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The Journal of Allergy and Clinical... Aug 2023Hereditary angioedema (HAE) is a rare and potentially fatal genetic disease associated with recurrent and unpredictable episodes of angioedema. Although modern therapies...
BACKGROUND
Hereditary angioedema (HAE) is a rare and potentially fatal genetic disease associated with recurrent and unpredictable episodes of angioedema. Although modern therapies have dramatically increased quality of life, insurance changes, delays, and denials are becoming more common.
OBJECTIVE
To examine the impact of insurance delays and denials on patient health and well-being.
METHODS
A total of 20 patients with HAE (type 1 and 2) who recently experienced insurance delays or denials completed an online survey, and 19 participated in a follow-up focus group. The survey and focus group addressed the impact of insurance challenges on the use of health care services, work/school attendance, and anxiety. Three independent reviewers coded each focus group transcript using a thematic saturation approach.
RESULTS
A total of 70% of participants reported an increased frequency of angioedema attacks resulting from insurance delays or denials. More than 50% missed work/school days because of increased attacks, and 90% reported greater anxiety. Twenty-five percent of respondents reported more urgent care or emergency department visits. In focus groups, participants identified specific ways that losing access to medication had a negative impact on their health, family, and work/school life. Insufficient notification of health insurance policy changes and the time and effort required to regain access to medications compounded patients' frustration and anxiety.
CONCLUSION
Insurance delays and denials have significant impacts on individuals with HAE including (1) increased urgent care and emergency department visits, (2) missed work/school days, (3) higher levels of anxiety, and (4) a negative impact on family life.
Topics: Humans; Angioedemas, Hereditary; Quality of Life; Angioedema; Insurance, Health; Insurance Coverage
PubMed: 37558360
DOI: 10.1016/j.jaip.2023.03.006 -
PLoS Biology Oct 2018This Editorial introduces a Collection of articles in which the authors explore the challenges and pitfalls of communicating the science of climate change in an...
This Editorial introduces a Collection of articles in which the authors explore the challenges and pitfalls of communicating the science of climate change in an atmosphere where evidence doesn't matter.
Topics: Animals; Aquatic Organisms; Arctic Regions; Climate Change; Communication; Denial, Psychological; Humans
PubMed: 30300346
DOI: 10.1371/journal.pbio.3000033 -
Current Opinion in Neurology Dec 2014The experience of ourselves as an embodied agent with a first-person perspective is referred to as 'bodily self'. We present a selective overview of relevant clinical... (Review)
Review
PURPOSE OF REVIEW
The experience of ourselves as an embodied agent with a first-person perspective is referred to as 'bodily self'. We present a selective overview of relevant clinical and experimental studies.
RECENT FINDINGS
Sharing multisensory body space with others can be observed in patients with structurally altered bodies (amputations, congenital absence of limbs), with altered functionality after hemiplegia, such as denial of limb ownership (somatoparaphrenia) and with alterations in bodily self-consciousness on the level of the entire body (e.g. in autoscopic phenomena). In healthy participants, the mechanisms underpinning body ownership and observer perspective are empirically investigated by multisensory stimulation paradigms to alter the bodily self. The resulting illusions have promoted the understanding of complex disturbances of the bodily self, such as out-of-body experiences. We discuss the role of interoception in differentiating between self and others and review current advances in the study of body integrity identity disorder, a condition shaped as much by neurological as by social-psychological factors.
SUMMARY
We advocate a social neuroscience approach to the bodily self that takes into account the interactions between body, mind and society and might help close the divide between neurology and psychiatry.
Topics: Humans; Illusions; Interpersonal Relations; Perceptual Disorders; Self Concept
PubMed: 25333602
DOI: 10.1097/WCO.0000000000000151 -
Autism Research : Official Journal of... May 2022Compared to the general population, mental health difficulties are commonly reported in autistic adults. However, the ways in which coping strategies are associated with...
Compared to the general population, mental health difficulties are commonly reported in autistic adults. However, the ways in which coping strategies are associated with mental health and well-being in this population remain unknown. Further, we do not know if, and if so, how these associations might differ to that of non-autistic adults. In this study, we hypothesized that in both our autistic (N = 255) and non-autistic (N = 165) adult samples, disengagement coping strategies (e.g., denial) would relate to poorer mental health and well-being, while engagement coping strategies (e.g., problem solving) would relate to better mental health and well-being. Regression analyses revealed that higher use of disengagement coping strategies was significantly associated with higher levels of anxiety and depression, and lower levels of well-being in both samples. In contrast, increased use of engagement coping strategies was associated with better well-being, but only in the autistic sample. Our results contribute to the characterization of negative and positive mental health outcomes in autistic adults from a coping perspective, with potential to offer novel information regarding coping strategies to consider when addressing support options for mental health difficulties in the autistic adult population. LAY SUMMARY: Mental health conditions (such as anxiety and depression) and poor well-being are commonly reported in autistic adults. Research suggests that how one copes with stress is associated with one's mental health and well-being. However, we have little information about how coping strategies relate to the mental health of autistic adults, and whether this might be different in non-autistic adults. In this study, we examined the relationship between coping strategies and mental health in a large group of autistic individuals aged 15-80 years. We then compared this with similar aged non-autistic individuals. We found that in both the autistic and non-autistic individuals, using more disengagement coping strategies (such as being in denial, blaming oneself) was related to poorer mental health and well-being. Additionally, using more engagement coping strategies (such as problem solving, acceptance) was related to better mental health and well-being, but only in the autistic individuals. These results can help inform support services, as they highlight the coping strategies that may need to be focused on (i.e., developing engagement coping strategies and reducing disengagement coping strategies) in order to better support the mental health of autistic individuals.
