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Journal of Marital and Family Therapy Jun 2024This study aimed to investigate the comparative effectiveness of enhanced cognitive-behavioral couple therapy (ECBCT) on emotional self-regulation and couple burnout in...
Comparison of the effectiveness of enhanced cognitive-behavioral couple therapy on emotional self-regulation and couple burnout of self-assigned and court-referred incompatible couples.
This study aimed to investigate the comparative effectiveness of enhanced cognitive-behavioral couple therapy (ECBCT) on emotional self-regulation and couple burnout in incompatible couples. The study hypothesizes that ECBCT is efficacious in emotional self-regulation and marital burnout of incompatible Iranian couples (self-assigned and court-referred) visiting counseling centers. Twenty-eight Iranian couples were divided into four groups (two self-assigned and court-referred experimental groups and two self-assigned and court-referred control groups) who were selected using the available sampling. The experimental groups were subjected to ECBCT, while the control groups received no therapy. Over time, there was an improvement in emotional self-regulation and marital burnout in experimental groups compared with control groups. This intervention was more efficacious for the self-assigned couples of the experimental group according to the Eta coefficient, which was 71 for emotional self-regulation and 66 for marital burnout. ECBCT helps couples improve their emotional self-regulation and couple burnout.
PubMed: 38887127
DOI: 10.1111/jmft.12722 -
Journal of Marital and Family Therapy Jun 2024Alliance ruptures and their repair are robustly associated with outcomes in individual therapy. Little is known about these processes in couple therapy, despite the...
Alliance ruptures and their repair are robustly associated with outcomes in individual therapy. Little is known about these processes in couple therapy, despite the acknowledged challenges of nurturing the alliance when working with two parties in conflict. One factor contributing to this gap in the literature is the lack of an instrument to capture ruptures and repair in couple therapy. We adapted the Rupture Resolution Rating System (3RS) to identify ruptures and repairs in couple therapy at the within-system (between the two partners) and the between-system (between each partner and the therapist) levels. Sessions from one couple with good outcome and one couple with poor outcome were coded. Couples were in therapy to deal with emotional injury. Rupture-repair events in both the within-system and between-system were common. The couple with the poor outcome showed greater levels of rupture with the therapist. The injured partners (vs. injurer partners) demonstrated higher frequencies of ruptures.
PubMed: 38887106
DOI: 10.1111/jmft.12723 -
Journal of Marital and Family Therapy Jun 2024This article explores couples' perceptions and expectations of closeness in a clinical setting, and how relationship perceptions and expectations are associated with...
This article explores couples' perceptions and expectations of closeness in a clinical setting, and how relationship perceptions and expectations are associated with treatment outcomes. Bowen's theory of differentiation suggests that healthy relationships require a balance of autonomy and connection. However, some research suggests that contemporary societal expectations are pushing couples to expect greater degrees of closeness and less autonomy. Utilizing a clinical sample of 185 couples from an on-campus Couple and Family Therapy training clinic, this article explores couples' perceptions and expectations of relationship closeness utilizing graphics of overlapping circles. Latent profile analysis was conducted to identify three different profile groups based on perceptions and expectations. Wald tests for significant mean differences among the profiles were performed. Results identified significant differences between the three groups for satisfaction and separateness and connectedness variables, number of sessions and termination.
PubMed: 38886896
DOI: 10.1111/jmft.12724 -
BMC Public Health Jun 2024This study aims to analyze variables related to patient activation in 78 individuals with visual impairment. The Patient Activation Measure (PAM) scores of participants...
This study aims to analyze variables related to patient activation in 78 individuals with visual impairment. The Patient Activation Measure (PAM) scores of participants showed no differences between males and females. It was found that the individuals living in urban areas, and participants with higher income and education levels had higher PAM scores. Still, the difference between the groups was statistically insignificant (p > 0.05). The PAM scores of the visually impaired individuals reflect taking action level of activation (66.51 ± 18.14-PAM level 3). There was a moderately significant relationship between PAM scores and visually impaired individuals' self-management, self-efficacy, healthy life awareness, social relations, and environment (p < 0.001). We found that the variables included in the regression model (marital status, self-management, self-efficacy, healthy life awareness, social relations, and environment) explained 72.2% of the PAM score. Individuals with visual impairment can be given training on self-management, self-efficacy, healthy life awareness, and quality of life associated with social relations and environment to develop positive health behaviors.
