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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 -
Family Medicine and Community Health Jul 2023General practice receptionists provide an essential function in the healthcare system but routinely encounter acts of incivility and aggression from patients, including...
OBJECTIVE
General practice receptionists provide an essential function in the healthcare system but routinely encounter acts of incivility and aggression from patients, including hostility, abuse and violence. This study was conducted to summarise what is known about patient-initiated aggression towards general practice receptionists, including impacts on reception staff and existing mitigation strategies.
DESIGN
Systematic review with convergent integrated synthesis.
ELIGIBILITY CRITERIA
Studies published at any time in English that examine patient aggression experiences of reception staff in primary care settings.
INFORMATION SOURCES
Searches of five major databases were performed (CINAHL Complete, Scopus, PubMed, Healthcare Administration Database and Google Scholar) to August 2022.
RESULTS
Twenty studies of various designs were included, ranging from the late 1970s to 2022 and originating from five OECD countries. Twelve were assessed as high quality using a validated checklist. Reviewed articles represented 4107 participants; 21.5% were general practice receptionists. All studies reported that displays of aggression towards receptionists by patients were a frequent and routine occurrence in general practice, particularly verbal abuse such as shouting, cursing, accusations of malicious behaviour and use of racist, ablest and sexist insults. Although infrequent, physical violence was widely reported. Inefficient appointment scheduling systems, delayed access to doctors and prescription denial appeared common precipitators. Receptionists adapted their behaviour and demeanour to placate and please patients to avoid escalation of patient frustrations at the cost of their own well-being and clinic productivity. Training in patient aggression management increased receptionist confidence and appeared to decrease negative sequalae. Coordinated support for general practice reception staff who had experienced patient aggression was generally lacking, with a small proportion receiving professional counselling.
CONCLUSIONS
Patient aggression towards reception staff is a serious workplace safety concern for general practices and negatively affects healthcare sector function more broadly. Receptionists in general practice deserve evidence-based measures to improve their working conditions and well-being for their own benefit and that of the community.
REGISTRATION
Pre-registered in Open Science Framework (osf.io/42p85).
Topics: Humans; Aggression; Family Practice; General Practice; Violence; Physicians
PubMed: 37414572
DOI: 10.1136/fmch-2023-002171 -
Perspectives in Health Information... 2023The objective of the study is to identify challenges and associated factors for privacy and security related to telehealth visits during the COVID-19 pandemic. The...
The objective of the study is to identify challenges and associated factors for privacy and security related to telehealth visits during the COVID-19 pandemic. The systematic search strategy used the databases of PubMed, ScienceDirect, ProQuest, Embase, CINAHL, and COCHRANE, with the search terms of telehealth/telemedicine, privacy, security, and confidentiality. Reviews included peer-reviewed empirical studies conducted from January 2020 to February 2022. Studies conducted outside of the US, non-empirical, and non-telehealth related were excluded. Eighteen studies were included in the final analysis. Three risk factors associated with privacy and security in telehealth practice included: environmental factors (lack of private space for vulnerable populations, difficulty sharing sensitive health information remotely), technology factors (data security issues, limited access to the internet, and technology), and operational factors (reimbursement, payer denials, technology accessibility, training, and education). Findings from this study can assist governments, policymakers, and healthcare organizations in developing best practices in telehealth privacy and security strategies.
Topics: Humans; Privacy; Pandemics; COVID-19; Confidentiality; Risk Factors; Telemedicine
PubMed: 37215337
DOI: No ID Found -
Sensors (Basel, Switzerland) May 2023Software-defined networking (SDN) is a revolutionary innovation in network technology with many desirable features, including flexibility and manageability. Despite... (Review)
Review
Software-defined networking (SDN) is a revolutionary innovation in network technology with many desirable features, including flexibility and manageability. Despite those advantages, SDN is vulnerable to distributed denial of service (DDoS), which constitutes a significant threat due to its impact on the SDN network. Despite many security approaches to detect DDoS attacks, it remains an open research challenge. Therefore, this study presents a systematic literature review (SLR) to systematically investigate and critically analyze the existing DDoS attack approaches based on machine learning (ML), deep learning (DL), or hybrid approaches published between 2014 and 2022. We followed a predefined SLR protocol in two stages on eight online databases to comprehensively cover relevant studies. The two stages involve automatic and manual searching, resulting in 70 studies being identified as definitive primary studies. The trend indicates that the number of studies on SDN DDoS attacks has increased dramatically in the last few years. The analysis showed that the existing detection approaches primarily utilize ensemble, hybrid, and single ML-DL. Private synthetic datasets, followed by unrealistic datasets, are the most frequently used to evaluate those approaches. In addition, the review argues that the limited literature studies demand additional focus on resolving the remaining challenges and open issues stated in this SLR.
