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Psycho-oncology Nov 2022It is imperative to provide care for patients with terminal illnesses such as cancer, though it demands time, financial resources and other unmet needs. Subsequently,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is imperative to provide care for patients with terminal illnesses such as cancer, though it demands time, financial resources and other unmet needs. Subsequently, caregivers might be exposed to psychological stress and other mental health problems. Previous meta-analysis finding shows caregivers of cancer patient suffer from depression. During the past 4 years, there has been a considerable increase in the number of newly studies, and we therefore intended to update this finding and provide current global prevalence of depression among caregivers of Cancer patients.
METHODS
We searched PubMed, SCOPUS, CINAHIL, Embase, and PsychINFO to identify peer-reviewed studies which reported the prevalence of depression among caregivers of cancer patients using pre-defined eligibility criteria. Studies were pooled to estimate the global prevalence of depression using a random-effect meta-analysis model. Heterogeneity was assessed using Cochran's Q and I statistics. Funnel plot asymmetry and Egger's regression tests were used to check for publication bias.
RESULT
Our search identified 4375 studies, of which 35 studies with 11,396 participants were included in the meta-analysis. In the current review, the pooled prevalence of depression among caregivers of Cancer patients was 42.08% (95% CI: 34.71-49.45). The pooled prevalence of depression was higher in the studies that used cross-sectional data (42%, 95% CI: 31-52) than longitudinal data (34%, 95% CI: 18-50). We also observed a higher rate of depression among female caregivers when compared to their male counterparts (57.6%) (95% CI: 29.5-81.5).
CONCLUSION
Globally, around two in five cancer patient caregivers screened positive for depression, which needs due attention. Routine screening of depressive symptoms and providing psychosocial support for caregivers is crucial.
Topics: Humans; Male; Female; Caregivers; Depression; Cross-Sectional Studies; Anxiety; Prevalence; Neoplasms
PubMed: 36209385
DOI: 10.1002/pon.6045 -
PloS One 2022Emergency responders (ERs), often termed First Responders, such as police, fire and paramedic roles are exposed to occupational stressors including high workload, and...
Emergency responders (ERs), often termed First Responders, such as police, fire and paramedic roles are exposed to occupational stressors including high workload, and exposure to trauma from critical incidents, both of which can affect their mental health and wellbeing. Little is known about the impact of the ER occupation on the mental health and wellbeing of their families. The aim of the current study was to investigate what mental health and wellbeing outcomes and experiences have been researched internationally in ER families, and to examine the prevalence and associated risk and protective factors of these outcomes. We conducted a systematic review in accordance with an a priori PROSPERO approved protocol (PROSPERO 2019 CRD42019134974). Forty-three studies were identified for inclusion. The majority of studies used a quantitative, cross-sectional design and were conducted in the United States; just over half assessed police/law enforcement families. Themes of topics investigated included: 1) Spousal/partner mental health and wellbeing; 2) Couple relationships; 3) Child mental health and wellbeing; 4) Family support and coping strategies; and 5) Positive outcomes. The review identified limited evidence regarding the prevalence of mental health and wellbeing outcomes. Family experiences and risk factors described were ER work-stress spillover negatively impacting spousal/partner wellbeing, couple relationships, and domestic violence. Traumatic exposure risk factors included concerns family had for the safety of their ER partner, the negative impact of an ER partners' mental health problem on the couples' communication and on family mental health outcomes. Protective factors included social support; however, a lack of organisational support for families was reported in some studies. Study limitations and future research needs are discussed. Progressing this area of research is important to improve knowledge of baseline needs of ER families to be able to target interventions, improve public health, and support ER's operational effectiveness.
Topics: Child; Cross-Sectional Studies; Emergency Responders; Humans; Mental Health; Social Support; Spouses
PubMed: 35704626
DOI: 10.1371/journal.pone.0269659 -
PLoS Medicine 2013Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated with incident depression and suicide attempts, and vice versa, in both women and men.
METHODS AND FINDINGS
We conducted a systematic review and meta-analysis of longitudinal studies published before February 1, 2013. More than 22,000 records from 20 databases were searched for studies examining physical and/or sexual intimate partner or dating violence and symptoms of depression, diagnosed major depressive disorder, dysthymia, mild depression, or suicide attempts. Random effects meta-analyses were used to generate pooled odds ratios (ORs). Sixteen studies with 36,163 participants met our inclusion criteria. All studies included female participants; four studies also included male participants. Few controlled for key potential confounders other than demographics. All but one depression study measured only depressive symptoms. For women, there was clear evidence of an association between IPV and incident depressive symptoms, with 12 of 13 studies showing a positive direction of association and 11 reaching statistical significance; pooled OR from six studies = 1.97 (95% CI 1.56-2.48, I² = 50.4%, p(heterogeneity = 0.073). There was also evidence of an association in the reverse direction between depressive symptoms and incident IPV (pooled OR from four studies = 1.93, 95% CI 1.51-2.48, I² = 0%, p = 0.481). IPV was also associated with incident suicide attempts. For men, evidence suggested that IPV was associated with incident depressive symptoms, but there was no clear evidence of an association between IPV and suicide attempts or depression and incident IPV.