Topics: Humans; Male; Female; Middle Aged; Adult; Vision Disorders; Self Efficacy; Patient Participation; Aged; Quality of Life; Young Adult; Surveys and Questionnaires
PubMed: 38877430
DOI: 10.1186/s12889-024-18856-5 -
Medicine Jun 2024Psychiatric patients exhibit a higher rate of missed appointments compared to other medical specialities, leading to provider frustration, increased relapse, and...
Psychiatric patients exhibit a higher rate of missed appointments compared to other medical specialities, leading to provider frustration, increased relapse, and suboptimal outcomes. This study investigates the patterns and correlates of missed appointments among outpatients at the Federal Neuropsychiatric Hospital in Calabar, Nigeria. A cross-sectional study involving 403 consecutive outpatient clinic attendees was conducted. The study questionnaire inquired about sociodemographic characteristics and hospital utilization. The Oslo Social Support Scale, the Internalized Stigma of Mental Illness Scale, the Perceived Devaluation and Discrimination Scale, and the Treatment Perception Questionnaire were administered. The mean participant age was 36.19 years (SD = 11.25), with females constituting 52.6%. Missed appointments occurred in 16.6%. The primary reasons for missed appointments included financial difficulties, forgetfulness, and distance to the hospital. Factors significantly associated with missed appointments were marital status (married), having children, believing appointments were too frequent, medication nonadherence, and concerns about medication cost (P < .05). Additionally, individuals who received unorthodox or delayed traditional care during their first mental health episode were more likely to miss appointments (P < .05). Missed appointments are prevalent among psychiatric patients, often attributed to financial challenges, forgetfulness, and geographical barriers to the hospital. Some of these factors are modifiable, suggesting targeted interventions in adherence improvement programs are needed.
Topics: Humans; Female; Cross-Sectional Studies; Male; Adult; Nigeria; Appointments and Schedules; Middle Aged; Hospitals, Psychiatric; Mental Disorders; Social Stigma; Surveys and Questionnaires; Young Adult
PubMed: 38875386
DOI: 10.1097/MD.0000000000038564 -
The Journal of Knee Surgery Jul 2024Outpatient total knee arthroplasty (TKA) is being performed more frequently in ambulatory surgical centers (ASCs) to decrease the cost of care. Discharge pathways...
Outpatient total knee arthroplasty (TKA) is being performed more frequently in ambulatory surgical centers (ASCs) to decrease the cost of care. Discharge pathways include 23-hour observation (OBSERVATION) or same-day discharge home (HOME), which differ in postoperative medical supervision. Few studies allow patients to self-select their discharge pathway. This study compared patient variables between self-selected OBSERVATION or HOME discharge after TKA at an ASC. We hypothesized that age, sex, and distance lived from the ASC would differ between discharge pathways. Clinical and patient-reported outcomes were explored.A chart review identified 130 patients with TKA at an ASC between November 2017 and December 2019. Patients self-selected OBSERVATION or HOME during a preoperative physician visit. Patient variables obtained from the electronic medical record were age, sex, race/ethnicity, marital status, body mass index, diabetic status, American Society of Anesthesiologists (ASA) class, distance lived from the ASC, anesthesia type, procedure time, and time in the postanesthesia recovery unit. Clinical outcomes (knee range of motion, infection rate, and reoperation rate) and patient-reported outcomes (Knee Injury and Osteoarthritis Outcome Score, Joint Replacement [KOOS, JR]; Oxford Knee Score [OKS]) were collected at either 6 or 12 weeks postsurgery. Variables were compared between groups.Pathway selection was = 70 OBSERVATION and = 60 HOME, and all patients completed their self-selected discharge pathway. Age and proportion of females were significantly higher in OBSERVATION than in HOME (61.3 ± 3.5 vs. 58.5 ± 5.4 years, 85.7 vs. 65.0%, respectively; < 0.05). Distance lived from the ASC tended to be greater in OBSERVATION than HOME (22.1 ± 24.6 vs. 15.3 ± 10.1 miles, = 0.056). Across groups, clinical outcomes were favorable (i.e., >88% met the 6-week knee flexion milestone, 1.9% infection rate, and 3.1% manipulation under anesthesia), and the preoperative to 12-week postoperative change in KOOS, JR and OKS scores met the minimal clinically important difference.Older age, female sex, and farther distance lived from the ASC may influence patients to select OBSERVATION over HOME discharge following TKA at an ASC. No robust differences were found in early outcomes.
