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Blood Advances Apr 2023Caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) must cope with substantial caregiving burden, high rates... (Randomized Controlled Trial)
Randomized Controlled Trial
Caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) must cope with substantial caregiving burden, high rates of psychological distress, and diminished quality of life (QOL). However, data describing coping strategies before HSCT and the association between coping, QOL, and psychological outcomes in this population are lacking. We conducted a secondary analysis of data collected during a multisite randomized clinical trial of a supportive care intervention in HSCT recipients and their caregivers. Caregivers completed the Brief COPE, Hospital Anxiety and Depression Scale, and the Caregiver Oncology Quality of Life Questionnaire to measure coping strategies, psychological distress, and QOL, respectively. We grouped coping into 2 higher-order domains: approach-oriented (ie, emotional support and active coping) and avoidant (ie, self-blame and denial). We used the median split method to describe the distribution of coping and multivariate linear regression models to assess the relationship between coping and caregiver outcomes. We enrolled 170 caregivers, with a median (range) age of 53 (47-64) years. Most were White (87%), non-Hispanic (96%), and female (77%). Approach-oriented coping was associated with less anxiety (β = -0.210, P = .003), depression symptoms (β = -0.160, P = .009), and better QOL (β = 0.526, P = .002). In contrast, avoidant coping was associated with more anxiety (β = 0.687, P<.001), depression symptoms (β = 0.579, P < .001), and worse QOL (β = -1.631, P < .001). Our findings suggest that coping is related to distress and QOL among caregivers of HSCT recipients even before transplant. Hence, caregivers of patients with hematologic malignancies undergoing HSCT may benefit from resources that facilitate adaptive coping with the demands of caregiving.
Topics: Humans; Female; Middle Aged; Caregivers; Quality of Life; Depression; Adaptation, Psychological; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation
PubMed: 36398978
DOI: 10.1182/bloodadvances.2022008281 -
Artificial Organs Mar 2022After the rehabilitation program, patients with left ventricular assist device (LVAD) are discharged home, but the adaption to the daily life with the implant is... (Observational Study)
Observational Study
BACKGROUND
After the rehabilitation program, patients with left ventricular assist device (LVAD) are discharged home, but the adaption to the daily life with the implant is challenging, both with practical and psychological consequences. Literature is lacking detailed information about the quality of life of LVAD patients and caregivers after discharge to home.
OBJECTIVE
This study aimed at evaluating the post-discharge outcomes of both LVAD patients and their caregivers in terms of quality of life, affectivity, and psychological health.
METHODS
In this observational follow-up study, LVAD dyads discharged home from 1 year to 6 years were re-contacted by phone and received by mail an envelope with self-report questionnaires. Responses of 39 complete dyads of patients (mean age 68.59 ± 4.31; males: 92.31%) and their caregivers (mean age 61.59 ± 11.64; males: 17.95%) were analyzed.
RESULTS
Patients and caregivers reported the moderate levels of anxiety, depression, and caregiver strain, and Illness denial and conscious avoidance were associated between them. The couples often reported that the LVAD has impairments for their sleep and for their affective-sexual relationship. Caregivers often reported impairment in social life and self-care.
DISCUSSIONS
Despite the satisfaction for the medical and territorial assistance, patients showed psychological difficulties such as anxious and depressive symptoms and caregivers tend to neglect themselves. Even after a long time from discharge to home, the psychological distress of LVAD patients and caregivers is still considerable. Structured and continuous psychological interventions are required to support their psychological health overtime after the discharge to home.
Topics: Aged; Anxiety; Attitude to Health; Caregivers; Denial, Psychological; Depression; Female; Follow-Up Studies; Heart-Assist Devices; Humans; Male; Mental Health; Middle Aged; Quality of Life; Stress, Psychological
PubMed: 34519060
DOI: 10.1111/aor.14071 -
European Archives of Psychiatry and... Jun 2021
Topics: Denial, Psychological; Humans; Mental Disorders
PubMed: 33942147
DOI: 10.1007/s00406-021-01272-w -
Journal of Clinical Medicine Feb 2023Pregnancy loss can be defined as a loss before either 20 or 24 weeks of gestation (based on the first day of the last menstrual period) or the loss of an embryo or fetus... (Review)
Review
Pregnancy loss can be defined as a loss before either 20 or 24 weeks of gestation (based on the first day of the last menstrual period) or the loss of an embryo or fetus less than 400 g in weight if the gestation age is unknown. Approximately 23 million pregnancy losses occur worldwide every year, equating to 15-20% of all clinically recognized pregnancies. A pregnancy loss is usually associated with physical consequences, such as early pregnancy bleeding ranging in severity from spotting to hemorrhage. However, it can also be associated with profound psychological distress, which can be felt by both partners and may include feelings of denial, shock, anxiety, depression, post-traumatic stress disorder, and suicide. Progesterone plays a key part in the maintenance of a pregnancy, and progesterone supplementation has been assessed as a preventative measure in patients at increased risk of experiencing a pregnancy loss. The primary objective of this piece is to assess the evidence for various progestogen formulations in the treatment of threatened and recurrent pregnancy loss, postulating that an optimal treatment plan would preferably include a validated psychological support tool as an adjunct to appropriate pharmacological treatment.
