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European Annals of Allergy and Clinical... Mar 2022Adherence to asthma medications is a significant problem among pregnant women. Objective. To evaluate asthma medication adherence in pregnant women and to determine the...
Adherence to asthma medications is a significant problem among pregnant women. Objective. To evaluate asthma medication adherence in pregnant women and to determine the factors that may predict non-adherence in a real-life setting. A cross-sectional study was performed with pregnant women with asthma followed in a specialized asthma consultation at the Pulmonology Department, between 2014 and 2019. Sociodemographic and clinical variables were collected. Structured telephone interviews were conducted to determine regular medication use during pregnancy. Multiple logistic regression was used to identify predictive factors of asthma medication non-adherence (cessation or dose reduction). A total of 82 pregnant women were included: mean age of 31.3 ± 6.5 years, non-adherence was detected in 29% (n = 24). Multivariable logistic regression analysis revealed that mild asthma during pregnancy (OR, 4.8; 95% CI 1.4-17.1, p = 0.015) and single, separated or divorced mothers (OR, 4.0; 95% CI 1.3-11.8, p = 0.014) were independent predictors of poor adherence to asthma medications. Asthma severity and marital status can strongly predict the asthma medication non-adherence in pregnant females. These findings may help improve asthma education strategies to promote.
Topics: Adult; Asthma; Cross-Sectional Studies; Female; Humans; Logistic Models; Medication Adherence; Pregnancy; Young Adult
PubMed: 33939348
DOI: 10.23822/EurAnnACI.1764-1489.201 -
Ginekologia Polska 2021Over the last few years, the impact of infertility on the psychological well-being of couples has been well recognised. Men and women with infertility experience stress,...
OBJECTIVES
Over the last few years, the impact of infertility on the psychological well-being of couples has been well recognised. Men and women with infertility experience stress, anxiety and depression and their relationship might be under pressure.
MATERIAL AND METHODS
We conducted a non-experimental correlational descriptive study where transversal analysis using questionnaires and quantitative data was performed for 76 couples with diagnosed infertility under the care of various reproductive medicine clinics in Romania between 2018 to 2019. Participants were asked to fill, via internet or in person, a set of tests including data on socio-demographic and infertility characteristics along with five psychological tests: The Fertility Problem Inventory (FPI), State-Trait Anxiety Inventory, Beck's Depression Inventory (BDI), Dyadic Adjustment Scale and Interpersonal Support Evaluation List-12. The aim of the study was to explore how couples with infertility respond and adapt to this diagnosis and to assess the relationship between emotional disorders, marital adjustment and social support.
RESULTS
Mean age of females was 34.2 and of males 36.7 and 38.2% of the couples were experiencing infertility for > 6 years. Women had worse scores on infertility-related distress (FPI) (t = -4.35, p = 0.01), on the BDI depression scale (t = -5.43, p = 0.01) and on anxiety scales (t = -5.48, p = 0.01). Participants with a longer duration of infertility scored significantly higher on infertility-related distress than those with more recent difficulties. Marital adjustment scores correlated negatively with emotional disorders. Both appraisal social support and belonging support moderated the relationship between state-anxiety and marital adjustment.
CONCLUSIONS
Infertility carries a significant psychological burden for the couple and the longer its duration, the higher the distress level. Women seem to be more vulnerable to its psychological consequences. Marital adjustment correlates negatively with the degree of emotional disorders. In couples with high levels of social support, the relationship between state-anxiety and marital adjustment was negatively correlated.
Topics: Adaptation, Psychological; Adult; Child; Depression; Emotional Adjustment; Female; Humans; Infertility; Male; Marriage; Middle Aged; Psychological Distress; Social Support
PubMed: 33448003
DOI: 10.5603/GP.a2020.0173 -
BMC Psychology Apr 2022Psychological stress is commonly found among infertile women. Untreated stress can affect negatively the success of infertility treatment. Most of the available...
BACKGROUND
Psychological stress is commonly found among infertile women. Untreated stress can affect negatively the success of infertility treatment. Most of the available knowledge is generated from developed countries and is largely based on women undergoing In vitro fertilization (IVF) treatment. However, very little is known on infertile women from Ethiopia including other countries in East Africa. The aim of this study was to determine the prevalence of psychological stress and possible demographic-clinical correlates in Ethiopian women suffering from infertility.