PubMed: 38870991
DOI: 10.1055/a-2344-4993 -
AIDS and Behavior Jun 2024This 12-year cohort study of 80 long-term non-progressors (LTNPs) observed a cumulative follow-up duration of 628.5 person-years. Among them, 60 received antiretroviral...
This 12-year cohort study of 80 long-term non-progressors (LTNPs) observed a cumulative follow-up duration of 628.5 person-years. Among them, 60 received antiretroviral therapy (ART) for a total of 418.6 person-years. Twenty-four deaths occurred during the follow-up period, with an average age of 42.36 years and a lowest 8-year survival rate of 0.90. Cox model analysis revealed that the risk of AIDS-related death was 1.47 times higher for non-marital, non-commercial heterosexual transmission than for injection drug use. Treatment initiation at ages 31-40 was correlated with an elevated risk of mortality, while treatment for 3-10 years reduced mortality risks in untreated LTNPs. Flow cytometry observed significant differences in the proportion of NK cells. Long-term ART (> 2 years) before LTNPs developed AIDS symptoms could lower mortality risk and potentially extend lifespan, especially when it was initiated at a younger age without affecting NK cell balance. Epidemiological and immunological studies on ART-treated LTNPs are vital for advancing HIV treatment and achieving functional cures for AIDS individuals.
PubMed: 38869754
DOI: 10.1007/s10461-024-04396-x -
Cancer Control : Journal of the Moffitt... 2024The purpose of this study is to employ a competing risk model based on the Surveillance, Epidemiology, and End Results (SEER) database to identify prognostic factors for...
BACKGROUND
The purpose of this study is to employ a competing risk model based on the Surveillance, Epidemiology, and End Results (SEER) database to identify prognostic factors for elderly individuals with sigmoid colon adenocarcinoma (SCA) and compare them with the classic Cox proportional hazards model.
METHODS
We extracted data from elderly patients diagnosed with SCA registered in the SEER database between 2010 and 2015. Univariate analysis was conducted using cumulative incidence functions and Gray's test, while multivariate analysis was performed using both the Fine-Gray and Cox proportional hazards models.
RESULTS
Among the 10,712 eligible elderly patients diagnosed with SCA, 5595 individuals passed away: 2987 due to sigmoid colon adenocarcinoma and 2608 from other causes. The results of one-way Gray's test showed that age, race, marital status, AJCC stage, differentiation grade, tumor size, surgical status, liver metastasis status, lung metastasis status, brain metastasis status, radiotherapy status, and chemotherapy status all affected the prognosis of SCA ( < .05). Multivariate analysis showed that sex, age, race, marital status, and surgical status affected the prognosis of SCA ( < .05). Multifactorial Fine-Gray analysis revealed that key factors influencing the prognosis of SCA patients include age, race, marital status, AJCC stage, grade classification, surgical status, tumor size, liver metastasis, lung metastasis, and chemotherapy status ( < .05).
CONCLUSION
Data from the SEER database were used to more accurately estimate CIFs for sigmoid colon adenocarcinoma-specific mortality and prognostic factors using competing risk models.
Topics: Humans; Male; Female; Aged; Adenocarcinoma; Prognosis; SEER Program; Sigmoid Neoplasms; Risk Assessment; Aged, 80 and over; Proportional Hazards Models; Risk Factors
PubMed: 38868954
DOI: 10.1177/10732748241262184 -
BMC Psychiatry Jun 2024To analyze the economic benefits of paliperidone palmitate in the treatment of schizophrenia.
BACKGROUND
To analyze the economic benefits of paliperidone palmitate in the treatment of schizophrenia.
