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Health & Social Care in the Community Nov 2022Patient satisfaction is a critical component of quality of care assessment in the pursuit of universal health coverage to end the tuberculosis epidemic and other... (Review)
Review
Patient satisfaction is a critical component of quality of care assessment in the pursuit of universal health coverage to end the tuberculosis epidemic and other diseases. This study aimed to review the level of satisfaction of tuberculosis patients and related factors. Articles were accessed from Web of Science, EMBASE, PubMed and Google Scholar. Twenty-six papers fulfilled the eligibility criteria from 13 countries. The percentage of satisfied tuberculosis patients ranged from 53.5% to 97.0% in the five African countries, 67.8 to 97.2% in India, South-East Asia, 82.0% in Pakistan, East-Mediterranean and 92.9% in Armenia, the European region. Accessibility, healthcare cost, treatment duration and taking supervised-directly observed treatment were healthcare service-related determinants. Technical competency, interpersonal relationships, confidentiality, time spent with healthcare providers, time spent waiting for care and counselling and health education were health worker-related determinants. Patient-related variables that determine satisfaction were gender, age, ethnicity, place of residence, marital status, educational status, income and health status. Developing and/or approaching an internationally-agreed tool to measure tuberculosis patient satisfaction in healthcare settings will improve the availability of high-quality and comparable data to verify actual variation across and within a country. A multidimensional approach considering clients, health workers and healthcare settings is required to holistically address satisfaction issues of tuberculosis patients to gradually realise universal health coverage.
Topics: Humans; Patient Satisfaction; Personal Satisfaction; Tuberculosis; Health Personnel; Counseling
PubMed: 35920598
DOI: 10.1111/hsc.13953 -
Frontiers in Psychology 2023The current research examined the effect of Emotionally Focused Couples Therapy (EFCT) on perceived intimacy, affect, and dyadic connection in cancer survivor couples...
OBJECTIVE
The current research examined the effect of Emotionally Focused Couples Therapy (EFCT) on perceived intimacy, affect, and dyadic connection in cancer survivor couples with relationship challenges.
METHOD
In this longitudinal replicated single-case study, positive and negative affect, intimacy, partner responsiveness, and expression of attachment-based emotional needs were reported every 3 days before and during treatment. Thirteen couples, with one partner having survived colorectal cancer or breast cancer, participated for the full duration of the study. Statistical analysis of the data was performed using randomization tests, piecewise regression, and multilevel analyses.
RESULTS
Adherence to the therapeutic protocol was tested and found adequate. Compared with baseline, significant positive effects on affect variables were found during the therapeutic process. Positive affect increased and negative affect decreased. Partner responsiveness, perceived intimacy, and the expression of attachment-based emotional needs improved, but only in the later phase of treatment. Results at the group level were statistically significant, whereas effects at the individual level were not.
DISCUSSION
This study found positive group-level effects of EFCT on affect and dyadic outcome measures in cancer survivors. The positive results warrant further research, including randomized clinical trials, to replicate these effects of EFCT in cancer survivor couples experiencing marital and sexual problems.
PubMed: 37205090
DOI: 10.3389/fpsyg.2023.1123821 -
BMC Neurology May 2021In patients with multiple sclerosis (MS), the disease's complications and manifestations affect a person's ability to function normally and leads to further disruptions...
BACKGROUND
In patients with multiple sclerosis (MS), the disease's complications and manifestations affect a person's ability to function normally and leads to further disruptions in their education, family life, job opportunities, and daily life activities, thereby reduce their quality of life. Different factors as facilitators or inhibitors affect the quality of life in patients with MS. This study aimed to explain the facilitators of quality of life in patients with MS.
METHODS
This research applied qualitative methodology, utilizing semi-structured interviews with individuals with MS and their family members/caregivers. Purposeful sampling was done among people who referred to Isfahan MS Association. Participants were selected with a maximum variation in terms of gender, age, education, occupation and marital status. Interviews were continued to reach data saturation. The gathered data were concurrently analyzed by the content analysis technique. MAXQDA software version 10 was used for data management.
