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Annals of Behavioral Medicine : a... Dec 2010Evidence continues to build for the impact of the marital relationship on health as well as the negative impact of illness on the partner. Targeting both patient and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Evidence continues to build for the impact of the marital relationship on health as well as the negative impact of illness on the partner. Targeting both patient and partner may enhance the efficacy of psychosocial or behavioral interventions for chronic illness.
PURPOSE
The purpose of this report is to present a cross-disease review of the characteristics and findings of studies evaluating couple-oriented interventions for chronic physical illness.
METHODS
We conducted a qualitative review of 33 studies and meta-analyses for a subset of 25 studies.
RESULTS
Identified studies focused on cancer, arthritis, cardiovascular disease, chronic pain, HIV, and Type 2 diabetes. Couple interventions had significant effects on patient depressive symptoms (d = 0.18, p < 0.01, k = 20), marital functioning (d = 0.17, p < 0.01, k = 18), and pain (d = 0.19, p < 0.01, k = 14) and were more efficacious than either patient psychosocial intervention or usual care.
CONCLUSIONS
Couple-oriented interventions have small effects that may be strengthened by targeting partners' influence on patient health behaviors and focusing on couples with high illness-related conflict, low partner support, or low overall marital quality. Directions for future research include assessment of outcomes for both patient and partner, comparison of couple interventions to evidence-based patient interventions, and evaluation of mechanisms of change.
Topics: Chronic Disease; Female; Health Behavior; Humans; Interpersonal Relations; Male; Marriage; Patient Education as Topic; Self Care; Treatment Outcome
PubMed: 20697859
DOI: 10.1007/s12160-010-9216-2 -
Clinical Cardiology Aug 2023Conflicting evidence exists regarding the association between marital status and outcomes in patients with heart failure (HF). Further, it is not clear whether type of...
BACKGROUND
Conflicting evidence exists regarding the association between marital status and outcomes in patients with heart failure (HF). Further, it is not clear whether type of unmarried status (never married, divorced, or widowed) disparities exist in this context.
HYPOTHESIS
We hypothesized that marital status will be associated with better outcomes in patients with HF.
METHODS
This single-center retrospective study utilized a cohort of 7457 patients admitted with acute decompensated HF (ADHF) between 2007 and 2017. We compared baseline characteristics, clinical indices, and outcomes of these patients grouped by their marital status. Cox regression analysis was used to explore the independency of the association between marital status and long-term outcomes.
RESULTS
Married patients accounted for 52% of the population while 37%, 9%, and 2% were widowed, divorced, and never married, respectively. Unmarried patients were older (79.8 ± 11.5 vs. 74.8 ± 11.1 years; p < 0.001), more frequently women (71.4% vs. 33.2%; p < 0.001), and less likely to have traditional cardiovascular comorbidities. Compared with married patients, all-cause mortality incidence was higher in unmarried patients at 30 days (14.7% vs. 11.1%, p < 0.001), 1 year, and 5 years (72.9% vs. 68.4%, p < 0.001). Nonadjusted Kaplan-Meier estimates for 5-year all-cause mortality by sex, demonstrated the best prognosis for married women, and by marital status in unmarried patients, the best prognosis was demonstrated in divorced patients while the worst was recorded in widowed patients. After adjustment for covariates, marital status was not found to be independently associated with ADHF outcomes.
CONCLUSIONS
Marital status is not independently associated with outcomes of patients admitted for ADHF. Efforts for outcomes improvement should focus on other, more traditional risk factors.
Topics: Humans; Female; Retrospective Studies; Marital Status; Heart Failure; Risk Factors; Hospitalization
PubMed: 37309080
DOI: 10.1002/clc.24053 -
Strahlentherapie Und Onkologie : Organ... Oct 2023The principal goal of treatment of laryngeal cancer is to eliminate a tumour while preserving laryngeal function with radio(chemo)therapy being the mainstay of...
PURPOSE
The principal goal of treatment of laryngeal cancer is to eliminate a tumour while preserving laryngeal function with radio(chemo)therapy being the mainstay of treatment. The aim of this report is to present the influence of comorbidities and lifestyle factors on treatment outcomes in our cohort of patients.
METHODS
During the period 2009-2018, curative radio(chemo)therapy for laryngeal cancer was performed on 189 patients.
