-
Otology & Neurotology : Official... Sep 2022To characterize the degree to which individual coping strategies may influence speech perception after cochlear implantation.
OBJECTIVE
To characterize the degree to which individual coping strategies may influence speech perception after cochlear implantation.
STUDY DESIGN
Retrospective cohort study.
SETTING
Tertiary referral center.
PATIENTS
Adult, postlingually deaf cochlear implant recipients.
INTERVENTIONS
The Coping Orientation to Problems Experience inventory, a validated, multidimensional self-reported coping scale, was administered preoperatively.
MAIN OUTCOME MEASURES
Speech perception was measured using consonant-nucleus-consonant (CNC) phoneme and word scores, AzBio sentence accuracy in quiet and noise, and Hearing in Noise Test sentences in quiet preoperatively and at 1, 3, and 6 months postoperatively. Quality of life was measured with the Hearing Implant Sound Quality Index and the Nijmegen Cochlear Implant Questionnaire.
RESULTS
Thirty-six patients were included in this study. Mean age at surgery was 70.7 ± 11.4 years. Acceptance was associated with a decreased AzBio in noise score in the 6 months after CI (regression coefficient b = -0.05; 95% confidence interval [CI], -0.07 to -0.03; p < 0.01). Denial was associated with a decreased AzBio in quiet score (b = -0.05; 95% CI, -0.09 to -0.01; p < 0.05), whereas humor was associated with an increased AzBio in quiet score (b = 0.02; 95% CI, 0.01 to 0.04; p < 0.05). Humor was also associated with an increased Hearing in Noise Test score (b = 0.05; 95% CI, 0.02 to 0.07; p < 0.05). Denial was associated with decreased CNC word (b = -0.04; 95% CI, -0.06 to -0.02; p < 0.01) and phoneme (b = -0.04; 95% CI, -0.07 to -0.02; p < 0.01) scores, whereas substance use was associated with increased CNC word (b = 0.03; 95% CI, 0.01 to 0.05, p < 0.01) and phoneme (b = 0.04; 95% CI, 0.02 to 0.06; p < 0.01) scores. Scores on self-reported quality of life measures were not significantly correlated with coping strategies.
CONCLUSION
A variety of adaptive and maladaptive coping strategies are used by postlingually deaf adult cochlear implant users. Denial and acceptance may be more predictive of poor speech performance, whereas humor and substance use may be more predictive of improved speech performance.
Topics: Adaptation, Psychological; Adult; Cochlear Implantation; Cochlear Implants; Humans; Quality of Life; Retrospective Studies; Self Report; Speech; Speech Perception; Treatment Outcome
PubMed: 35970167
DOI: 10.1097/MAO.0000000000003621 -
Frontiers in Psychology 2020While a number of empirical studies have appeared on impaired self-awareness (ISA) after traumatic brain injury (TBI) over the last 20 years, the relative role of denial... (Review)
Review
While a number of empirical studies have appeared on impaired self-awareness (ISA) after traumatic brain injury (TBI) over the last 20 years, the relative role of denial (as a psychological method of coping) has typically not been addressed in these studies. We propose that this failure has limited our understanding of how ISA and denial differentially affect efforts to rehabilitate persons with TBI. In this selective review paper, we summarize early findings in the field and integrate those findings with more recent observations (i.e., 1999-2019). We believe that this synthesis of information and expert clinical opinion will inform future research on ISA and denial as well as approaches to rehabilitation for persons with TBI.
PubMed: 32765359
DOI: 10.3389/fpsyg.2020.01569 -
Cutis Aug 2022Medicare has updated its guidance for documentation of Mohs micrographic surgery (MMS). Recent insurer audits have focused on and issued denials and recoupments based on...
Medicare has updated its guidance for documentation of Mohs micrographic surgery (MMS). Recent insurer audits have focused on and issued denials and recoupments based on these criteria. Understanding and implementing the latest documentation requirements is critical to proper reimbursement for MMS.
