma, with the goal of improving outcomes. Furthermore, special attention to the unique medical needs and hurdles encountered by transgender males can break down health care barriers in this marginalized patient population. This article offers male perceptions on breast cancer, the psychosocial implications of being diagnosed with a gendered disease, and suggestions on how to improve the MBC experience.

Ethics of Bariatric Surgery in Adolescence and Its Implications for Clinical Practice.

Obesity is increasingly prevalent among adolescents. Clinical and research data support the use of bariatric surgery (BS) as a treatment option for severely obese adolescents, with good results in terms of weight loss, improvement or resolution of comorbidities, and compliance to follow up. Nevertheless, concerns still remain, with significant disparities among countries and ethical concerns mainly raised by performing an irreversible and invasive procedure in adolescence, with potential life-long alterations. In this context, the purpose of this narrative review was to discuss the main current ethical challenges in performing BS in adolescence and to inform appropriate clinical management in the field. The core ethical principles of autonomy, beneficence, nonmaleficence, and justice were revised in terms of patient-centered healthcare through the lens of psychosocial implications. The review concludes with a discussion regarding the potential directives for future research for effective, patient-centered, and ethical management of obesity in the adolescent population.

Evaluation, Treatment, Complication and Prognosis of Ameloblastoma

Ameloblastoma is a significant tumor originating from tissue known for its aggressive nature and tendency to come back after treatment. This review explores the aspects of factors that affect prognosis and strategies for managing a rare tumor that originates from tooth related tissues. Examining patients and utilizing imaging techniques to detect the tumor at an early stage is crucial for good survivability. Prognosis is influenced by recurrence rates, types of tissue characteristics observed under a microscope and how treatments affect surrounding structures, highlighting the necessity for management approaches. Surgical removal is considered the intervention in ameloblastoma management. Histopathological examination remains the gold standard for confirming the diagnosis. Incisional biopsies are often performed to confirm the diagnosis and determine the subtype based on characteristics. Furthermore, it discusses techniques for reconstructing affected areas. Explores the benefits of additional therapies to provide a comprehensive understanding of treatment options. Managing this tumor requires considering both the psychosocial implications and the need for lifelong follow-up. As research progresses, there is potential for markers and evolving treatment methods to enhance accuracy and improve the effectiveness of treatments.

Management of chronic non-cancer pain in primary care.

Management of chronic non-cancer pain in primary care.

Efficacy and safety of cysteamine-isobionicamide complex in postinflammatory hyperpigmentation: A 16-week, randomized, double-blinded, vehicle-controlled trial

Abstract Background: Postinflammatory hyperpigmentation (PIH) is a prevalent acquired hyperpigmentation disorder with significant psychosocial implications. Cysteamine has demonstrated notable efficacy and safety in treating hyperpigmentation disorders. This study conducted a double-blinded, randomized clinical trial to evaluate the efficacy and safety of the cysteamine-isobionicamide complex in managing PIH. Objectives: The objective was to assess the cysteamine-isobionicamide complex’s efficacy for PIH treatment through comprehensive clinical and imaging evaluations. Methods: Forty patients with PIH were recruited at a tertiary medical center from 2021 to 2022 and randomized into the cysteamine-isobionicamide complex treatment group and placebo-vehicle control group. Dermatological assessments, investigator and patient global assessments, and quality of life scores were collected at baseline, week 4, week 8, and week 16. Quantitative evaluation of skin type and lesion pigmentation was performed with the Mexameter®, VISIA skin analyzer, and cellular resolution optical coherence tomography (OCT). Results: At week 8, the cysteamine-isobionicamide complex treatment group exhibited marked advancement in dermatological assessments, melasma area and severity index (MASI), total postacne hyperpigmentation index, and life quality score compared with the placebo-vehicle control group. Furthermore, melanin index and erythema index scores from Mexameter® and VISIA analysis exhibited significant improvement for brown spots at week 16. Cellular resolution OCT imaging revealed decreased melanosome capping and fewer hyperreflective melanophages. Conclusion: This study demonstrated the clinical effectiveness and safety of the cysteamine-isobionicamide complex through comprehensive dermatological assessments, imaging techniques, and patient-reported outcomes. The complex emerges as a promising therapeutic option for PIH, offering potential relief to individuals affected by this hyperpigmentation disorder.

The racial pandemic experienced by Black American men: Cognitive-behavioral and structural implications.