RESULTS
Saturation was reached after eighteen interviews. A total of three main categories and 8 sub-categories were extracted from the data. The identified facilitators were: personal facilitators (leisure time and coping strategies), interpersonal facilitators (exercise therapy, social support and social organizations) and needs and suggestions for improvement (family therapy, adopting urban architecture and facilities, and supportive systems).
CONCLUSIONS
Based on these findings, in order to improve the quality of life in patients with MS, we should pay attention to factors such as leisure time, spirituality and positive thinking, exercise, social support and social organizations. Health professionals, the government, community and families could help to improve patients' quality of life through adapting urban architecture, holding family therapy sessions and providing supportive systems.
Topics: Adult; Caregivers; Female; Humans; Interviews as Topic; Male; Middle Aged; Multiple Sclerosis; Qualitative Research; Quality of Life; Social Support
PubMed: 33975555
DOI: 10.1186/s12883-021-02213-9 -
Brain and Behavior May 2022Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk...
BACKGROUND
Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed.
OBJECTIVES
We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh.
METHODS
We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing suicidality and family dynamics in Bangladesh.
RESULTS
Risk factors for suicide prevailing in the family have been organized, and several strategies for coping with family risk factors, including marital discord and family conflict have been proposed for testing empirically.
CONCLUSIONS
The family has an important role to play in suicide prevention in Bangladesh. However, potential prevention strategies and their effectiveness have been untapped in the country. Studies are warranted to test the effectiveness of the proposed strategies.
Topics: Adaptation, Psychological; Bangladesh; Humans; Risk Factors; Suicidal Ideation; Suicide Prevention
PubMed: 35398979
DOI: 10.1002/brb3.2562 -
Cancer Dec 2021Phase 1 trials are increasingly important in the molecularly driven era of oncology, but few studies have examined phase 1 participation disparities. The authors of this...
BACKGROUND
Phase 1 trials are increasingly important in the molecularly driven era of oncology, but few studies have examined phase 1 participation disparities. The authors of this study investigated factors associated with phase 1 versus phase 2/3 trial enrollment.
METHODS
They authors conducted a cross-sectional study using serial samples of patients age ≥18 years enrolling on cancer trials from October 2011 to November 2014 at an academic cancer center. They used univariable and multivariable logistic regression models to analyze sociodemographic and clinical associations with phase 1 versus phase 2/3 trial enrollment.
RESULTS
Among 3103 patients enrolled in cancer trials, 2657 unique patients participated in phase 1/2/3 trials. For patients enrolled in phase 1 (n = 1401) versus phase 2/3 (n = 1256) trials, we found no significant differences by age, insurance status, marital status, and income. Overall, 1216 (93%) White, 72 (6%) Asian, and 21 (2%) Black patients enrolled on phase 1 trials, whereas 1068 (93%) White, 40 (3%) Asian, and 43 (4%) Black patients enrolled on phase 2/3 trials. Adjusting for age, sex, race, ethnicity, insurance status, marital status, income, cancer type, disease status, travel distance, and trial year, compared with White patients, Black patients had lower phase 1 enrollment (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.25-0.82), as did Hispanic/Latino (OR, 0.25; 95% CI, 0.08-0.79) and male patients (OR, 0.77; 95% CI, 0.62-0.94). Asian patients had higher phase 1 enrollment (OR, 1.38; 95% CI, 0.88-2.16).
CONCLUSIONS
Disparities in phase 1 versus phase 2/3 cancer clinical trial enrollment underscore the urgent need for interventions addressing inequities in early-phase trial participation.
LAY SUMMARY
Phase 1 trials are of increasing importance in oncology. The authors of the study analyzed all patients enrolling on cancer clinical trials at a large academic cancer center from October 2011 to November 2014. Among the 2657 trial participants, when age, sex, race, ethnicity, insurance status, marital status, income, cancer type, disease status, travel distance, and trial year were taken into account, Black, Hispanic/Latino, and male patients were less likely to enroll on phase 1 trials versus phase 2/3 trials. These findings suggest a need for targeted interventions to improve access to and education about phase 1 trials for Black and Hispanic/Latino patients.