Topics: Aged; Documentation; Humans; Medicare; Mohs Surgery; Skin Neoplasms; United States
PubMed: 36219633
DOI: 10.12788/cutis.0589 -
Psychotherapy and Psychosomatics 2023Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment. (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment.
OBJECTIVE
This systematic review was performed to clarify the clinical role and manifestations of illness denial, its impact on health attitudes and behavior, as well as on short- and long-term outcomes in patients with medical disorders.
METHODS
The systematic search according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was conducted on PubMed, Scopus, and Web of Science.
RESULTS
The initial search yielded a total of 14,098 articles; 176 studies met the criteria for inclusion. Illness denial appeared to be a relatively common condition affecting a wide spectrum of health attitudes and behavior. In some cases, it may help a person cope with various stages of illness and treatment. In other situations, it may determine delay in seeking treatment, impaired adherence, and reduced self-management, leading to adverse outcomes. The Diagnostic Criteria for Psychosomatic Research (DCPR) were found to set a useful severity threshold for the condition. An important clinical distinction can also be made based on the DCPR for illness denial, which require the assessment of whether the patient has been provided with an adequate appraisal of the medical situation.
CONCLUSIONS
This systematic review indicates that patients with medical disorders experience and express illness denial in many forms and with varying degrees of severity. The findings suggest the need for a multidimensional assessment and provide challenging insights into the management of medical disorders.
Topics: Humans; Psychophysiologic Disorders; Denial, Psychological
PubMed: 37429268
DOI: 10.1159/000531260 -
Stress and Health : Journal of the... Apr 2021Research on general coping is limited within compulsive buying (CB) literature. Nevertheless, other behavioural addictions and hoarding might provide insights into...
Research on general coping is limited within compulsive buying (CB) literature. Nevertheless, other behavioural addictions and hoarding might provide insights into coping in CB. One-hundred and ninety-nine participants (M age = 52.72, SD = 16.06; 50.3% female, 1% unknown sex) completed online questionnaires. Mental and behavioural disengagements were hypothesized to predict greater self-reported CB tendency. Whilst these relationships were found in the correlations, a regression analysis indicated that only mental disengagement significantly predicted CB tendency. Additionally, the exploration of denial and substance use identified that denial was an important predictor of CB tendency coping. The relationship between CB tendency and substance use could not be explored given the large degree of participants reporting minimal scores. CB tendency is associated with maladaptive mental disengagement, denial and lack of acceptance coping strategies, which could be useful to consider in therapy.
Topics: Adaptation, Psychological; Adult; Aged; Compulsive Behavior; Consumer Behavior; Female; Humans; Male; Middle Aged; Surveys and Questionnaires
PubMed: 33002314
DOI: 10.1002/smi.2994 -
The Journal of Physiology Jan 2022Locomotion on complex terrains often requires vision. However, how vision serves locomotion is not well understood. Here, we asked when visual information necessary for...
Locomotion on complex terrains often requires vision. However, how vision serves locomotion is not well understood. Here, we asked when visual information necessary for accurate stepping is collected and how its acquisition relates to the step cycle. In cats of both sexes, we showed that a brief (200-400 ms) interruption of visual input can rapidly influence cat's walking along a horizontal ladder. Depending on the phase within the step cycle, a 200 ms period of darkness could be tolerated fully without any changes to the strides or could lead to minor increases of stride duration. The effects of 300-400 ms of visual input denial, which typically prolonged stances and/or swings, also depended on the phase of the darkness onset. The increase of the duration of strides was always shorter than the duration of darkness. We conclude that visual information for planning a swing is collected starting from the middle of the preceding stance until the beginning of the current swing. For a stance (and/or a swing of the other paw), visual information is collected starting from the end of the previous stance and until the middle of the current stance. Acquisition of visual information during these windows is not uniform but depends on the phase of the step cycle. Notably, both the extension of these windows and their non-homogeneity are closely related to the pattern of gaze behaviour in cats, described previously. This new knowledge will help to guide research and understanding of neuronal mechanisms of visuomotor integration and modulation of visual function by strides during locomotion. KEY POINTS: Cats, like humans, rely on vision to navigate in complex environments. In cats walking along a horizontally placed ladder, we show that visual information required for accurate stepping is collected in a non-uniform manner throughout the stride cycle. Brief denial of visual input during a swing prolongs the next stance of that forelimb. Denial of visual input during a stance prolongs this stance, as well as the next swing and stance. Denial during the first half of a stance has a greater effect than during the second half. The phase dependence of the use of vision for accurate stepping and the pattern of affected swings and stances are closely related to the previously described pattern of gaze behaviour in cats. This new knowledge opens new perspectives for research into neuronal mechanisms of visuomotor coordination and visual function during walking and for understanding related disorders.