Issues of systemic racism, mass incarceration, and cultural trauma (CT) are linked to emotional sequelae sufficient for treatment. However, attempts to explain the psychosocial reactions of Black American (BA) men to racial injustice and treat CT must be considered in the context of the current and past structural environments in which they live. The purpose of the present study was to obtain in-depth, thick description of two related factors: BA males' perceptions of injustice during the racial pandemic and the consequent psychosocial implications for theory and treatment. An interview guide addressing racial injustice, CT, and coping was used to conduct individual and focus groups' interviews with 20 BA men. The data were analyzed using thematic analysis. The qualitative analysis found five themes that collectively fulfilled the study's aims: (1) A violation of the social contract for Black American men, (2) Black American male distrust for police, (3) tripartite Black American male, police fear and heterogeneous emotions, (4) spiritual, technological, appraisal, and relational Black American male coping for racial injustice, and (5) Black American male resilience despite permanence of the racial status quo. As it pertains to BA male racial injustice and the residual CT, the qualitative data suggested multidimensional interventions that are cognitive-behavioral and structural in nature may be worthy of further empirical investigation. From a CT intervention perspective, the five emerging themes can be directly translated into cognitive-behavioral principles regarding therapeutic rapport, cultural adaptation, emphasis on positivity, and collaborative empiricism when working with BA men. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Non-syndromic hypodontia of maxillary lateral incisors and its association with other dental anomalies

BackgroundTooth agenesis (TA) is the developmental absence of one or more teeth and is the most common craniofacial disorder in humans. Maxillary lateral incisor agenesis (MLIA) is a specific subtype of TA and can have esthetic, functional, and psychosocial implications for patients. The aim of this study was to evaluate the prevalence of MLIA amongst patients with non-syndromic tooth agenesis, as well as its association with other dental anomalies.Materials and methodsThe dental records of 240 patients with non-syndromic congenitally missing teeth treated at the University of Alabama at Birmingham Department of Orthodontics were reviewed. Dolphin Imaging software was used to identify missing teeth, microdonts, peg laterals, impactions, and transpositions. Data were analyzed using chi-square or Fisher’s exact test. All the tests were two-sided at the significance level of 0.05 (SAS 9.4).ResultsIn the patient cohort, MLIA prevalence was 37.5% (second most common) and no gender or ethnic differences were identified. We also observed the bilaterally missing lateral incisors more frequently than the unilateral presentation (p = 0.0006). Additionally, 62.5% of patients with unilateral MLIA displayed a contralateral tooth that was a peg (p = 0.0001); however, no association was found with other microdonts. Furthermore, of the 90 patients missing at least one maxillary lateral incisor, 42.2% were missing another tooth type and 10% of MLIA patients also had an impacted tooth (mainly maxillary canines). However, these were not statistically significant. Finally, no transposed teeth were found in our patients.ConclusionsThis study found that maxillary lateral incisors were the second most frequently missing teeth. When clinicians diagnose congenital absence of a maxillary lateral incisor, the patient should be evaluated for other missing teeth, peg lateral incisors, or potential impactions, especially maxillary canines.

Social and psychological effects of circumcision: A narrative review

Descriptions of penile circumcision have focused primarily on disease, dysfunction, or sensation, with relatively little consideration of the psychological and psychosocial implications of the procedure. It is also reported to be of interest regarding potential qualitative changes in the subjective experience of sexual activity following changes in penile anatomy (removal of the foreskin) or related sexual biomechanics. Circumcision indeed has psychological, psychosocial, and psychosexual effects. The differences in circumcisions performed during infancy, childhood, and adulthood are remarkable. There are also potential psychosocial effects on parents who may or may not choose circumcision for their children. We argue that additional attention should be paid to the potential for long-term effects of the procedure, which may not be appropriately considered when the patient is an infant or child.

“If It's not on Strava it Didn’t Happen”: Perceived Psychosocial Implications of Strava use in Collegiate Club Runners

The fitness app Strava incorporates the utility of a fitness tracker with the connection of social media. Since 2009, Strava has attracted over 100 million users, yet little research has assessed the implications of its use. The purpose of this study was to explore the perceived psychosocial implications of Strava use among collegiate club runners. Semi-structured interviews were conducted with 18 runners from collegiate running clubs across the United States who were Strava users. Results indicated that runners perceived the psychosocial implications of Strava use to fall into three main themes: 1) self-presentation, 2) social pressure, and 3) motivation. The findings of this study support the utility of Strava to connect collegiate club runners and support their motivation to run while also suggesting some potential concerns related to social pressure and self-presentation that could influence mental or physical health.

Experiences of Patients Adopting and Adapting to Closed-Loop Insulin Delivery Systems (CLIDS).

