Psychosocial Research Articles

Does The Sinusitis Affect Bronchial Hyperresponsiveness In Asthmatic Children ?

278 Psycho Social Stresses and Asthma Morbidity In Children Dr. Ejaz Yousef, MD, FAAAI; Marshfield Clinic, Marshfield, WI; Marshfield Clinic, MARSHFIELD, WI. RATIONALE: The purpose of this review is to investigate the influence of psycho-social stress on asthma morbidity in children. METHODS: Data on 56 asthmatic children aged 5-18 years were collected. Subjects were examined for the influence of psychological stresses (AHDH, Anxiety, Depression) and social factors (parental divorce, poor school performance, chronic illness in the family and any other stress in the family). The study subjects were divided into two groups. Group A (N5 30) comprised of children without personal or family history of psychosocial stress. Subjects in Group B (N5 26) had 2 or more background psychosocial stressors. RESULTS: Group A: Average asthma related hospital admission rate for group Awas 2 ER/Urgent care visits/year. 10 subjects had >2 courses of systemic steroids/year. Average asthma related missed school days/parental job time in the group was 4 days/year. Non compliance with asthma medications/care plan was found in 11 subjects Group B: Average hospital admission rate for group B was > 1.5 /year/subject.16 Subjects had >2 ER/Urgent care visits/year. 17 subjects had >2 courses of systemic steroids /year. Average missed school /parental job time in group was 9 days/ year. 16 subjects in Group were found to be non-compliant with medication/asthma care plan. CONCLUSIONS: These data suggest that psychosocial stressors may act as risk factors for asthma morbidity. Further research is needed to characterize the relationship with stress at multiple levels to more fully understand and address asthma morbidity in children.

Psychosocial Health and Workability among Staff Working with People with Cognitive Restrictions and Intellectual Disabilities

Little is known about the psychosocial work situation among staff working with people with cognitive restrictions, and research is needed. Aim: The aim of this study was to describe the symptom panorama and psychosocial work situation of staff working with people with cognitive restrictions and to identify predictors for their job satisfaction and workability. A cross sectional study was performed. Method: The Questionnaire Psycho Social Nordic (QPS-Nordic questionnaire) was used. Results: The results showed that the majority of the staff working with people with cognitive restrictions were satisfied with their job, but musculoskeletal symptoms were described by 40%. Decision demands at work were high compared to quantitative and learning demands. Musculoskeletal symptoms were related to low ability to master the work, low job control and high job demands. Symptoms from the neck region were correlated to stress. A low level of neck pain was related to a high level of job satisfaction. Predictors for workability were positive challenges in work and not being hindered by musculoskeletal symptoms in work. Predictors for job satisfaction were mastery, workability and not having pain during the last 7 days. Conclusion: Due to the relatively small sample the results should be interpreted with caution. The results indicated that positive challenges in work and not being hindered by musculoskeletal disorders predicted workability in this group and that mastery, workability and not having pain during the last 7 days predicted job satisfaction.

The validity of the Menopause-specific Quality of Life questionnaire in women with type 2 diabetes

Objectives To examine the validity and reliability of the Menopause-specific Quality of Life (MENQOL) questionnaire in a sample of women with diabetes in Malaysia, with the secondary aim of determining whether MENQOL domain scores were associated with depression and diabetes.Methods A total of 337 postmenopausal women (241 with diabetes, 96 controls) were evaluated. Construct validity was evaluated using principal components analysis (PCA) and comparing scale items against the mental component score of the Short Form-12 (SF-12 MCS), and against the Center for Epidemiologic Studies Depression Scale 10 (CES-D 10). Consistency assessment was conducted using Cronbach's α.Results The internal consistencies for the physical (PHS), psychosocial (PS), sexual (VSS) and vasomotor domains were 0.86, 0.79, 0.79 and 0.70, and 0.90 for the full scale of MENQOL. PCA revealed a four-factorial model. Diabetes and non-diabetes subjects experienced their first period (13.25 vs. 13.10 years, p = 0.680) and achieved menopause around the same age (49.35 vs. 48.87 years, p = 0.426). We found significant variations in the MENQOL's PHS and PS domain scores that could be explained by SF-12 PCS (25%) and SF-12 MCS (20%) sub-scales. The validity of the MENQOL domains was demonstrated through significant associations with the equivalent SF-12 MCS and PCS subscales. The PS domain of the MENQOL also predicted the likelihood of symptoms of depression (1.42, 95% confidence interval 1.01–2.02).Conclusions This study confirms the validity and internal consistency of the MENQOL questionnaire for measuring quality of life in postmenopausal women with diabetes, suggesting that the instrument can be used to screen people for menopausal symptoms.