CONCLUSIONS
In women, IPV was associated with incident depressive symptoms, and depressive symptoms with incident IPV. IPV was associated with incident suicide attempts. In men, few studies were conducted, but evidence suggested IPV was associated with incident depressive symptoms. There was no clear evidence of association with suicide attempts.
Topics: Adolescent; Adult; Age Factors; Depression; Female; Humans; Incidence; Male; Mental Health; Odds Ratio; Risk Assessment; Risk Factors; Sex Factors; Spouse Abuse; Suicide, Attempted; Time Factors; Young Adult
PubMed: 23671407
DOI: 10.1371/journal.pmed.1001439 -
Journal of Alzheimer's Disease : JAD 2023Information technology can enhance timely and individual support for people with Alzheimer's disease and other dementias and their informal carers. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Information technology can enhance timely and individual support for people with Alzheimer's disease and other dementias and their informal carers.
OBJECTIVE
To review the effectiveness of technology-based counselling interventions for people with dementia and informal carers.
METHODS
Randomized controlled trials of remote dementia counselling interventions were included. We searched CINAHL, Cochrane Library, MEDLINE, PsycINFO, and the Web of Science Core Collection (April 2021) in combination with citation tracking and free web searching (October to November 2021). We provide meta-analyses for caregiver depression, burden, and self-efficacy/mastery and structured reporting for other outcomes. The Grading of Recommendations Assessment, Development and Evaluation approach and the Risk of Bias 2 tool were applied.
RESULTS
We included five randomized controlled trials involving 880 participants. Interventions were provided for carers (four studies) or dyads (one study). Carers were predominantly women and were the spouses or children of people with dementia. Counselling was delivered via telephone or videoconference with two to 23 sessions over 1 to 12 months. Control groups received educational and resource materials only, standard (helpline) services, non-directive support, or home visits. Meta-analysis for our primary outcome, depressive symptoms in carers, revealed no statistically significant effect (SMD -0.15; 95% CI -0.40 to 0.10). There were also no significant effects on burden and self-efficacy/mastery. We rated the certainty of evidence as low to very low and all outcomes at an overall high risk of bias.
CONCLUSION
The effectiveness of technology-based counselling interventions for people with dementia and informal carers remains uncertain. Theory-based approaches are needed for the development and evaluation of these interventions.
Topics: Humans; Female; Male; Caregivers; Alzheimer Disease; Self Efficacy; Counseling; Technology; Quality of Life
PubMed: 37125549
DOI: 10.3233/JAD-221194 -
PLoS Medicine Jan 2014Intimate partner violence (IPV) and termination of pregnancy (TOP) are global health concerns, but their interaction is undetermined. The aim of this study was to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Intimate partner violence (IPV) and termination of pregnancy (TOP) are global health concerns, but their interaction is undetermined. The aim of this study was to determine whether there is an association between IPV and TOP.
METHODS AND FINDINGS
A systematic review based on a search of Medline, Embase, PsycINFO, and Ovid Maternity and Infant Care from each database's inception to 21 September 2013 for peer-reviewed articles of any design and language found 74 studies regarding women who had undergone TOP and had experienced at least one domain (physical, sexual, or emotional) of IPV. Prevalence of IPV and association between IPV and TOP were meta-analysed. Sample sizes ranged from eight to 33,385 participants. Worldwide, rates of IPV in the preceding year in women undergoing TOP ranged from 2.5% to 30%. Lifetime prevalence by meta-analysis was shown to be 24.9% (95% CI 19.9% to 30.6%); heterogeneity was high (I (2)>90%), and variation was not explained by study design, quality, or size, or country gross national income per capita. IPV, including history of rape, sexual assault, contraceptive sabotage, and coerced decision-making, was associated with TOP, and with repeat TOPs. By meta-analysis, partner not knowing about the TOP was shown to be significantly associated with IPV (pooled odds ratio 2.97, 95% CI 2.39 to 3.69). Women in violent relationships were more likely to have concealed the TOP from their partner than those who were not. Demographic factors including age, ethnicity, education, marital status, income, employment, and drug and alcohol use showed no strong or consistent mediating effect. Few long-term outcomes were studied. Women welcomed the opportunity to disclose IPV and be offered help. Limitations include study heterogeneity, potential underreporting of both IPV and TOP in primary data sources, and inherent difficulties in validation.