METHODS
We collected 546 patients who met the diagnostic criteria for schizophrenia according to the 《International Statistical Classification of Diseases and Related Health Problems,10th》(ICD-10). We gathered general population data such as gender, age, marital status, and education level, then initiated treatment with paliperidone palmitate. Then Follow-up evaluations were conducted at 1, 3, 6, 9, and 12 months after the start of treatment to assess clinical efficacy, adverse reactions, and injection doses. We also collected information on the economic burden before and after 12 months of treatment, as well as the number of outpatient visits and hospitalizations in the past year to analyze economic benefits.
RESULTS
The baseline patients totaled 546, with 239 still receiving treatment with paliperidone palmitate 12 months later. After 12 months of treatment, the number of outpatient visits per year increased compared to before (4 (2,10) vs. 12 (4,12), Z=-5.949, P < 0.001), while the number of hospitalizations decreased (1 (1,3) vs. 1 (1,2), Z = 5.625, P < 0.001). The inpatient costs in the direct medical expenses of patients after 12 months of treatment decreased compared to before (5000(2000,12000) vs. 3000 (1000,8050), P < 0.05), while there was no significant change in outpatient expenses and direct non-medical expenses (transportation, accommodation, meal, and family accompanying expenses, etc.) (P > 0.05); the indirect costs of patients after 12 months of treatment (lost productivity costs for patients and families, economic costs due to destructive behavior, costs of seeking non-medical assistance) decreased compared to before (300(150,600) vs. 150(100,200), P < 0.05).
CONCLUSION
Palmatine palmitate reduces the number of hospitalizations for patients, as well as their direct and indirect economic burdens, and has good economic benefits.
Topics: Humans; Paliperidone Palmitate; Schizophrenia; Male; Female; Antipsychotic Agents; Adult; Middle Aged; Hospitalization; Cohort Studies; Cost of Illness; Treatment Outcome
PubMed: 38867159
DOI: 10.1186/s12888-024-05874-1 -
Frontiers in Psychiatry 2024Depression is a primary cause of illness and disability among teenagers, and the incidence of depression and the number of untreated young people have increased in...
BACKGROUND
Depression is a primary cause of illness and disability among teenagers, and the incidence of depression and the number of untreated young people have increased in recent years. Effective intervention for those youths could decrease the disease burden and suicide or self-harm risk during preadolescence and adolescence.
OBJECTIVE
To verify the short efficacy of the systemic couple group therapy (SCGT) on youths' depression changes and families with depressed adolescents.
METHODS
The study was a self-control trial; only within-group changes were evaluated. Participants were couples with a depressed child who was resistant to psychotherapy; they were recruited non-randomly through convenient sampling. The paired-sample -test and Wilcoxon signed-rank test were used to compare differences before and after interventions. The effect sizes were also estimated using Cohen's d. Spearman's correlation analysis was used to examine associations between changes.
RESULTS
A downward trend was seen in depressive symptoms after treatment, and Cohen's d was 0.33 ( = 0.258). The adolescents perceived fewer interparental conflicts, and the effect sizes were medium for perceived conflict frequency (0.66, = 0.043), conflict intensity (0.73, = 0.028), conflict solutions (0.75, = 0.025), coping efficacy (0.68, = 0.038), and perceived threat (0.57, = 0.072). For parents, global communication quality, constructive communication patterns, and subjective marital satisfaction significantly improved after interventions, with large effect sizes (1.11, 0.85, and 1.03, respectively; all 0.001). Other destructive communication patterns such as demand/withdraw ( = 0.003) and mutual avoidance ( = 0.018) and communication strategies like verbal aggression ( = 0.012), stonewalling ( = 0.002), avoidance-capitulation ( = 0.036), and child involvement ( = 0.001) also reduced, with medium effect sizes (0.69, 0.52, 0.55, 0.71, 0.46, and 0.79, respectively). Meanwhile, the associations between depression changes and changes in interparental conflicts ( 0.001) and marital satisfaction ( = 0.001) were significant.
CONCLUSIONS AND CLINICAL RELEVANCE
The SCGT offers the possibility for the treatment of families with depressed children who are unwilling to seek treatment. Helping parents improve communication and marital quality may have benefits on children's depressive symptoms.
PubMed: 38863609
DOI: 10.3389/fpsyt.2024.1283519