Responsiveness of the Child Health Questionnaire‐Parent Form in adolescents with non‐specific chronic pain or fatigue

The Child Health Questionnaire (CHQ) is a widely used instrument for measuring health-related quality of life covering both the physical and psychosocial domain. This study examined the responsiveness of the Dutch CHQ 50-item Parent Form (PF50) in a sample of adolescents with chronic non-specific pain and/or fatigue. Five different methods were used to calculate the responsiveness for the physical (PhS) and psychosocial (PsS) subscale of the CHQ-50: standardized response mean (SRM), pooled effect sizes (ESs), standard error of measurement of agreement (SEMagreement ), minimal detectable change (MDC) and the area under the receiver operating characteristics (ROC) curve. For data analysis, the population was divided into two groups based on the parent's global perceived effect of treatment: a changed group (A) and an unchanged group (B). The responsiveness analyses were performed including 92 adolescents (88.0% girls; mean age 16.4 years). The SRMs are 2.89 and 1.01 for the PhS and PsS, respectively. Large ESs are found for group A (PhS = 3.30; PsS = 1.16). The method used for calculating SEMagreement results in a score of PhS = 18.92 and PsS = 11.39. The MDCs of PhS and PsS are 52.45 and 31.57, respectively. The area under the ROC curve (AUC) for PhS = 0.79 and for PsS = 0.64, and the corresponding optimal cut-off points are 21.1 and 7.0. Using the methods SRM, ES and AUC, the responsiveness of the CHQ-PF50 in adolescents with non-specific chronic pain or fatigue treated in a rehabilitation clinic is adequate for the physical scale and moderate for the psychosocial scale.

THU0477 Canakinumab Improves Health-Related Quality of Life (HRQOL) and Daily Functioning in Systemic Juvenile Idiopathic Arthritis (SJIA) Patients

BackgroundEfficacy and safety of canakinumab (CAN), a selective, fully human, anti-interleukin-1β monoclonal antibody, in SJIA is supported by the results of 2 phase III trials. In Trial 1 (4-Wk, randomized...

Psycho Social Stressors in Elderly Assessed with Heart Rate Variability

BACKGROUNDPsycho‐socio stressors may over time result in dominance of the sympathetic nervous system (SNS) over the parasympathetic nervous system (PNS). Reduced PNS control over cardiovascular processes has been associated with decreased health. Heart rate variability (HRV) has been proposed as a technique to quantify SNS and PNS interactions and thus might offer a noninvasive predictive index.OBJECTIVETo investigate the impact of real‐life stressors on HRV fluctuations in independent living elders (EL).METHODSFor three months every two weeks EL (N=22; Age=75±9; M/F ratio=17/5) performed autonomic tests consisting of quiet breathing, paced breathing and hand grip. All did a questionnaire assessing depression, positive/negative live events, and isolation.RESULTSNegative events (r=0.36, p=.01) and isolation (r=0.35, p=0.02) are correlated with HR. Personal changes in HRV, SDNN (r=−0.43, p<0.005) and Poincare Width (r= −0.42, p<0.005), are correlated to negative life events.CONCULSIONNegative life events reduce HRV which suggests either SNS activation and/or PNS withdrawal.Research was made possible by Healthy for Life, TNO, and the Center for Innovation, Mayo Clinic.

Psycho Social Function of Women with Disabilities in Tiruchirappalli District, Tamil Nadu, India.