Topics: Adaptation, Psychological; Adult; Autism Spectrum Disorder; Autistic Disorder; Humans; Mental Health; Outcome Assessment, Health Care
PubMed: 35218321
DOI: 10.1002/aur.2694 -
Applied Psychology. Health and... Nov 2023This follow-up study aimed to analyze the protective role of positivity and coping strategies on the well-being and psychological distress levels reported during... (Review)
Review
This follow-up study aimed to analyze the protective role of positivity and coping strategies on the well-being and psychological distress levels reported during Portugal's first and third waves of COVID-19. The total sample consisted of 135 participants (82.0% women) with ages ranging from 20 to 72 years (M = 39.29, SD = 11.46). Results suggested a significant decrease in well-being levels but no changes in psychological distress were observed. Positivity was a strong and significant predictor of well-being and psychological distress during the pandemic crisis. Among the set of strategies used by individuals at the first wave, denial, self-blame, and self-distraction predicted a poorer adaptation with more significant mental health impairment, with self-blame standing out as the most harmful. This study highlighted the key role of positivity in adjusting to the current pandemic crisis and the lasting detrimental impact of specific coping strategies.
Topics: Humans; Female; Male; Emotional Adjustment; COVID-19; Follow-Up Studies; Pandemics; Portugal; Adaptation, Psychological
PubMed: 37321921
DOI: 10.1111/aphw.12462 -
Gynecologie, Obstetrique, Fertilite &... Apr 2022Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an...
Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an absence of the physical signals associated with pregnancy such as abdominal swelling, amenorrhea, weight gain, or even perception of fetal movements. Despite the potential consequences for mother and child, there is still little data on its clinical features and the neurocognitive mechanisms involved. In this paper, we provide an update on the clinical, socio-demographic, and psychopathological characteristics of pregnancy denial based on contemporary scientific literature. We first define denial of pregnancy by referring to the history of the concept, previous definitions, and nosographic classifications. We then detail the clinic of denial by distinguishing the physical and psychological symptoms of this disorder, then the socio-demographic, gynecological, and psychiatric characteristics. We describe the consequences of denial on the mother, infant, and the dyad, referring to situations of cryptic neonaticide. Finally, we show the importance of perinatal neuroscience research on maternal interoception to understand the mechanisms involved in denial of pregnancy, and improve their medical management in clinical practice.
Topics: Child; Denial, Psychological; Female; Humans; Infant; Infant, Newborn; Infanticide; Mothers; Parturition; Pregnancy
PubMed: 35272081
DOI: 10.1016/j.gofs.2022.02.079 -
British Journal of Nursing (Mark Allen... Nov 2017understanding the impact of role ambiguity (both professional and patient) can be a factor in deepening the understanding of the ongoing personal, professional and...
BACKGROUND
understanding the impact of role ambiguity (both professional and patient) can be a factor in deepening the understanding of the ongoing personal, professional and organisational requirements of nurses who are cancer survivors.
PURPOSE
the aim of this qualitative study was to elucidate an in-depth description of nurses' experiences of surviving cancer.
METHOD
an exploratory qualitative research design was used (n=8), with participants recruited between September 2014 and December 2016.
DISCUSSION
data analysis led to the emergence of six themes: being practical about the diagnosis and treatment, empathy and compassion, a 'new normal' and the role of organisational support, medical knowledge and treatment experiences, coping in silence and denial, and being resilient.
CONCLUSION
nurses as cancer survivors who return to work offer a richness of experience related to enhanced empathetic responses to patients in their care and have the potential to be great practice role-models for other staff.
Topics: Adaptation, Psychological; Australia; Cancer Survivors; Clinical Competence; Empathy; Female; Humans; Interviews as Topic; Life Change Events; Middle Aged; Nurses; Resilience, Psychological; Return to Work; Social Support
PubMed: 29168945
DOI: 10.12968/bjon.2017.26.21.1170 -
Physical Medicine and Rehabilitation... Nov 2014This article discusses the principles and practices that guide psychological intervention with injury, and encourages a psychological approach to injury for clinicians.... (Review)
Review
This article discusses the principles and practices that guide psychological intervention with injury, and encourages a psychological approach to injury for clinicians. Part 1 reviews the research literature, and serves as a foundation for the review of clinical practices in part 2. Examination of the research literature highlights 4 areas: (1) psychological factors influencing rehabilitation, (2) social factors affecting rehabilitation, (3) performance concerns among returning athletes, and (4) tools/inventories for assessing psychological readiness to return. A synopsis of an injury intervention plan is provided, and the influence of pain and fear in the rehabilitation process is described.
Topics: Adaptation, Psychological; Athletic Injuries; Humans; Recovery of Function; Sports Medicine
PubMed: 25442166
DOI: 10.1016/j.pmr.2014.06.011 -
The New England Journal of Medicine Jan 2019
Topics: Amyotrophic Lateral Sclerosis; Critical Illness; Denial, Psychological; Father-Child Relations; Female; Grief; Humans; Male; Prognosis
PubMed: 30625056
DOI: 10.1056/NEJMp1810685 -
Psychodynamic Psychiatry 2021The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the... (Review)
Review
The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the COVID-19 pandemic. He reviews the contributions of Ernst Becker, Wilfred Bion and Sheldon Solomon, and formulates ideas of his own based on decades of experience treating patients with cancer. This short essay focuses on how to help patients during the COVID-19 pandemic work through fear and uncertainty while developing adaptive skills.
Topics: Adaptation, Psychological; Anxiety; Attitude to Death; COVID-19; Fear; Humans; Pandemics; Psychotherapy, Psychodynamic; SARS-CoV-2; Uncertainty
PubMed: 34478325
DOI: 10.1521/pdps.2021.49.3.384