PubMed: 36902614
DOI: 10.3390/jcm12051827 -
L'Encephale Jun 2020Emerging infectious diseases like Covid-19 cause a major threat to global health. When confronted with new pathogens, individuals generate several beliefs about the...
Emerging infectious diseases like Covid-19 cause a major threat to global health. When confronted with new pathogens, individuals generate several beliefs about the epidemic phenomenon. Many studies have shown that individual protective behaviors largely depend on these beliefs. Due to the absence of treatment and vaccine against these emerging pathogens, the relation between these beliefs and these behaviors represents a crucial issue for public health policies. In the premises of the Covid-19 pandemic, several preliminary studies have highlighted a delay in the perception of risk by individuals, which potentially holds back the implementing of the necessary precautionary measures: people underestimated the risks associated with the virus, and therefore also the importance of complying with sanitary guidelines. During the peak of the pandemic, the salience of the threat and of the risk of mortality could then have transformed the way people generate their beliefs. This potentially leads to upheavals in the way they understand the world. Here, we propose to explore the evolution of beliefs and behaviors during the Covid-19 crisis, using the theory of predictive coding and the theory of terror management, two influential frameworks in cognitive science and in social psychology.
Topics: Adaptation, Psychological; Attitude to Health; Betacoronavirus; Brain; COVID-19; Communicable Disease Control; Coronavirus Infections; Culture; Denial, Psychological; Fear; Guideline Adherence; Guidelines as Topic; Health Behavior; Health Risk Behaviors; Humans; Hygiene; Models, Psychological; Pandemics; Pneumonia, Viral; Protective Devices; Risk Management; Risk Reduction Behavior; SARS-CoV-2; Universal Precautions
PubMed: 32517998
DOI: 10.1016/j.encep.2020.05.012 -
Frontiers in Psychology 2022People often deny having meant what the audience understood. Such denials occur in both interpersonal and institutional contexts, such as in political discourse, the...
People often deny having meant what the audience understood. Such denials occur in both interpersonal and institutional contexts, such as in political discourse, the interpretation of laws and the perception of lies. In practice, denials have a wide range of possible effects on the audience, such as conversational repair, reinterpretation of the original utterance, moral judgements about the speaker, and rejection of the denial. When are these different reactions triggered? What factors make denials credible? There are surprisingly few experimental studies directly targeting such questions. Here, we present two pre-registered experiments focusing on (i) the speaker's incentives to mislead their audience, and (ii) the impact of speaker denials on audiences' moral and epistemic assessments of what has been said. We find that the extent to which speakers are judged responsible for the audience's interpretations is modulated by their (the speakers') incentives to mislead, but not by denials themselves. We also find that people are more willing than we expected to revise their interpretation of the speaker's utterance when they learn that the ascribed meaning is false, regardless of whether the speaker is known to have had incentives to deceive their audience. In general, these findings are consistent with the idea that communicators are held responsible for the cognitive effects they trigger in their audience; rather than being responsible for, more narrowly, only the effects of what was "literally" said. In light of our findings, we present a new, cognitive analysis of how audiences react to denials, drawing in particular on the Relevance Theory approach to communication. We distinguish in particular: (a) the spontaneous and intuitive re-interpretation of the original utterance in light of a denial; (b) the attribution of responsibility to the speaker for the cognitive effects of what is communicated; and (c) the reflective attribution of a particular intention to the speaker, which include argumentative considerations, higher-order deniability, and reputational concerns. Existing experimental work, including our own, aims mostly at (a) and (b), and does not adequately control for (c). Deeper understanding of what can be credibly denied will be hindered unless and until this methodological problem is resolved.
PubMed: 36687811
DOI: 10.3389/fpsyg.2022.1073213 -
The Journal of the Association of... 1995Older gay men over the age of 50 have been and continue to be an invisible part of the HIV/AIDS epidemic. The reasons for this phenomenon are many, but among them are... (Review)
Review
Older gay men over the age of 50 have been and continue to be an invisible part of the HIV/AIDS epidemic. The reasons for this phenomenon are many, but among them are societal beliefs, myths, and stereotypes emanating from ageism and homophobia. In addition, HIV/AIDS is sometimes misdiagnosed in older adults because many of its symptoms mimic other illness that affect older people. Among the HIV risk factors of older gay men are internalized homophobia, denial of risk, alcohol and other substance use, and anonymous sexual encounters. The challenge for nurses and other providers is to reach, educate, and assist older gay men effectively in changing and maintaining safe behaviors when they are engaging in sexual and drug-using behaviors that can transmit HIV.