The Differently abled women face many disadvantages due to their status as women. They are kept aside of the conventional movements and are denied of their rights. Their identity is very much questioned and so they lead a life without any identity. This marginalized section of the society search for an identity and the inability to cope up with the existing oppressing structures causes them to have psychosocial problems. The sexual harassment, domestic violence and exploitation in the workplace met by the Women with disabilities deepen their psychosocial problems. This research study is an attempt to help the policy makers, government and Non-governmental organizations to help the Women with disabilities to come up in life and to have right self image and identity. The present descriptive study was conducted in 16 blocks of Tiruchirappalli district. The universe consists of 1249 WWD in Tiruchirappalli District. The researcher selected 20 women with disabilities as a sample from each block of Tiruchirappalli District (N=320) through stratified disproportionate random sampling method. The researcher suggests that mainstream organizations must support and work in partnership with organizations led by women with disabilities. Rehabilitation and adaptive technology must be available for women with disabilities, and women with disabilities must be involved in the development and production of adaptive devices.

P-1387 - Psychosocially stress mice treated by acute CB1 agonist show behavioral deficits and endocannabinoids changes

Aim of the study: to examine the role of endocannabinoids and CB1 receptors in psychosocial (PS) stress in mice. PS stress was induced in C57Bl/6 mice by resident-intruder paradigm (Brzózka et al. 2010). After 3 weeks PS stress anandamide (AEA), 2-arachidonoylglycerol (2-AG), N-oleoylethanolamine (OEA) and palmitoylethanolamide (PEA) were estimated in hippocampus, prefrontal cortex, striatum and cerebellum. Identically stressed and control mice (N = 15) were injected with WIN55212.2 (3 mg/kg) ± Rimonabant (3 mg/kg). Functional Observational Battery (FOB) (Golub et al., 2004), Open Field (OF), Prepulse Inhibition test (PPI) were studied. All behavioral recordings were done at night. Stressed mice showed significantly lowered AEA and OEA in Hippocampus, significant increase of 2-AG in Cortex, decrease of OEA in Striatum and increase of 2-AG in Cerebellum. Stressed mice displayed significantly lowered body weight gain, higher scratching activity, decrease of righting reflex time in FOB, higher distance travelled, time moving and hyperactivity in OF. In stressed mice WIN55212.2 significantly lowered rearings, increased righting reflex time, reduced distance travelled, time moving and hyperactivity in OF. Rimonabant did not significantly antagonize the effect of WIN55212.2 in stressed mice, but in controls. In controls WIN55212.2 significantly increased the number of scratches, reduced distance travelled, time moving and climbing and increased the startle response amplitude in PPI. The latter effect was significantly antagonized by Rimonabant. To sum up significant stress effects could be recorded in behavior, but less in PPI. PPI seems to be dependent on CB1-receptor processes but in case of stress endocannabinoids-activities may contribute.

Psychosocial (PS) resilience augmenting strategies (RAS) in patients (PT) with cancer (CA) post-traumatic growth (PTG): A pilot study for personalized survivorship improvement.