METHOD
This cross sectional descriptive correlation study was conducted from May to August, 2021 involving 96 women undergoing a non-IVF treatment for infertility at Gandhi Memorial and Tikur Anbessa hospitals. The sampling was continuous and based on inclusion criteria that include infertility duration of a minimum one year, female sex and Ethiopian nationality. Data on Infertility related stress was collected using the Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress questionner administered by an interviewer. The socio demographic and clinical factors were collected using Amharic version of structured interviewer administered questionnaire and chart review. The analysis of relationship between infertility related stress and background variables was done with an independent sample t-test or one-way ANOVA statistics supplemented with effect size assessment.
RESULTS
The prevalence of infertility related stress was overall 92.71% (95% CI, 87-98%). The personal, marital, and social subdomain mean scores (SD) were 2.74 (.80), 1.54 (.81) and 1.90 (.80), respectively. Infertility related stress was higher for those women who were: aged above 35, living in a cohabitation marital type, has no living children, and with 4-6 years duration of infertility (all P < 0.05). Whereas, there was insufficient evidence to suggest that infertility related stress varies by education, income, knowledge of cause of infertility or history of past treatment (all P > 0.05).
CONCLUSIONS
The prevalence of psychological stress among Ethiopia women having infertility was very high. The results provide preliminary evidence that infertility related stress is associated with age, marital status, motherhood status and duration of infertility. Responsible bodies need to avail psychological screening and services prioritizing women at higher risk of developing stress.
Topics: Aged; Child; Cross-Sectional Studies; Female; Hospitals; Humans; Infertility, Female; Prevalence; Stress, Psychological
PubMed: 35392978
DOI: 10.1186/s40359-022-00804-w -
Frontiers in Psychology 2020Studies of therapy influence on after-aphasia marital relations are lacking. Much needs to be learned about the range of factors associated with couples benefiting from...
BACKGROUND
Studies of therapy influence on after-aphasia marital relations are lacking. Much needs to be learned about the range of factors associated with couples benefiting from therapy. Understanding these issues is key to facilitating optimal post-aphasia outcomes from the perspective of the patient and his caretaking spouse. This paper reports an evaluation of a group therapy intervention conducted with aphasic people and their life partners.
METHODS
The intervention comprised of 10 sessions of approximately 90 min duration and included two groups of couples, with fluent and non-fluent aphasic partner. The therapy program consisted of basic communication activities within the group which encouraged sharing of personal experience but mostly relied on psychoeducation, gaining knowledge about after-stroke aphasia. The respondents were interviewed and completed neuropsychological assessment. Quality of marriage was determined using Dyadic Adjustment Scale. Marital adjustment was measured twice, before intervention and after 6 months. Long-time effects of therapy included a significant mean difference in quality of marriage between therapy attendants and controls. Marital relationship decline seems to be worse amongst control subjects, who were not involved in any kind of psychological support. In spite of initial non-distressed relationship they report deterioration of their bond in half a year's time. We also showed changes in dynamics of quality of marriage during this time in all investigated groups. The implications of these findings for counseling services are discussed.
PubMed: 32733342
DOI: 10.3389/fpsyg.2020.01574 -
Materia Socio-medica Jun 2019There was growing evidence of increased cardiovascular risk in patients with depressive disorders.
INTRODUCTION
There was growing evidence of increased cardiovascular risk in patients with depressive disorders.
AIM
To determinate the percentage of depression of the three investigated groups of patients with myocardial infarction and to determinate the correlation between sociodemographic characteristic and level of depression in survivors of AMI.
METHODS
The study was designed as observation cross-section including 120 patients treated at the University Clinic of Cardiology Skopje during 2018-2019 year, observed as 3 groups: group 1 was presented with patients during hospitalization for AMI, group 2 were patients survivors after 3 months of the acute coronary event and group 3 patients survivors after 12 months of the acute coronary event, Depression status was assessed using BDI.
RESULTS
the three groups presented almost equal representation of depression according BDI (X²=1,182, df=2, p=0,913) presented with 34,1 %, 30,8% and 30% respectively. The three groups of patients did not show significant difference according distribution of gender smoking , physical activity, stress, diabetes mellitus, age, mean BDI, BMI, Systolic BP, age of education and marital status . Only group 3 presented significantly higher diastole BP comparing in group 1 and group 2 (F=9,532, df=2,p< 0,001). The depression (BDI score) in examination groups was associated with sociodemographic and clinical parameters where female gender, higher education level, decreased BMI, smoking, decreased physical activity, younger age and single status are independent predictors of depression in patients who survived acute myocardial infarction.