RESULTS
The median OS was 50.8 months, with a mean PFS of 96.5 months, mean LC of 101.4 months and a median follow-up of 38.1 months. Acute and late treatment toxicity grade 3-4 was observed in 39.2% patients and 10.1% patients, respectively. A significant effect on overall survival was confirmed for the baseline PS (performance status), severity of weight loss, baseline haemoglobin values, history of alcohol abuse, marital status and comorbidities according to the Charlson Comorbidity Index, as well as the ACE-27 and ASA scores.
CONCLUSIONS
In our cohort of patients treated with radio(chemo)therapy for laryngeal cancer, we found good therapeutic results and an acceptable side-effect profile. Statistically significant predictors of overall survival were the baseline PS, weight loss, anaemia, associated comorbidities, history of alcohol abuse and marital status.
Topics: Humans; Laryngeal Neoplasms; Alcoholism; Retrospective Studies; Treatment Outcome; Chemoradiotherapy; Comorbidity; Life Style
PubMed: 37042973
DOI: 10.1007/s00066-023-02072-y -
SAGE Open Medicine 2024Pain perception and management vary across cultural contexts; yet, little is known about pain approaches in the general population of Palestine. Existing research lacks...
BACKGROUND
Pain perception and management vary across cultural contexts; yet, little is known about pain approaches in the general population of Palestine. Existing research lacks specific knowledge about how pain is coped with in this region.
OBJECTIVE
To explore pain management among Palestine's general population, studying prevalence, characteristics, and sociodemographic influences. It aims to uncover treatment choices and understand cultural impacts on pain experiences, offering insights into Palestinian pain perception and coping strategies.
METHODS
Convenience and snowball sampling methods were employed to collect data from 646 adults in Palestine. Participants' sociodemographic characteristics, pain experiences, and pain management strategies were examined. Descriptive statistics, chi-square tests, and binary logistic regression followed by multiple logistic regressions were used for data analysis.
RESULTS
A significant portion of participants reported experiencing pain, with chronic pain being predominant. Pain prevalence varied across age groups, with higher rates in the elderly, followed by middle-aged and younger participants. Marital status and education level were linked to pain prevalence. Participants employed diverse pain management strategies, such as self-medication, physician visits, complementary medicine, and physical therapy. Age, gender, marital status, and education level influenced choices in pain management approaches. For instance, the elderly favored traditional medical interventions, while higher education levels were associated with reduced inclination toward conventional treatments.
CONCLUSION
This study underscores the complex interaction of sociodemographic factors, pain experiences, and treatment preferences in pain management. It emphasizes personalized strategies considering age, marital status, education, and gender. Integrating these aspects improves treatment and satisfaction. The findings empower healthcare providers to create precise strategies, enhancing patient experiences for better outcomes.
PubMed: 38268944
DOI: 10.1177/20503121231223442 -
Case Reports in Psychiatry 2023Phantom limb pain is a pain sensation experienced in the area of the missing body part. The pain generally appears in the first few days after surgery. PLP could occur...
INTRODUCTION
Phantom limb pain is a pain sensation experienced in the area of the missing body part. The pain generally appears in the first few days after surgery. PLP could occur in teeth, tongue, breast, eyes, rectum, bladder, testicles, and penis. Phantom pain in the penis is not only felt as pain but sometimes as an erection or urination, even after the removal of the penis. . A 35-year-old man was referred to the psychiatrist due to phantom erection after undergoing reimplantation of the penis by the urologist. A few days before the referral, he was admitted to the emergency department after a penile amputation that his wife performed. During the recovery phase after the penile reimplantation procedure, the patient worried about his penis' outcome and became depressed. The patient was in severe anxiety and moderate-to-severe depression status. . The patient was given nonpsychopharmacology such as supportive psychotherapy, family psychoeducation, relaxation and marital therapy, and psychopharmacology, such as amitriptyline 12.5 Mg PO two times a day and clobazam 10 Mg PO each day for 3 months. One and a half months later, his anxiety and depression were better.
CONCLUSION
A psychiatric approach was needed in an amputated limb patient with psychopathologic symptoms. Nonpsychopharmacotherapy and psychopharmacotherapy were needed if the patient had symptoms. Further studies with a large number will be necessary to validate the psychiatric approach in amputated limb patients with psychopathologic symptoms cases.
PubMed: 37032998
DOI: 10.1155/2023/4113455 -
Medicine Apr 2023Marriage has been reported as a beneficial factor associated with improved survival among cancer patients, but conflicting results have been observed in cervical...