e19718 Background: PS distress is common in CA PTs. Resilience after CA-associated PS trauma requires effective support and coping strategies. In order to increase the information about which strategies are most useful to PTs in achieving PTG, we evaluated PT experiences. Methods: Unstructured interviews were conducted in 10 PTs about their CA experience and RAS (teaching cohort- TC). Based on RAS most often recommended, we then conducted semi-structured interviews and administered surveys to PTs (validation cohort- VC) to determine the frequency and importance of each RAS. We evaluated the relationship between age, gender, and self-perception to the type of strategy used. Results: TC identified four major RAS: family (F), religion (R), self-will (SW) and support group (SG). 34 PTs in the VC were mean age 65, and 59% female. Diagnoses were breast (15), prostate (5), lung (4), colon (3) and miscellaneous CA(7). Time from diagnosis was <1 yr in 5, 1-5 yr in 16, and >5 yr in 9. 79% rated themselves as generally happy, 21% as intermittently happy and worried, and none as worried. PTs rated the following RAS as highly important: F 79%, SW 74%, R 47% and SG 21%. PTs ranked as most important F 53% followed by SW 35%, R 21%, but SG 0%. Mean rankings (scale 1 most important to 5 least important) were F 1.53, SW 2.06, R 2.74, SG 3.73, and other 4.25 (friends, coworkers, blogs, medical staff). F, SW and R were more important than SG (p<0.0001). When asked if CA had changed their attitudes on life, 18% said they had a more positive attitude, 9% said they had a more negative attitude, while 76% said it was unchanged. Analyses indicated no correlation between RAS and gender, age, type of CA, or change in life attitude. Conclusions: RAS identified in order of importance are F, SW, R and SG. Since demographic data does not predict which strategy will be most important to increasing the resilience of the individual PT, PTs should be counseled about all the most commonly used RAS, and monitored to identify their use in managing distress and fostering PTG. Oncologists should not rely solely on SG to increase resilience. These results suggest that promotion of RAS can be more focused and personalized.

The results of an attachment promotion program for children in a child-care institution

This study was conducted to evaluate the effect of an attachment promotion program as an early intervention for children with developmental delays in a child-care institution. The developmental status of the experimental group of 7 children (mean age; 25 months) who were referred to the program by child care workers due to their developmental delays was assessed by Psycho Educational Profile and Social Maturity Scale before and after the program. The program was composed of 32 sessions of intensive interactive plays and every child was coupled with an adult therapist. During same period, we also assessed developmental changes of a control group of chronologically same aged 7 children (mean age; 27months) in the same institution who did not participate the treatment program. The experimental group showed statistically significant increase of Total score (p&lt;0.05), Imilation (p&lt;0.05), Perception (p&lt;0.05), Gross-motor (p&lt;0.05), Eye-hand integration (p&lt;0.05) and cognitive verbal areas (p&lt;0.05) subscale scores of PEP after the program. But the comparison group showed significant change only in imitation (p&lt;0.05) subscale of PEP. In SMS both group showed significant change. ln comparison of difference scores (pretreatment, score-post-treatment score) between experimental group and control group, all subscales of PEP except fine motor, cognitive performance and cognitive verbal areas subscales showed statistically significant differences between two groups. In SMS, there was also significant difference between groups. The results suggest that the attachment promotion program as an early intervention for children in a child-care institution is an effective tool for preventing and improving their developmental delays.

Health status of children with cerebral palsy living in Europe: a multi‐centre study

The aim of this report is to describe the health status of 8-12-year-old children with cerebral palsy (CP) of all severities in Europe using the Child Health Questionnaire (CHQ). A total of 818 children with CP from nine centres in defined geographical areas participated. CP type, gross and fine motor function, additional impairments were classified and family data were obtained. The CHQ was used to measure the parent's perception of their child's physical (PHY) and psychosocial (PSY) health. PHY scores were lower than the reference samples with a median of 46. The severity of gross motor function influenced the CHQ scores significantly in the PHY scale with the lowest scores for children with least gross motor function. There were significant differences between the CP types in PHY with the higher scores for children with unilateral spastic and the lowest scores for children with bilateral spastic and dyskinetic CP type. Fine motor function severity significantly affected both the PHY and PSY scales. The severity of intellectual impairment was significantly associated with CHQ scores in most dimensions with higher scores for higher IQ level in PHY and PSY. Children with seizures during the last year had a significantly lower health compared with children without seizures. The results of the multivariate regression analyses (forward stepwise regression) of CHQ scores on CP subtype, gross and fine motor function, cognitive function, additional impairments, seizures, parental education and employment revealed gross motor function, cognitive level and type of school attended were significant prognostic factors. This report is based on the largest sample to date of children with CP. Health status as measured using the CHQ was affected in all children and was highly variable. Gross motor function level correlates with health from the PHY well-being perspective but the PSY and emotional aspects do not appear to follow the same pattern.