CONCLUSION
The results obtained in our study showed indicative representation of depression in patients survivors of AMI and significant association with sociodemographic and clinical parameters as predictors of depressive disorder. Regular screening for depression in patients survivors of AMI may improve the therapy decision, prognosis and the quality of patients' life.
PubMed: 31452635
DOI: 10.5455/msm.2019.31.110-114 -
Breast (Edinburgh, Scotland) Apr 2022Adherence to long-term adjuvant hormonal therapy in hormonal receptors (HR)-positive breast cancer is really challenging and can affect the survival outcome. The present...
BACKGROUND
Adherence to long-term adjuvant hormonal therapy in hormonal receptors (HR)-positive breast cancer is really challenging and can affect the survival outcome. The present study aims to assess rate of compliance with hormonal therapy and possible predictive factors in a single institute in Saudi Arabia.
PATIENTS &METHODS
We recruited patients with HR-positive breast cancer who presented to oncology outpatient clinics. Patients were assessed for compliance using a study questionnaire. Compliance was defined as taking ≥80% of prescribed doses of oral hormonal therapy. Different epidemiological, clinical, pathological and treatment data were checked in patients' medical records and correlated with compliance/interruption of hormonal therapy.
RESULTS
Among the 203 recruited patients, 95.1% were compliant with hormonal therapy, while it was interrupted in 16.7% of patients, and 58.1% reported missing intake of hormonal pills. Age >50 years, having permanent job and higher education level were significantly associated with non-compliance in univariate analysis. On multivariate analysis, job status was the only independent predictor of non-compliance. The following parameters were significantly related to hormonal therapy interruption: marital status (single: 28.8% vs married patients: 12.6%, p = 0.01) and residence location (Makkah: 11.7% vs. outside Makkah: 25.3%, p = 0.019), lymphovascular invasion (LVI) (No: 20.9%, Yes: 7.8%, p = 0.025) and N0 tumours (compared to node-positive patients, p = 0.008). On multivariate analysis, marital status, residence location and N-stage, maintained significance relation with hormonal therapy interruption.
CONCLUSION
Compliance with hormonal therapy was high in the study cohort. Marital status, residence location, job status and N-stage may be related to interruption/compliance with hormonal therapy.
Topics: Breast Neoplasms; Chemotherapy, Adjuvant; Female; Hormones; Humans; Patient Compliance; Phenotype
PubMed: 35131645
DOI: 10.1016/j.breast.2022.01.017 -
HIV/AIDS (Auckland, N.Z.) 2022Tuberculosis is one of the commonest coinfections and leading causes of death among people living with HIV in resource-limited countries. There is limited evidence on...
BACKGROUND
Tuberculosis is one of the commonest coinfections and leading causes of death among people living with HIV in resource-limited countries. There is limited evidence on the short- and long-term mortality rate in people receiving antiretroviral therapy and coinfected by tuberculosis in sub-Saharan Africa, where the burden of coinfection is highest.
PURPOSE
This study aimed to compare mortality among HIV positives with and without tuberculosis coinfection receiving antiretroviral therapy in Addis Ababa, Ethiopia.
METHODS
HIV positives' medical records were reviewed between 2011 to 2018 and identified 7038 HIV-positive adults enrolled for antiretroviral therapy in Addis Ababa. The outcome of interest for this study was death. A parametric Gompertz regression model was applied to compare mortality between HIV with tuberculosis coinfection versus HIV without tuberculosis.
RESULTS
Overall, 1123 (15.96%, 95% CI: 15.11-16.83%) individuals with HIV had tuberculosis coinfection at antiretroviral therapy enrollment. After adjusting for age, sex, education, marital status, cotrimoxazole therapy, body mass index, baseline CD4 cell count, and year in ART enrollment, HIV positives with tuberculosis coinfection had more than twice a higher overall mortality risk than HIV positives without tuberculosis coinfection (AHR: 2.53; 95% CI 1.63-3.91, p < 0.001).
CONCLUSION
This large retrospective cohort study reveals significantly higher mortality in HIV and tuberculosis coinfected group. This suggests the need for enhanced utility of integrated HIV and tuberculosis health services in sub-Saharan Africa where tuberculosis prevalence is highest.