Marriage has been reported as a beneficial factor associated with improved survival among cancer patients, but conflicting results have been observed in cervical adenocarcinoma (AC). Thus, this study is aimed to examine the relationship between the prognosis of cervical AC and marital status. Eligible patients were selected from 2004 to 2015 using the surveillance, epidemiology and end results (SEER) database. Cancer-specific survival (CSS) and overall survival (OS) were compared between married and unmarried groups. A total of 3096 patients had been identified, with married ones accounting for 51.29% (n = 1588). Compared to unmarried groups, more patients in the married group were relatively younger (aged ≤ 45) and belonged to white race, with grade I/II, Federation of International of Gynecologists and Obstetricians (FIGO) stage I/II and tumor size ≤4 cm. Apart from that, more patients received surgery, whereas fewer patients received chemotherapy and radiotherapy (all P < 0.05). The 5-year CSS and OS rates were 80.16% and 78.26% in married patients, 68.58% and 64.62% in the unmarried group (P < .0001). Multivariate analysis showed that marital status was an independent prognostic factor, and the married group performed better CSS (hazard ratio [HR]: 0.770; 95% confidence interval [CI]: 0.663-0.895; P = .001) as well as OS (HR: 0.751; 95%CI: 0.653-0.863; P < .001). As demonstrated by the results of subgroup analysis, married patients had better CSS and OS survival than unmarried ones in nearly all the subgroups. Marital status was identified as an independent prognostic factor for improved survival in patients with cervical AC.
Topics: Humans; Prognosis; SEER Program; Marital Status; Marriage; Adenocarcinoma
PubMed: 37083782
DOI: 10.1097/MD.0000000000033597 -
Scientific Reports Mar 2023Diabetes, a non-communicable metabolic disease, causes multiple complications and deaths worldwide. It is a complex, chronic disease that requires continuous medical...
Diabetes, a non-communicable metabolic disease, causes multiple complications and deaths worldwide. It is a complex, chronic disease that requires continuous medical care with multifactorial risk reduction strategies beyond glycemic control. Ongoing patient education and self-management support are critical for preventing acute complications and reducing the risk of long-term complications. There is ample evidence that healthy lifestyle choices, such as a healthy diet, moderate weight loss, and regular exercise, can maintain normal blood sugar levels and minimize diabetes-related complications. In addition, this lifestyle change has a major impact on controlling hyperglycemia and can help to maintain normal blood sugar levels. This study aimed to assess lifestyle modification and medication use in patients with diabetes mellitus at Jimma University Medical Center. Hospital-based prospective cross-sectional study was conducted from April 1 to September 30, 2021 among DM patients who have follow-up at diabetic clinic of Jimma University Medical Center. Consecutive sampling was used until the required sample size was achieved. Data were checked for completeness, then entered into Epidata version 4.2 software and exported to SPSS version 21.0. Pearson's chi-square test was performed to determine the association between KAP and independent factors. Variables with a p value < 0.05 were considered significant. A total of 190 participants took part in this study with a response rate of 100%. In this study, 69 (36.3%) participants had good knowledge, 82 (43.2%) moderate knowledge and 39 (20.5%) poor knowledge, 153 (85.8%) had positive attitudes, 141 (74.2%) had good practice. Marital status, Occupational status and educational status were significantly associated with knowledge and attitude towards LSM and medication use. Marital status was the only variable that remained significantly associated with knowledge, attitude and practice towards LSM and medication use. The result of this study showed that more than 20% of the participants had poor knowledge, attitude, and practice towards medication use and LSM. Marital status was the only variable which remained to be significantly associated with KAP towards LSM and medication use.
Topics: Humans; Blood Glucose; Ethiopia; Cross-Sectional Studies; Prospective Studies; Diabetes Mellitus; Life Style; Academic Medical Centers
PubMed: 36973400
DOI: 10.1038/s41598-023-32145-y -
Journal of Assisted Reproduction and... Jun 2016The purpose of this study was to examine the effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples... (Review)
Review
The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: a systematic review.
PURPOSE
The purpose of this study was to examine the effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization (IVF), as determined through RCT studies.
METHODS
Using the electronic databases PubMed, EMBase, Cochrane Library, CINAHL, PsycInfo, and CAJ, a systematic literature search was conducted in July 2015. MeSH terms, key words, and free words such as "infertility," "fertilization in vitro," "psychotherapy," "intervention," "anxiety," "depression," and "marital satisfaction" were used to identify all potential studies. The quality of the studies that were included was assessed using the risk of bias assessment tool developed by the Cochrane Back Review Group. Descriptive analysis was adopted to synthesize the results.