PubMed: 37177643
DOI: 10.3390/s23094441 -
Sexual Medicine Reviews Oct 2022The term "paedophilia erotica" was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a "psycho-sexual perversion." It was at the beginning of...
INTRODUCTION
The term "paedophilia erotica" was first coined in 1886 by the psychiatrist Krafft-Ebing and it was considered a "psycho-sexual perversion." It was at the beginning of the twentieth century that the term "pedophilia" was adopted and it started to appear in medical dictionaries. Sexual abuse is legally defined as the engagement in sexual contact with a person below a specified age or who is incapable of giving consent. Both, pedophilia and child sexual abuse (CSA) are worldwide phenomena requiring deep scientific knowledge in order to improve prevention strategies. Individuals' misconceptions of pedophilia and CSA may legitimize sexual violence, which can influence prevention strategies and policies.
OBJECTIVES
This review aimed to summarize existing research to help answer the question: "What are laypeople´s myths regarding pedophilia and CSA?"
METHODS
This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify as many relevant articles as possible. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost databases for articles published before January 2022. Sixty-one articles were included in the current review.
RESULTS
Overall, findings revealed a significant number of myths regarding pedophilia and CSA, organized into the following categories: (i) blame diffusion, (ii) denial of abusiveness, (iii) restrictive stereotypes, (iv) victim age and consequences, (v) social stigma, (vi) punitive attitudes, and (vii) treatment.
CONCLUSION
Findings suggested that laypeople's perceptions should be taken into account when devising prevention policies. Additionally, perceptions should also be a target of prevention since there is evidence of social stigma and prejudice involving individuals with pedophilia. Such phenomena can contribute to social, emotional, and cognitive problems, among said individuals as well as causing these individuals to exhibit a higher risk for abusive behavior and less help-seeking.
Topics: Child; Humans; Pedophilia; Child Abuse, Sexual; Sexual Behavior; Paraphilic Disorders; Social Stigma
PubMed: 37051950
DOI: 10.1016/j.sxmr.2022.06.010 -
Drug and Alcohol Dependence Mar 2023The prevalence of drug use in Muslim communities is difficult to estimate due to religious, social, and cultural prohibition toward drug use. With Islam affecting all... (Review)
Review
Barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in the Muslim communities: A systematic narrative review of studies on the experiences of people who receive services and service providers.
BACKGROUND
The prevalence of drug use in Muslim communities is difficult to estimate due to religious, social, and cultural prohibition toward drug use. With Islam affecting all aspects of life in the Muslim world, people who use drugs do it clandestinely to avoid stigma and exclusion from the community, leading to a low number of them seeking treatment for their drug use. This review explored the barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in Muslim communities.
METHODS
This review was in accordance with PRISMA. Seven databases were systematically searched for qualitative, quantitative, and mixed methods studies conducted in countries where at least 70% of the population were Muslim or where data were presented separately for Muslim communities in other countries. Eligible articles were reviewed, and key qualitative themes were abstracted and compared across studies and settings.
RESULTS
Twenty-four studies were included from Iran, Bangladesh, Afghanistan, Tajikistan, Kazakhstan, Kyrgyzstan, Egypt, Lebanon, and UAE. Two themes were identified: a psychosocial theme included denial of the problem severity, lack of trust in the treatment system, fear of breach in confidentiality and privacy, the need for community support, religion and women who use drugs. Additionally, an organizational theme included affordability, treatment Service characteristics, lack of Awareness, service providers' Attitudes, drug use registration and fear of legal consequences of drug use. Stigma was also identified as an over-arching theme. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies with where 12 of the studies met all 5 the quality criteria. No studies were excluded for having lower quality scores.
CONCLUSION
This review reflected how diverse the Muslim world is in drug use. It is important to use mosques to raise awareness on people who use drugs and reduce stigma. Providing holistic services for people who use drugs specially women will improve their access to treatment and harm reduction services in the Muslim world.
Topics: Humans; Female; Islam; Harm Reduction; Inpatients; Substance-Related Disorders; Social Stigma; Qualitative Research
PubMed: 36805826
DOI: 10.1016/j.drugalcdep.2023.109790 -
Frontiers in Psychiatry 2022Receiving a child's autism diagnosis can be stressful; as such, parent resolution contributes to the wellbeing and development of healthy parent-child relationships. In...