PubMed: 35370424
DOI: 10.2147/HIV.S354436 -
Strengthening Clinical Research in Marriage and Family Therapy: Challenges and Multilevel Solutions.Journal of Marital and Family Therapy Jan 2019There is a critical need for high-quality and accessible treatments to improve mental health. Yet, there are indications that the research being conducted by...
There is a critical need for high-quality and accessible treatments to improve mental health. Yet, there are indications that the research being conducted by contemporary marriage and family therapy (MFT) scholars focuses less on advancing and disseminating clinical interventions than in previous decades. In this article, we describe challenges to increasing rigorous clinical research in MFT. We use systems mapping and the intervention-level framework to identify strategic goals designed to drive innovation in clinical research in the field. It is our hope this article encourages dialog and action among MFT stakeholder groups to support clinical science that will improve the health and functioning of families.
Topics: Biomedical Research; Family Therapy; Humans; Marital Therapy
PubMed: 29862521
DOI: 10.1111/jmft.12338 -
Frontiers in Oncology 2022The purpose of this study is to reveal the clinicopathological features and identify risk factors of prognosis among patients with pancreatic cancer bone metastasis...
PURPOSE
The purpose of this study is to reveal the clinicopathological features and identify risk factors of prognosis among patients with pancreatic cancer bone metastasis (PCBM).
PATIENTS AND METHODS
Patients with PCBM were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. Independent predictors for survival of those patients were determined by the univariate and multivariate Cox regression analysis. Forest plots were drawn by GraphPad 8.0.1 and used to visually display the results of multivariate analysis.
RESULTS
We identified 2072 eligible PCBM patients, of which 839 patients (40.5%) were female. Patients with age >60 years accounted for 70.6%. Multivariable Cox regression analysis indicated that age, pathological type, chemotherapy, liver metastasis, lung metastasis, and marital status were independent prognostic factors for both overall survival (OS) and cancer-specific survival (CSS). Kaplan-Meier survival curves showed that for patients with PCBM, age ≤60 years, non-ductal adenocarcinoma type, chemotherapy, no liver metastasis, no lung metastasis, and married status were correlated with increased survival. This population-based study showed that 1-year OS and CSS were 13.6% and 13.7%, respectively.
CONCLUSION
The present study identified six independent predictors of prognosis in PCBM, including age, pathological type, chemotherapy, liver metastasis, lung metastasis, and marital status. Knowledge of these survival predictors is helpful for clinicians to accelerate clinical decision process and design personalized treatment for patients with PCBM.
PubMed: 35223464
DOI: 10.3389/fonc.2022.759403 -
Indian Journal of Dermatology 2023The management and treatment of psoriasis has rarely considered patient needs, which are numerous, multi-dimensional and are of great importance to improving treatment...
BACKGROUND
The management and treatment of psoriasis has rarely considered patient needs, which are numerous, multi-dimensional and are of great importance to improving treatment outcomes.
OBJECTIVES
This study aimed to evaluate and compare the patients' needs for psoriasis treatment and identify factors predicting the need to make patient-centred decisions about treatment.
MATERIALS AND METHODS
This nationwide multicentre cross-sectional study included subjects between October 2020 and August 2021. The status quo of the needs in psoriasis treatment and their influencing factors were analysed mainly using the Chi-square test and binary logistic regression.
RESULTS
Information on sociodemographic and clinical characteristics were obtained. Factor analysis of a specially designed questionnaire showed that rapid skin clearance, reduced treatment expense and fewer hospital visits or treatment time were the first three patient needs in psoriasis treatment. Several influencing factors were important including the sociodemographic characteristics of gender, marital status, education level and family history, special location of skin lesions, dermatology life quality index (DLQI), Investigator's Global Assessment modified 2011 (IGA mod 2011), condition of the episode, clinical type of psoriasis, seasonal exacerbation and therapy.
CONCLUSIONS
Patients with psoriasis pursued a wide range of treatment goals, with the most desired being rapid skin clearance, reduced treatment expense and time-saving. Paying attention to sex, marital status, education level, the special location of skin lesions and the DLQI will help dermatologists develop patient-centred treatment, meet the patient's needs and eventually improve the treatment outcomes.
PubMed: 38099128
DOI: 10.4103/ijd.ijd_611_23