RESULTS
A total of 20 randomized controlled trials were included in this review. There were reports of positive effects on the anxiety levels, pregnancy rates, or marital function of infertile couples in six studies that adopted different psychosocial approaches, including mind body intervention (Eastern body-mind-spirit, Integrative body-mind-spirit, and Mind/body intervention), cognitive behavioral therapy, group psychotherapy, and harp therapy. However, there were methodological or practical issues related to measurement points and attrition rates in these studies. None of these interventions were found to be efficacious in relieving the depression or stress of individuals or couples undergoing IVF treatment. None of the included studies tackled or measured the mental health status of the couples during the most stressful time of waiting for the pregnancy results of their treatment.
CONCLUSIONS
A complex intervention, based on sound evidence, should be developed targeting both females and males of infertile couples undergoing IVF treatment, particularly during the stressful period of waiting for the results of the pregnancy test result and after failed cycles.
Topics: Anxiety; Depression; Female; Fertilization in Vitro; Humans; Infertility; Male; Marriage; Mental Health; Pregnancy; Pregnancy Rate; Psychosocial Support Systems; Randomized Controlled Trials as Topic; Stress, Psychological
PubMed: 26979745
DOI: 10.1007/s10815-016-0690-8 -
BMC Cancer Aug 2021Colon cancer is largely implicated in elderly patients (age ≥ 60 years). The prognosis of patients diagnosed with the M1b stage is vastly poor. Marital and...
BACKGROUND
Colon cancer is largely implicated in elderly patients (age ≥ 60 years). The prognosis of patients diagnosed with the M1b stage is vastly poor. Marital and insurance status has been considered important prognostic factors in various cancer types. However, how these factors influence elderly patients with stage M1b colon cancer remains to be explored. This study aims to uncover the role of marital and insurance status in the survival of elderly patients with stage M1b colon cancer.
METHODS
We retrieved data for patients diagnosed with stage M1b colon cancer between 2010 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis of the clinicopathological features, overall survival (OS), and cancer-specific survival (CSS) was based on the marital and insurance status, respectively.
RESULTS
In sum, 5709 stage M1b colon cancer patients with complete information from SEER were enrolled for analysis. The OS and CSS of the Non-married group were poorer compared to that of the Married group. The OS and CSS of the Uninsured group were poorer than both of the Insured group and Medicaid group. However, OS was comparable between Uninsured group and Medicaid groups. The findings allude that marital and insurance status potentially impact the long-term survival of elderly patients with M1b colon cancer. The subgroup survival analyses revealed the lowest risk for death among the Insured Married group based on the comparison of the OS and CSS across all other groups. Moreover, Univariate and multivariate analyses revealed race, marital status, surgery, and chemotherapy as independent predictors for OS, whereas insurance status, surgery,and chemotherapy were independent predictors for CSS in elderly patients with M1b colon cancer.
CONCLUSION
The marital and insurance status greatly impact the survival of elderly patients with M1b colon cancer. Therefore, it is imperative to provide more support to this vulnerable patient group who are lonely and uninsured, particularly in the psychological and health insurance aspect.
Topics: Age Factors; Colonic Neoplasms; Combined Modality Therapy; Databases, Factual; Female; Humans; Insurance Coverage; Insurance, Health; Male; Marital Status; Neoplasm Staging; Prognosis; SEER Program; Survival Analysis
PubMed: 34353300
DOI: 10.1186/s12885-021-08627-5 -
British Medical Journal Apr 1976Six cases of persistent non-accidental poisoning of children by their parents are reported. Certain features may draw attention to the diagnosis, particularly bizarre...
Six cases of persistent non-accidental poisoning of children by their parents are reported. Certain features may draw attention to the diagnosis, particularly bizarre symptoms and signs with no apparent pathological explanation, and toxicological analysis should be carried out to obtain rapid confirmation of the diagnosis. The underlying disorder may include marital conflict, overinvolvement between parent and child, or drug abuse in the parents. A suggested plan of action for managing this problem is outlined.
Topics: Child; Child Abuse; Child, Preschool; Female; Humans; Infant; Interpersonal Relations; Male; Mental Disorders; Parent-Child Relations; Poisoning; Social Work, Psychiatric
PubMed: 1260335
DOI: 10.1136/bmj.1.6013.793