BACKGROUND
Receiving a child's autism diagnosis can be stressful; as such, parent resolution contributes to the wellbeing and development of healthy parent-child relationships. In other significant childhood diagnoses (e.g., cerebral palsy, diabetes), the degree to which parents adjust to (a) their child's diagnosis and (b) their changes in expectations concerning their child's development and capacity (referred to as resolution to diagnosis), has been associated with improved outcomes including facilitating parent-child relationships and improved parental wellbeing. Given potential benefits to parent and child, and the heterogenous nature of autism, examining the unique factors associated with resolution to diagnosis is important. In this systematic review we identified factors that support or inhibit parental resolution to their child receiving a diagnosis of autism.
METHODS
We completed a systematic review following PRISMA guidelines of peer-reviewed studies from 2017 to 2022, that investigated parental resolution or acceptance of an autism diagnosis. Papers including "acceptance" needed to encompass both accepting the diagnosis and the implications regarding the child's abilities. We searched six databases (Scopus, Web of Science, MEDLINE, PsycINFO, ProQuest), with additional papers located following review of reference lists.
RESULTS
Fourteen papers with 592 participants that investigated parental resolution or acceptance of an autism diagnosis, were included. We identified six common factors that facilitate or inhibit parental resolution and acceptance of an autism diagnosis including: symptom severity; religion, belief, and culture; knowledge and uncertainty; negative emotions (i.e., denial, shame, guilt); positive emotions; and support. Greater resolution was associated with improved "attunement and insightfulness" in the parent-child relationship.
LIMITATION
The review was limited by the small number of studies meeting inclusion criteria. Second, the quality of included studies was mixed, with over half of the studies being qualitative and only one randomized control trial (RCT) identified.
CONCLUSION
Parental resolution can have an impact on parent's perception of their child's capabilities and impact the parent-child relationship. We identified six categories that aid in inhibiting or promoting resolution to diagnosis. Despite taking a broad approach on the definition of resolution, the low number of studies identified in the review indicates a need for more research in this area.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO/, PROSPERO [ID: CRD42022336283].
PubMed: 36683975
DOI: 10.3389/fpsyt.2022.1079371 -
BMC Palliative Care Nov 2022Cancer is one of the leading causes of death worldwide and a cancer death is a major risk factor for pathological bereavement. This systematic review of the literature...
BACKGROUND
Cancer is one of the leading causes of death worldwide and a cancer death is a major risk factor for pathological bereavement. This systematic review of the literature aimed to identify biopsychosocial and existential determinants specific to the palliative phase of cancer that influence the grieving experience of the caregiving relative.
METHOD
A systematic review of the literature was conducted without language or time restrictions. The Cairn, Cochrane Library, PubMed, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection databases were explored. All studies assessing pre- and post-death measures and focusing on friends and relatives caring for adults with cancer in palliative care services were included in the review.
RESULTS
Out of 645 articles identified, 18 full text studies were finally included in our systematic review of the literature. Many factors specific to the cancer palliative phase were identified as influencing the bereavement experience of caregivers, with factors relating to: 1) the caregiver (e.g. social support, psychological burden, preparation for loss, action and discussion related to death); 2) the patient (e.g. denial or acceptance); 3) the interactions between patient and their caregivers (e.g. tensions, communication difficulties, and presence at the time of death); and 4) the end-of-life context. The caregiver's grief experience can be described by the following terms: typical and pathological grief, anxiety, depression, guilt, psychological distress, post-traumatic stress disorder and post-traumatic growth, and life satisfaction.
CONCLUSIONS
Many contextual, sociodemographic, dispositional and transactional factors specific to the palliative cancer phase are involved in the caregiver's grieving experience. Avenues for reflection and recommendations are proposed including supporting communication and patient-relative relationships, evaluating the nature and degree of functionality of coping strategies, strengthening the robustness of methodologies, considering impact of COVID-19, and new lines of enquiry for research.
Topics: Adult; Humans; Palliative Care; COVID-19; Bereavement; Grief; Neoplasms
PubMed: 36451118
DOI: 10.1186/s12904-022-01096-y -
Journal of Nursing Scholarship : An... Mar 2023Emergency healthcare professionals (EHPs) face significant occupational stressors requiring the skilled use of adaptive coping strategies. Some EHP resort to maladaptive...