Development and initial validation of a new short and simple Health-Related Quality Of Life (HRQL) Questionnaire for Pediatric Rheumatic Diseases (PRD)

Methods The Pediatric Rheumatology Quality of Life (PRQL) includes 10 questions, each scored from 0 (normal) to 3 (worst). Score range is 0–30. The PRQL contains two subscales, each composed of 5 questions (score range 0–15), that assess physical (PhH) and psychosocial (PsH) health. Validation of PRQL included evaluation of feasibility, face and content validity. Construct validity was assessed by calculating Spearman's correlation with JIA outcome measures in 723 visits (403 patients) made between 2007 and 2008. Construct validity of PRQL was compared with that of Child Health Questionnaire (CHQ) by assessing the same correlations of in a historical sample of 501 visits (448 patients) made between 2002 and 2006 who had CHQ completed.

Clinico psycho social conference: A novel learning experience for postgraduate students of community medicine

The School of Public Health (SPH), Postgraduate Institute of Medical Education and Research (PGIMER), has initiated a Clinico Psycho Social Conference (CPSC) for its postgraduate students. Focus is on the social aspects of the disease. Present case attempts to demonstrate the potential of CPSC as a training method. The index case was a female, who got married at 35 years of age to a graduate farmer from a joint Jat family of Punjab. She conceived within 2 months of marriage. A private practitioner referred her to government hospital. Her husband accompanied her to the hospital, where she was confirmed HIV positive. She was then referred to PGIMER. The patient was in a state of shock, initially, when she knew about her HIV status, as she said, “Eh bimari mainu kithon lag gai, kyun lag gai? ? ?” (from where and why did I get this disease?). Her husband supported her in this phase of crisis as she told, “Pati ne keha ki bade hospital vich dikha ke dekhiye” (My husband suggested that we should take a chance and consult a bigger hospital.). Her main concern seemed to be the survival of the fetus. She said, “Sayad bacha bach jave, kafi muridan ton mangaya hai” (May be our child survives; the conception was a result of lots of praying to the God). She was counseled in PGIMER on various issues such as immunization, breast feeding, etc. She regularly took Ziduvudine. She told, “Davai Khani hai, CD4 jaida hai ate AIDS hon vich time lagda hai” (The doctor told me that my CD4 count was high; it takes time for the development of AIDS, so I have to take the medicine). She did not tell her in-laws about her HIV status. Her mother, sister and brother accompanied her to the hospital. She gave birth to a 4-kg male baby through caesarian. About her plans, she told that “asi hun bachha karna hi nahin” (We do not want another child). Her husband was reported to be HIV negative.

Effect of change in workplace and family environment on general and mental health of middle-aged working women: A cross-sectional study

The aim of the present work was to assess the health status of middle aged (45 �55 yrs) women working as school teacher. Number of subjects selected for study was 50. An interview schedule with General Health Questionnaire and Psycho Social Stress Scale questionnaire was simultaneously administered to the selected subjects. Results revealed some interesting findings that may be useful in planning future such studies.

A Comparison Of Mental Health Status During Menopause And Post-Menopause Middle-Aged Working Women

The aim of the present work was to compare the mental health status of middle aged (45-55 yrs) working women who were under menopause period with those in post-menopause period. The number of subjects selected for study was 50. An interview schedule with General Health Questionnaire and Psycho Social Stress Scale questionnaire was simultaneously administered to the selected subjects. The observed mean scores of post-menopausal group were comparatively higher than those for during menopausal group however, the study resulted not statistically significant difference between the groups on various scores.

Early childhood factors influencing health‐related quality of life in adolescents at 13 years