CONCLUSIONS
IPV is associated with TOP. Novel public health approaches are required to prevent IPV. TOP services provide an opportune health-based setting to design and test interventions.
Topics: Abortion, Induced; Adult; Contraception Behavior; Female; Humans; Male; Men; Pregnancy; Prevalence; Risk Factors; Socioeconomic Factors; Spouse Abuse; Women
PubMed: 24409101
DOI: 10.1371/journal.pmed.1001581 -
Obesity Facts 2011The emergence of obesity as a distinct disease could have far reaching consequences for an organisation where optimum health and physical fitness are required for... (Review)
Review
OBJECTIVE
The emergence of obesity as a distinct disease could have far reaching consequences for an organisation where optimum health and physical fitness are required for personnel to perform their occupational roles effectively. The objectives of this paper are to systematically review the literature concerning correlates and treatment of obesity in military populations.
METHODS
Through computerised searches of English language studies, 17 papers were identified (treatment (13), correlates (4)).
RESULTS
Successful treatment interventions incorporated exercise, healthy eating information, behavioural modification, self-monitoring, relapse prevention, and structured follow-up and were supported by trained personnel. Efficacy due to physical activity was underreported. Reduction in body fat rather than body weight was the most significant outcome. The major significant correlates of obesity were being enlisted personnel, male, ≥35 years of age, African-American/Hispanic ethnicity, and married (with spouse present).
CONCLUSION
This systematic review highlights the deficit in knowledge concerning treatment and the lack of engagement in relation to the specific correlates of obesity in military populations.
Topics: Adipose Tissue; Diet; Ethnicity; Exercise; Health Promotion; Humans; Marital Status; Military Personnel; Obesity; Social Control, Informal; Treatment Outcome
PubMed: 21701240
DOI: 10.1159/000329450 -
PloS One 2014Despite progress reducing maternal mortality, HIV-related maternal deaths remain high, accounting, for example, for up to 24 percent of all pregnancy-related deaths in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Despite progress reducing maternal mortality, HIV-related maternal deaths remain high, accounting, for example, for up to 24 percent of all pregnancy-related deaths in sub-Saharan Africa. Antiretroviral therapy (ART) is effective in improving outcomes among HIV-infected pregnant and postpartum women, yet rates of initiation, adherence, and retention remain low. This systematic literature review synthesized evidence about individual and contextual factors affecting ART use among HIV-infected pregnant and postpartum women.
METHODS
Searches were conducted for studies addressing the population (HIV-infected pregnant and postpartum women), intervention (ART), and outcomes of interest (initiation, adherence, and retention). Quantitative and qualitative studies published in English since January 2008 were included. Individual and contextual enablers and barriers to ART use were extracted and organized thematically within a framework of individual, interpersonal, community, and structural categories.
RESULTS
Thirty-four studies were included in the review. Individual-level factors included both those within and outside a woman's awareness and control (e.g., commitment to child's health or age). Individual-level barriers included poor understanding of HIV, ART, and prevention of mother-to-child transmission, and difficulty managing practical demands of ART. At an interpersonal level, disclosure to a spouse and spousal involvement in treatment were associated with improved initiation, adherence, and retention. Fear of negative consequences was a barrier to disclosure. At a community level, stigma was a major barrier. Key structural barriers and enablers were related to health system use and engagement, including access to services and health worker attitudes.
CONCLUSIONS
To be successful, programs seeking to expand access to and continued use of ART by integrating maternal health and HIV services must identify and address the relevant barriers and enablers in their own context that are described in this review. Further research on this population, including those who drop out of or never access health services, is needed to inform effective implementation.
Topics: Adult; Antiretroviral Therapy, Highly Active; Culture; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Medication Adherence; Postpartum Period; Pregnancy; Pregnancy Complications, Infectious; Risk Factors
PubMed: 25372479
DOI: 10.1371/journal.pone.0111421 -
Trauma, Violence & Abuse Jan 2021Familicides have received relatively little attention and are mostly discussed in studies with broader aims. Here, we reviewed 67 studies from 18 countries on...