Topics: Adolescent; Black People; Cross-Sectional Studies; Ethnicity; Healthcare Disparities; Humans; Insurance Coverage; Male; Neoplasms
PubMed: 34379799
DOI: 10.1002/cncr.33853 -
Journal of Education and Health... 2023In recent studies, the deficit in the cognitive process has been investigated as one of the etiological hypotheses in a wide range of obsessive-compulsive disorders...
Comparison of the effectiveness of acceptance and commitment therapy (ACT) with metacognitive therapy (MCT) in objective cognitive information processing style of obsessive-compulsive patients (OCD).
BACKGROUND
In recent studies, the deficit in the cognitive process has been investigated as one of the etiological hypotheses in a wide range of obsessive-compulsive disorders (OCD). This study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and metacognitive therapy (MCT) on objective cognitive information processing style in obsessive-compulsive patients.
MATERIALS AND METHODS
This quasi-experimental study with a pre-test and post-test plan and a control group was conducted on 45 patients with OCD, matched with gender, age, and educational and marital status. The samples in three groups were selected using the convenience sampling method. Finally, the study participants were randomly divided into two experimental groups and one control group and assessed using Pacini and Epstein's rational experimental Inventory (REI) in two stages, pre-test, and post-test. The experimental groups received ACT and MCT weekly during eight and seven sessions and in a group.
RESULTS
The results showed that ACT and MCT are effective at a significant level in the objective cognitive information processing style of obsessive-compulsive patients ( < 0.05). The post-test results showed that the effect of ACT in changing rational processing style is more effective than MCT treatment. Also, the effect of ACT on intuitive processing style changes was greater than on MCT treatment.
CONCLUSION
The findings of this study indicate that ACT and MCT cause a significant change in intuitive style to rationalism in the thematic processing of cognitive information of obsessive-compulsive patients. According to the results, both methods of treatment improve the research variables in these patients.
PubMed: 38144015
DOI: 10.4103/jehp.jehp_40_23 -
Frontiers in Global Women's Health 2023The migrant population, consisting of individuals who relocate from rural to urban areas, faces unique challenges that heighten their vulnerability to HIV infection....
INTRODUCTION
The migrant population, consisting of individuals who relocate from rural to urban areas, faces unique challenges that heighten their vulnerability to HIV infection. These challenges stem from a combination of sociodemographic factors and limited access to healthcare services. Understanding the dynamics of HIV transmission within this population is crucial for the development of effective prevention strategies.
METHODS
To investigate the factors contributing to HIV vulnerability among migrants, we conducted a cross-sectional study at Dongguan People's Hospital from January 1, 2018, to December 31, 2021. Our study focused on pregnant women living with HIV and their infants, with a particular emphasis on sociodemographic characteristics, HIV testing and treatment profiles, and neonatal clinical data. Data were systematically collected using standardized forms.
RESULTS
Analysis of data from 98 participants revealed noteworthy findings. No significant associations were observed between age, marital status, and educational background regarding HIV vulnerability. Similarly, factors such as the status of sexual partners, spousal therapy, and the number of children had no significant impact. However, our analysis highlighted the critical role of treatment strategies for HIV-positive women and the timing of antiretroviral therapy initiation for women with HIV, both of which were associated with HIV transmission ( < 0.05). Additionally, factors such as feeding type, neonatal antiretroviral prophylaxis, and preventive treatment strategies showed significant associations, while the preventive treatment program for neonates demonstrated no significant impact.
DISCUSSION
These findings provide valuable insights into the specific risk factors and barriers to HIV prevention faced by the migrant population in Dongguan. They underscore the importance of targeted interventions and policies aimed at curtailing mother-to-child HIV transmission. By addressing the unique challenges experienced by migrant mothers and their infants, this study contributes significantly to broader efforts in controlling the spread of HIV, ultimately enhancing the health outcomes and well-being of Dongguan's migrant population. Furthermore, our research introduces a distinctive perspective within the extensively examined domain of Prevention of Mother-to-Child Transmission (PMTCT) programs, focusing on the internally migrant Chinese population, an understudied demographic group in this context. This study, conducted in Dongguan, China, represents one of the pioneering investigations into pregnant women with HIV and their infants within this migrant community.