. Wilkins, A.J., O'Callaghan, M.J., Najman, J.M., Williams, G.M. &amp; Shuttlewood, G. ( 2004 ) 40 , 102 – 109 . Objective To understand the relationship of health‐related quality of life (HRQOL) to early life experience.Methodology Eight thousand five hundred and fifty‐six women enrolled in a prospective study at their first antenatal clinic visit. At 13 years, of 5345 women remaining, a consecutive sample of 901 mother/child pairs provided data on adolescent HRQOL using the Child Health Questionnaire‐Parent Report form (CHQ‐PF50) and the Dartmouth COOP Functional Assessment Charts for Adolescents. The CHQ‐PF50 yielded physical (PHS) and psychosocial (PSS) summary scores. We examined the relationship between HRQOL and early childhood predictive variables.Results PHS was related to gestation, maternal health symptoms in pregnancy, maternal anxiety at 6 months, child health and hours of childcare at 5 years (P &lt; 0.05). PSS was related to maternal age at index visit, maternal attitude to pregnancy, maternal satisfaction with caregiving and maternal depression at 6 months, and child health and behaviour problems at 5 years (internalizing and social/attentional/thought (SAT) domains) (P &lt; 0.05). Findings from adolescent self‐reports were similar.Conclusions This study has identified a number of early childhood determinants of adolescent HRQOL. These findings add to the evidence of the effects of early adversity on the developmental pathways of children and support the need for effective early intervention.

Early childhood factors influencing health-related quality of life in adolescents at 13 years.

To understand the relationship of health-related quality of life (HR-QOL) to early life experience. Eight thousand five hundred and fifty-six women enrolled in a prospective study at their first antenatal clinic visit. At 13 years, of 5345 women remaining, a consecutive sample of 901 mother/child pairs provided data on adolescent HR-QOL using the Child Health Questionnaire-Parent Report form (CHQ-PF50) and the Dartmouth COOP Functional Assessment Charts for Adolescents. The CHQ-PF50 yielded physical (PHS) and psychosocial (PSS) summary scores. We examined the relationship between health-related QOL and early childhood predictive variables. PHS was related to gestation, maternal health symptoms in pregnancy, maternal anxiety at 6 months, child health and hours of childcare at 5 years (P < 0.05). PSS was related to maternal age at index visit, maternal attitude to pregnancy, maternal satisfaction with care giving and maternal depression at 6 months, and child health and behaviour problems at 5 years (internalizing and social/attentional/thought (SAT) domains) (P < 0.05). Findings from adolescent self-reports were similar. This study has identified a number of early childhood determinants of adolescent HR-QOL. These findings add to evidence of the effects of early adversity on the developmental pathways of children and support the need for effective early intervention.

An action research approach to workplace health: integrating methods.

Action research, which combines the generation and testing of theory with social system change, demands multiple sources of knowledge about the research setting and encourages the integration of data collection techniques. This article describes the implementation of a longitudinal multi-methodological research and intervention project aimed both at examining the relationship between occupational stress and psychosocial moderating factors (e.g., social support, participation, and influence over decision-making) and health outcomes; and reducing work stress and improving employee health. Combining qualitative and quantitative research techniques such as semi-structured individual and focus group interviews, field notes and survey data increases confidence in research findings and strengthens the process and outcomes of needs assessment, program planning, implementation, and evaluation. Specific examples are provided that illustrate the usefulness of this approach in identifying and understanding problem areas and in developing and evaluating appropriate health education interventions.

Psycho Social Rehabilitation International Founding Congress 15 - 18 October 1986, Lyon/Vienne, France

(1987). Psycho Social Rehabilitation International Founding Congress 15 - 18 October 1986, Lyon/Vienne, France. World Federation of Occupational Therapists Bulletin: Vol. 15, No. 1, pp. 18-21.

A Study of Psychosocial Casework with Chicanos

Despite this scarcity, the literature implies that social casework is irrel evant and that psychosocial casework, in particular, is ineffective with Chi cano clients.3 Proponents of this view, however, have not substantiated their criticism with empirical data. Their presentations tend to be theoretical, based on subjective impressions and assumptions, or to be supported pri marily by anecdotal evidence and unsystematic use of case material.4 Brown, however, suggested that psy chosocial therapy can be used suc cessfully with Chicano clients, when therapy is provided within the frame work of the Chicano cultural system.5 But, Brown's discussion, like most others, is theoretically rather than empirically based. In fact, Brown rec ognized this shortcoming by indicat ing that a systematic study of the ef fects of psychosocial casework with Chicanos should be conducted.