Topics: Age Factors; Caregivers; Denial, Psychological; HIV Infections; Health Education; Homosexuality, Male; Humans; Male; Middle Aged; Patient Acceptance of Health Care; Risk Factors; United States
PubMed: 8580466
DOI: 10.1016/S1055-3290(05)80010-X -
Respiratory Medicine Jul 2003Adherence to asthma medication regimens by asthma patients is often poor and contributes to the continued and substantial burden of asthma in the community. There is... (Review)
Review
Adherence to asthma medication regimens by asthma patients is often poor and contributes to the continued and substantial burden of asthma in the community. There is evidence of increased rates of behavioural problems, anxiety and depression in people with moderate-to-severe asthma and these factors may interfere with adherence and contribute to poor asthma control. An alternative explanation is that the relationship between feelings of anxiety and depression, and adherence to the treatment regimen may be more accurately predicted from the coping styles used, rather than the experience of asthma itself. The objective of this paper was to review evidence for associations between coping strategies used by asthma patients, asthma management and health outcomes. The Medline and PsychInfo databases were searched for articles containing the terms "asthma" and "coping". Patients with asthma tended to use different strategies for coping with stress and illness compared to healthy participants and individuals with other chronic illnesses. Emotion-focussed coping strategies such as denial were commonly used by patients with poor medication adherence, those who attended emergency departments for asthma, were admitted to hospital for asthma, or suffered near-fatal asthma attacks. Interventions to improve coping strategies have been effective in reducing symptoms and psychological distress. The availability of coping resources to patients and/or their caregivers and the coping strategies that are used are likely to mediate the influence of psychosocial factors on the management of asthma. Further studies exploring the ways in which individuals cope with asthma will improve our understanding of the mechanisms linking psychological and social status to asthma morbidity and mortality.
Topics: Adaptation, Psychological; Adult; Anxiety; Asthma; Caregivers; Child; Chronic Disease; Depression; Emergencies; Hospitalization; Humans; Morbidity; Patient Compliance; Socioeconomic Factors
PubMed: 12854624
DOI: 10.1016/s0954-6111(03)00029-5 -
Iranian Journal of Nursing and... 2022As the 2019 coronavirus spreads rapidly around the world, it has caused widespread fear and anxiety in various populations. This study aimed to explore the psychological...
BACKGROUND
As the 2019 coronavirus spreads rapidly around the world, it has caused widespread fear and anxiety in various populations. This study aimed to explore the psychological effects of COVID-19 on patients with this disease.
MATERIALS AND METHODS
A qualitative study was conducted with a phenomenological approach. A purposive sample of 11 patients with COVID-19 was recruited. Data were collected from the beginning of March to the beginning of June 2020 using semi-structured interviews and they were analyzed according to Van Manen's method. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis.
RESULTS
Initially, 315 codes were extracted. During data analysis and comparisons, the codes were reduced to 108. Ultimately, 10 categories, 38 subcategories, and 3 themes emerged. The theme of "behavioral responses" including 5 categories (Remorse, Fear and despair, Death anxiety, Growth, Support), "disease-caused helplessness" including two categories (Failure, Denial), and "decline of social networks" including three categories (Rejection, Stigma, Feeling guilty).
CONCLUSIONS
After understanding the findings of this research, nurses working in the wards of patients with COVID-19 can better consider the importance of assessing and analyzing the psychological challenges and experiences of these patients during the course of illness and quarantine. Findings also enhance the identification and organization of training needs during such a pandemic and the design of nursing programs to meet them.
PubMed: 35419267
DOI: 10.4103/ijnmr.ijnmr_382_20 -
BMC Psychology Dec 2022Health-Related Quality of Life (HRQoL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of the disease, as regards the...
BACKGROUND
Health-Related Quality of Life (HRQoL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of the disease, as regards the physical, psychological and social functioning dimension. Big-Five personality traits can affect patients' HRQoL and willingness to take treatment options. Illness denial consists of denial of negative emotions, resistance to change and conscious avoidance. Poorer HRQoL can predict a higher risk of hospitalization and mortality, and broadly a worse adjustment to the dialytic therapy. Thus, a clearer knowledge of the psychological variables associated with a worse HRQoL in the predialysis stage might improve the intervention planning. No study investigated illness denial and personality traits simultaneously. We investigated the role of illness denial and Big-Five personality traits in the domains of HRQoL in predialysis patients with CKD.
METHODS
One hundred adults (mean age: 75.87 years) with CKD participated. The Kidney Disease Quality of Life Short form, the Italian version of Ten Item Personality Inventory Revised, the Illness Denial Questionnaire, and the State-Trait Anxiety Inventory Form-Y were administered.
RESULTS
Illness denial was associated with increased HRQoL related to symptoms/problems, effect and burden of CKD and cognitive functions domains, and it was a predictor of higher HRQoL in the last three domains mentioned above. Extraversion was related to better work status and sexual function; agreeableness was linked to elevated cognitive function, quality of social interaction and sexual function; conscientiousness was related to better sexual function; neuroticism was linked to improved cognitive and sexual functions; in the end, openness to experience was related to fewer symptoms and problems.
CONCLUSIONS
This is the first study which simultaneously assessed Big-Five personality traits and illness denial in different domains of HRQoL of CKD patients. Personalised psychological interventions aimed at improving HRQoL in this population might focus on specific illness denial processes and personality traits.
Topics: Adult; Humans; Aged; Quality of Life; Personality; Extraversion, Psychological; Personality Inventory; Renal Insufficiency, Chronic
PubMed: 36496378
DOI: 10.1186/s40359-022-00992-5