BACKGROUND
Emergency healthcare professionals (EHPs) face significant occupational stressors requiring the skilled use of adaptive coping strategies. Some EHP resort to maladaptive coping (MC) strategies that negatively impact their mental health, yet MC strategies are not clearly defined in the literature. Examining factors that predispose EHP to MC can support interventions to improve coping and well-being.
OBJECTIVE
This systematic review examined MC among EHP working in pre-hospital and hospital-based settings. The primary aim was to identify factors associated with MC strategies used by EHP.
METHODS
Embase, Ovid, CINAHL Plus, PsychInfo, and the Cochrane Library were systematically searched for quantitative studies measuring MC use among EHP. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 checklist was used to guide the review. Studies were included if they: (a) targeted licensed healthcare professionals providing patient care, (b) occurred in emergency department or pre-hospital emergency setting, and (c) examined provider coping. Studies were excluded if they: (a) did not include EHPs, (b) did not differentiate results in mixed samples, (c) did not clearly measure coping strategies, (d) failed to include MC strategies in the results, or (e) were not available in full text. Risk of bias and study quality was appraised using Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Bandura's Social Cognitive Theory (SCT) guided the final synthesis, drawing conclusions from the evidence to identify factors associated with MC in EHP.
RESULTS
A total of 14 cross-sectional studies, published between 2003 and 2021, were included in the review. Included studies were conducted in either pre-hospital, hospital, or a combination of both settings. Most studies included mixed samples or emergency physicians. A variety of coping strategies were significantly correlated with poor mental health outcomes including venting, denial, disengagement, self-blame, and substance use. Among personal factors, EHPs who were female, older than 50, living alone, with personal trauma history were significantly more likely to use MC strategies. Additionally, EHP with children, work experience, higher life satisfaction, and resilience were negatively associated with MC. Environmental factors positively associated with MC included work stress, workload, and poor benefits. Trauma exposure had a positive, but non-significant relationship.
CONCLUSIONS
Emergency healthcare professionals use a variety of coping strategies, many of which are maladaptive and significantly related to poor mental health outcomes. Several personal and environmental factors contribute to behavior that reflect the use of MC strategies, but findings are sparse. Researchers should consider current limitations and challenges, particularly mental health stigma, when designing future studies.
CLINICAL RELEVANCE
The evidence in this review suggests that certain factors predispose EHP for use of MC strategies. This review highlights an important research gap necessitating more robust studies to identify MC risk factors among EHP in chronically high-stress environments.
Topics: Child; Humans; Female; Male; Cross-Sectional Studies; Adaptation, Psychological; Health Personnel; Occupational Stress; Delivery of Health Care
PubMed: 36419400
DOI: 10.1111/jnu.12848 -
The International Journal of Eating... Feb 2023Treatment-seeking rates among eating disorder (ED) populations are relatively low, with only one in four individuals seeking help. Previous research has identified many... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Treatment-seeking rates among eating disorder (ED) populations are relatively low, with only one in four individuals seeking help. Previous research has identified many factors that might be associated with help-seeking in EDs, but to date no review has investigated the quantitative association between these factors and actual help-seeking behavior. The aim of the current review was to synthesize the relevant quantitative literature on factors (i.e., perceived barriers, characteristics associated with treatment seeking, demographic variables) associated with help-seeking using meta-analytic strategies, as well as provide recommendations on future early intervention research strategies to promote early help-seeking.
METHOD
Overall, 19 studies were included, identifying 141 perceived barriers (e.g., stigma) or individual characteristics (e.g., BMI, duration of illness) and 56 demographic variables (e.g., ethnicity), which were synthesized into 24 unique variables.
RESULTS
Less help-seeking was predicted by higher levels of denial and less perceived ability of others to provide help.
DISCUSSION
Given the small number of studies these results should be considered preliminary. Future studies should consider barriers to help-seeking when creating early intervention approaches. To improve help-seeking rates we suggest the use of targeted psychoeducational materials and co-design with people with lived experience when developing new strategies.
PUBLIC SIGNIFICANCE
The present study addresses a significant gap in the literature by synthesizing factors associated with help-seeking, with the aim of informing early intervention strategies to promote early help-seeking in eating disorder populations. Denial of illness and perceived inability of others to provide help were associated with lower help-seeking. Future studies should consider barriers to help-seeking and co-design with people with lived experience when creating new early intervention strategies.
Topics: Humans; Patient Acceptance of Health Care; Feeding and Eating Disorders; Social Stigma; Early Intervention, Educational; Ethnicity
PubMed: 36346008
DOI: 10.1002/eat.23845