Topics: Animals; Cats; Darkness; Electromyography; Female; Forelimb; Locomotion; Male; Walking
PubMed: 34761816
DOI: 10.1113/JP282255 -
Family Process Dec 2020A child's disclosure of sexual victimization is a difficult experience for parents and has been associated with traumatization, disbelief, denial, self-blame, and... (Review)
Review
A child's disclosure of sexual victimization is a difficult experience for parents and has been associated with traumatization, disbelief, denial, self-blame, and clinical difficulties. To date, most studies on parents' responses have been quantitative assessments of the psychological impact of disclosure on parents. A paucity of research has qualitatively explored mothers' experiences of their child's disclosure of child sexual abuse (CSA) and fathers' experiences have been even further neglected. The current study seeks to characterize parents' experiences of their child's disclosure of CSA and to uncover the process-oriented nature of parental responses. This qualitative study, using a grounded theory approach to analysis, involved interviews with 10 mothers and four fathers whose children (3-18 years) had experienced sexual abuse. Three themes emerged from the analysis. The first theme-making sense of the abuse in retrospect-captured the process through which parents sought to make sense of their child's disclosure, focusing on why their child had not disclosed the abuse to them earlier, and how they had noticed something was wrong but misattributed their child's behavior to other factors. The second theme-negotiating parental identity as protector-reflected how parents' identity as a protector was challenged, their perception of their world had been forever altered, and they now experienced themselves as hypervigilant and overprotective. The final theme-navigating the services-pertained to parents' struggle in navigating child protection and police services, and feelings of being isolated and alone. These findings highlight the need for empathy and parental support following child disclosure of sexual victimization.
Topics: Adolescent; Child; Child Abuse, Sexual; Crime Victims; Female; Grounded Theory; Humans; Male; Parenting; Parents; Perception; Qualitative Research; Truth Disclosure
PubMed: 31715020
DOI: 10.1111/famp.12507 -
Orphanet Journal of Rare Diseases Oct 2022Severe combined immunodeficiency (SCID) is a group of rare genetic disorders that cause disruption in immune system functioning. Parents of children with SCID experience...
BACKGROUND
Severe combined immunodeficiency (SCID) is a group of rare genetic disorders that cause disruption in immune system functioning. Parents of children with SCID experience many uncertainties related to their child's diagnosis, treatment, recovery, and quality of life. To fully understand parents' experiences throughout their SCID journey, it is important to explore the stressors generated by such uncertainties and how parents cope with these stressors.
METHODS
We conducted 26 in-depth interviews with parents whose child was diagnosed with SCID or a SCID-like condition through newborn screening. The interviews explored uncertainties related to their child's diagnosis and how parents coped with these uncertainties. Transcripts were generated from the interviews and analyzed using an inductive content analysis approach which included data immersion, generation and assignment of codes, and interpretation.
RESULTS
Parents used a variety of behavioral, cognitive, and affective coping strategies which evolved throughout their SCID journeys. Some parents reported coping by playing an active role in their child's treatment, which included reaching out to other SCID parents or seeking second medical opinions. Other types of coping included establishing house hygiene rules, thinking positively about the child's treatment progress, and relying on family members for help. These coping strategies were both deliberate and intuitive. Participants also described their struggles in coping with stressors related to their child's health and survival. They reported difficulty in processing their emotions and experiencing denial and guilt related to their child's diagnosis. Some parents adapted to ongoing uncertainties through such strategies as positive thinking, self-reflection, and relying on family and community. With successful adaptation, parents emphasized that they continue to use these strategies today.