Familicides have received relatively little attention and are mostly discussed in studies with broader aims. Here, we reviewed 67 studies from 18 countries on familicides, in which an offender killed or attempted to kill their current or former spouse/intimate partner and one or more of their biological or stepchildren. We conducted a systematic literature search in PubMed, PsycINFO, and Google Scholar. Eight studies investigated familicide specifically, while the remaining reported on familicide cases as a subsample. We retrieved data on offenders' gender, age, and background as well as on victims and their relationship to the offender. We also retrieved data on contextual factors and offense characteristics (i.e., modus operandi, offense location, premeditation, and whether or not the offender had committed suicide). We also coded methodological aspects of the studies. Familicides were almost exclusively committed by men and about half of the familicide cases led to the suicide of the offender. Mental health problems, relationship problems, and financial difficulties were prevalent. Because few studies reported population base rates of the investigated characteristics, it is difficult to draw conclusions about specific risk factors. Future research should further investigate typologies of familicide and examine risk factors for different types of familicides.
Topics: Criminals; Family; Homicide; Humans; Male; Mental Disorders; Suicide
PubMed: 30704336
DOI: 10.1177/1524838018821955 -
Journal of Advanced Nursing Apr 2023The current study aimed to systematically review the data obtained from studies on women with breast and gynaecologic cancers subjected to Intimate Partner Violence... (Review)
Review
AIM
The current study aimed to systematically review the data obtained from studies on women with breast and gynaecologic cancers subjected to Intimate Partner Violence (IPV).
DESIGN
Systematic review without meta-analysis.
DATA SOURCES
PubMed, ProQuest, Google Scholar, Scopus, Web of Science; databases were searched without time limit.
REVIEW METHOD
The PRISMA model was guided the systematic literature search using Boolean keywords and operators. PICO statement was used to develop a question of this review. Studies examining women with breast and gynaecologic cancers subjected to IPV were included in the study after the quality of the articles was reviewed.
RESULTS
Eight studies that met the inclusion criteria and were conducted between 2000 and 2021 were included in the study.
CONCLUSIONS
Studies confirm the effect of IPV on the severity and consequences of breast and gynaecologic cancers. Having a history of IPV can indirectly lead to breast and gynaecologic cancers. On the other hand, women suffering from IPV are more likely than other women to delay screening or not perform screening for cancer.
IMPACT
The dimensions and nature of violence and the disclosure or non-disclosure of violence in vulnerable women are strongly affected by society's culture. Therefore, researchers need to have sufficient knowledge of the culture and social factors governing the community to achieve reliable findings related to IPV in qualitative, quantitative, and psychometric studies and the design of IPV assessment tools. It is recommended that IPV screening teams, that is, multidisciplinary teams of trained physicians, nurses and social workers, participate in two-way screening programmes: IPV screening for women with gynaecological cancer and screening for gynaecological cancer in women with IPV.
Topics: Female; Humans; Intimate Partner Violence; Violence; Disclosure; Psychometrics; Neoplasms
PubMed: 35799466
DOI: 10.1111/jan.15285 -
Addiction (Abingdon, England) Jun 2020Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training...
BACKGROUND AND AIMS
Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training (CRAFT). This study aims to clarify which (1) treatment components and (2) participant characteristics contribute to rates of identified patient (IP) treatment entry.
METHOD
Systematic review of CRAFT evaluation studies of all designs (controlled and uncontrolled) with data synthesis and narrative analysis of addiction treatment services and university research departments in North America and Europe.
RESULTS
A total of 691 concerned significant others (CSOs), predominately female spouses/parents, participating in 20 distinct treatment conditions from 14 studies. The main outcome of IP treatment entry rate reported by CSOs up to 12 months after starting CRAFT with key predictors/correlates including IP addiction, IP-CSO relationship, CRAFT modality and integration of treatment for IP. Meta-analysis found CRAFT to be twice as effective as controls/comparison groups. Multi-modality treatment, including both individual and group sessions, yielded the highest IP treatment entry rates (77 and 86%), with progressively lower rates for individual (12.5-71%), group (60%) and self-directed workbook (13.3-40%) modalities. While all five studies targeting gambling addiction had consistently low rates (12.5-23%), other treatment components, including therapist training, treatment fidelity and integrating treatment for the IP, were implicated.
CONCLUSIONS
Adaptations of Community Reinforcement Approach and Family Training for different delivery modalities and addictions have yielded widely varying rates of treatment engagement for the identified patient, with those offering the most comprehensive support to the concerned significant other, including individual and group sessions, having highest levels of engagement success.
Topics: Adult; Aged; Aged, 80 and over; Behavior, Addictive; Europe; Family Therapy; Female; Humans; Male; Middle Aged; North America; Patient Acceptance of Health Care; Reinforcement, Psychology; Spouses; Substance-Related Disorders; Young Adult
PubMed: 31770469
DOI: 10.1111/add.14901