PubMed: 37867931
DOI: 10.3389/fgwh.2023.1106959 -
Sexuality and intimacy after head and neck cancer treatment: An explorative prospective pilot study.Dental and Medical Problems 2022While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been...
BACKGROUND
While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been adequately studied.
OBJECTIVES
Our aim was to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy.
MATERIAL AND METHODS
A questionnaire study with a 6-month follow-up period was conducted at the University Hospitals Leuven, Belgium, using the Maudsley marital questionnaire (MMQ), the sexual adjustment questionnaire (SAQ) and the short sexual functioning scale (SSFS) to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy.
RESULTS
Twelve patients (67%) reported a negative impact on their sexuality and/or intimacy. There were significant declines in marital, sexual and general life satisfaction (p < 0.000) at the 6-month follow-up as compared to baseline. There was a significant increase in frustration after sexual activity (p = 0.031). Sexual desire was also impacted, with a near doubling of patients reporting a decline. The perceived importance of discussing sexual issues with one's physician significantly increased from 7 to 16 patients (p = 0.004).
CONCLUSIONS
Sexual problems are common after head and neck cancer treatment. Using a screening instrument can help to identify patients that need intervention. Discussing sexuality and intimacy issues that patients may face before, during and after treatment can have a positive impact on QoL.
Topics: Head and Neck Neoplasms; Humans; Pilot Projects; Prospective Studies; Quality of Life; Sexual Behavior; Sexuality
PubMed: 36068944
DOI: 10.17219/dmp/148156 -
Journal of Marital and Family Therapy Apr 2021The COVID-19 pandemic has transformed so many aspects of our lives. For psychotherapists, telehealth is likely a permanent part of the future mental health landscape....
The COVID-19 pandemic has transformed so many aspects of our lives. For psychotherapists, telehealth is likely a permanent part of the future mental health landscape. For family therapists using a manualized treatment, this brings unique challenges and creative opportunities. In this article, we describe the adaptation of attachment-based family therapy (ABFT) in the context of telehealth and COVID-19. ABFT is an empirically supported treatment model designed for adolescents and young adults struggling with depression, anxiety, trauma, and suicide. ABFT is a semi-structured, process-oriented, and trauma-informed family therapy model which presents its own unique challenges and benefits in telehealth environments. We present our adaptations based on years of telehealth clinical experience and address how this model supports the impact of COVID-19 on families.
Topics: Adolescent; COVID-19; Couples Therapy; Family Therapy; Female; Humans; Male; Models, Psychological; Object Attachment; Professional-Family Relations; Telerehabilitation; Young Adult
PubMed: 33749898
DOI: 10.1111/jmft.12509 -
Clinical Practice and Epidemiology in... 2021Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or...
BACKGROUND
Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or mental behaviors to relieve discomfort. 40-60% of patients do not respond to Serotonin Reuptake Inhibitors, including fluvoxamine therapy.
INTRODUCTION
The aim of the study is to identify the predictors of fluvoxamine therapy in OCD patients by Bayesian Ordinal Quantile Regression Model.
METHODS
This study was performed on 109 patients with OCD. Three methods, including Bayesian ordinal quantile, probit, and logistic regression models, were applied to identify predictors of response to fluvoxamine. The accuracy and weighted kappa were used to evaluate these models.
RESULTS
Our result showed that rs3780413 (mean=-0.69, sd=0.39) and cleaning dimension (mean=-0.61, sd=0.20) had reverse effects on response to fluvoxamine therapy in Bayesian ordinal probit and logistic regression models. In the 75 quantile regression model, marital status (mean=1.62, sd=0.47) and family history (mean=1.33, sd=0.61) had a direct effect, and cleaning (mean=-1.10, sd=0.37) and somatic (mean=-0.58, sd=0.27) dimensions had reverse effects on response to fluvoxamine therapy.
CONCLUSION
Response to fluvoxamine is a multifactorial problem and can be different in the levels of socio-demographic, genetic, and clinical predictors. Marital status, familial history, cleaning, and somatic dimensions are associated with response to fluvoxamine therapy.
PubMed: 34880926
DOI: 10.2174/1745017902117010151