CONCLUSION
Our assessment revealed that parents of children diagnosed with SCID use a variety of behavioral, cognitive, and affective approaches to cope with SCID uncertainties. Although parents reported challenges in coping with SCID uncertainties, they also reported finding ways to overcome these stressors and establish patterns of effective coping. Findings from our study can serve as a guide for parents whose child was newly diagnosed with SCID and for providers such as social workers, genetic counselors, and psychologists.
Topics: Child; Infant, Newborn; Humans; Quality of Life; Severe Combined Immunodeficiency; Stress, Psychological; Adaptation, Psychological; Parents
PubMed: 36303152
DOI: 10.1186/s13023-022-02554-9 -
The New Zealand Medical Journal Oct 2019Across the world highly educated, science-literate parents are refusing to have their children vaccinated against contagious diseases. Decades of international,...
Across the world highly educated, science-literate parents are refusing to have their children vaccinated against contagious diseases. Decades of international, peer-reviewed climate science is being dismissed as institutional conspiracy. Activists troll and harass scientists who come to unfavourable conclusions in pet areas such as genome modification, childhood memory recall, chronic fatigue syndrome and even the hazards of smoking. And somewhat legitimising this behaviour are rising numbers of populist leaders who pour scorn on whichever science is inconvenient to their popularity. Science denial is tangible on a day-to-day basis and has measurable detriment to health and education. This article outlines the key research underpinning its ideological, psychological and pragmatic motivations.
Topics: Climate Change; Denial, Psychological; Humans; Motivation; New Zealand; Policy Making; Science; Vaccination
PubMed: 31647799
DOI: No ID Found -
Disability and Rehabilitation Nov 2022To examine the nature and severity of impaired self-awareness (ISA) and denial of disability (DD) in a community-dwelling traumatic brain injury (TBI) population....
PURPOSE
To examine the nature and severity of impaired self-awareness (ISA) and denial of disability (DD) in a community-dwelling traumatic brain injury (TBI) population. Additionally, to investigate reliability, internal consistency, and feasibility of the Clinician's Rating Scale for evaluating Impaired Self-Awareness and Denial of Disability after brain injury (CRS-ISA-DD).
MATERIALS AND METHODS
ISA and DD were studied using the CRS-ISA-DD in a cross-sectional study with 78 TBI patients (3.1 years post-injury).
RESULTS
42% of individuals approached consented to participate in this study. Most participants showed one or more symptoms of ISA and DD, but severity scores were in the lower range (ISA: 13.2 ± 16.2; DD: 9.4 ± 10.7). The CRS-ISA-DD takes <10 min to complete, has excellent inter-rater reliability (ISA: ICC(2,1) = 0.928; DD: ICC(2,1) = 0.835), and acceptable-good internal consistency (ISA: = 0.819; DD: = 0.645). ISA severity correlated with neuropsychological test scores ( = -0.30 to -0.47) and injury severity. DD severity correlated with anxiety ( = -0.22) but not with avoidance coping or defense mechanisms.
CONCLUSIONS
Low levels of ISA and DD occurred in this sample of TBI patients. The CRS-ISA-DD is a reliable and feasible instrument. We recommend using it as a diagnostic tool to differentiate between ISA and DD once self-awareness problems have been identified.IMPLICATIONS FOR REHABILITATIONUnawareness of deficits can persist into the chronic stage when rehabilitation treatment has ended.The two main factors of unawareness, impaired self-awareness and denial of disability, are related to different neurological and psychological mechanisms.The Clinician's Rating Scale for evaluating Impaired Self-Awareness and Denial of Disability after brain injury (CRS-ISA-DD) can be used to distinguish the two main factors of unawareness.
Topics: Humans; Reproducibility of Results; Cross-Sectional Studies; Awareness; Brain Injuries, Traumatic; Brain Injuries
PubMed: 34455888
DOI: 10.1080/09638288.2021.1970247