The purpose of the study was to explore the perspectives and experiences of adults with type 1 diabetes (T1DM) who are currently using the closed-loop insulin delivery system (CLIDS). Eleven adults with T1DM who used closed-loop insulin pumps for at least 6 months participated in this qualitative descriptive study. Four themes emerged from the rich descriptions: (1) striving for improvement, (2) missing a magic wand effect, (3) seeking support, and (4) barriers to adaptation. These themes represent both process-based and psychosocial implications for nursing practice and patient education. To optimize CLIDS use and outcome, the antecedent conditions that contribute to patients' decision to adopt it must be understood. Then, interventions that focus on setting realistic expectations must be created. Patients need support as they incorporate CLIDS into their T1DM self-management. Training health care providers on the idiosyncrasies of adapting to CLIDS is critical. Patients must learn to relinquish control and trust the machine and manage the anxiety the system's intrusive alarms cause them so they can be better supported cognitively and psychosocially.

Lived Experiences of Adults with Sickle Cell Disease: A Qualitative Study, Dar es Salaam, Tanzania.

Sickle Cell Disease (SCD) is most common genetic disorder and its prevalence in sub-Saharan Africa is increasing. Despite increased survival rates, experiences of adults living with SCD in Tanzania is not well explored. This article provides perceived causes of pain crisis, pain self-management approaches and psychosocial implication of SCD. This study aimed at exploring experiences of adults living with SCD regarding pain triggering or aggravating factors; self-management for pain; psychosocial-economical implication of SCD and coping mechanism used by individuals living with SCD. A qualitative study design was chosen using in-depth interviews with adults living with SCD to explore their experience of living with SCD. Fifteen adults aged 18 years and above living with SCD were interviewed. Data were analyzed by using content analysis approach. Four categories emerged that described experiences of individuals with SCD. The four categories are; "Pain Triggering and Aggravating Factors" describing participants' perceived factors causing pain in SCD; "Self-care remedies for the pain" referring to participants' methods for self-management of pain; "Psychosocial-economic impact of illness" referring to participants' experience of implication of illness on social and economic life and "Dealing and coping with illness" referring to experience of participants on management and coping strategies used to live with the illness. Individuals with SCD experiences several episodes of pain that affect their quality of life. Pain episode can be triggered or aggravated by various factors. Several approaches are used by individuals with SCD to self-manage the pain including taking rest, drinking plenty of water or using pain relieving medication. Care for individuals with SCD should be comprehensive and include proper management of pain, health education on home-based intervention for sickle cell pain, supportive services to deal with psychosocial implications of SCD and improving coping strategies to live with the illness.

Factors Affecting Resiliency in Outpatient Pediatric Occupational Therapist

<h3>Research Objectives</h3> 1. To investigate the resilience of pediatric occupational therapy practitioners during the Covid-19 pandemic. 2. To investigate the factors that may contribute to resilience levels in occupational therapists. <h3>Design</h3> This short-term, mixed-methods study utilized an electronic survey that consisted of demographic, qualitative, and quantitative questions to examine what factors were in place to aid in the overall resilience of pediatric occupational therapy practitioners working in an outpatient setting. <h3>Setting</h3> Study setting included a pediatric outpatient clinic located in the suburbs of a small, midwestern city. <h3>Participants</h3> A voluntary response sample was recruited from an outpatient pediatric therapy clinic in Iowa. Eleven (n=11) occupational therapy practitioners met the inclusion criteria and completed at least 50% of the survey. <h3>Interventions</h3> Participants voluntarily completed the electronic survey that was shared via an anonymous survey link. Twenty-one survey questions collected demographic, qualitative, and quantitative data. <h3>Main Outcome Measures</h3> The survey included ten questions adapted from the Life Orientation Test-Revised (LOT-R) which is used to measure optimism versus pessimism. Four additional qualitative questions were included to assess protective factors for psychosocial resilience and implications resulting from the Covid-19 pandemic. <h3>Results</h3> The results of the LOT-R demonstrated that the participants who had prior resilience training did not display a greater level of resilience or perceived ability to overcome adversity when compared to those who did not have prior resilience training. Positive resilience themes that emerged from the qualitative data include having a support system, practicing safety precautions, and taking life one day at a time. <h3>Conclusions</h3> Future research should consider factors that support caregivers, specifically occupational therapy practitioners and their quality of life. By understanding what factors contribute to resilience levels, these factors can further be implemented and supported in the workplace environment. Targeted education and training for practitioners focused on resilience building should be considered. This implementation could lead to stronger support networks and reduced burnout and compassion fatigue resulting in better resilience outcomes. <h3>Author(s) Disclosures</h3> No known conflicts to declare.

Lower Extremity Malformations.

Lower Extremity Malformations.