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Biomedical subjects

Barbara Hanna

Publications and source records attributed to Barbara Hanna.

8 recordsLinked to original sources

Patient reports of symptoms and their treatment at three palliative care projects servicing individuals with HIV/AIDS.

Self-reports of 32 symptoms and their treatments were obtained from patients of three palliative care programs that provide services to seriously ill HIV patients (>or=95% AIDS) in Alabama (n=47), Baltimore (n=91), and New York City (n=117). On average, patients reported 10.9 (SD=7.6) to 12.7 (SD=6.2) symptoms. Pain, lack of energy, and worrying were reported by a majority of patients at all sites, often with a high level of associated distress. For only four symptoms (pain, nausea, difficulty swallowing, and mouth sores) did half or more of patients at all sites experiencing the symptom also report treatment. Less than a third of patients experiencing 12 symptoms (five of six comprising a psychological subscale) reported treatment. Results show that despite the availability of more efficacious treatments, many HIV/AIDS patients continue to experience significant physical and psychological symptomatology. Many of those experiencing symptoms, however, do not perceive their symptoms as being treated.

Adult↗

Mental health status of clients from three HIV/AIDS palliative care projects.

OBJECTIVE: To describe mental health status and its correlates among clients of three palliative care programs targeting underserved populations. METHODS: Mental Health Inventory (MHI-5) scores of clients from programs in Alabama (n = 39), Baltimore (n = 57), and New York City (n = 84) were compared. RESULTS: Mean MHI-5 scores did not differ among sites and were indicative of poor mental health. Significant differences were noted among sites with regard to client sociodemographics, physical functioning, and perceptions of interpersonal relations. Results of multivariate regression models estimated for each site suggest variation in the relative importance of potential predictors among sites. Whereas poorer mental health was primarily associated with history of drug dependence at Baltimore and more physical symptomatology at New York, better mental health was most strongly correlated with more positive perceptions of interpersonal relationships at Baltimore and increasing age and more positive perceptions of meaning and purpose in life at New York. SIGNIFICANCE OF RESULTS: The data presented suggest the importance of assessing clients' history of and current need for mental health services. Evidence of a relationship between positive perceptions of meaning and purpose and better psychological function underscores the importance of existential issues for the overall well-being of those who are seriously ill.

Acquired Immunodeficiency Syndrome↗

Service needs of patients with advanced HIV disease: a comparison of client and staff reports at three palliative care projects.

Despite prolonged survival and improved quality of life as a result of treatment advances for HIV/AIDS, thousands still suffer with the disease and 15-16,000 a year die in the United States alone. Little is known about those patients with HIV/AIDS who still require palliative care services or the types of services needed. This paper describes the program elements and clients of three programs providing palliative care to persons with HIV/AIDS in Alabama (n = 41), Baltimore, Maryland, (n = 55), and New York City (n = 52). Also presented are the prevalence of need for 27 services as assessed by clients and staff, the level of agreement found between client and staff assessments at each site, and services for which prevalence of need varied among programs. Interviews were conducted between June 2000 and October 2002. The majority of clients at all programs were socioeconomically disadvantaged, persons of color, and had a history of substance abuse, although significant differences were noted in the distributions of clients at each program with regard to these characteristics. Greater differences were observed among programs in the prevalence of need reported than were found between reports of clients and staff at the same program. Despite these differences, a common set of medical (ambulatory/outpatient care, laboratory testing, pharmacy) and ancillary (nutritional counseling, transportation) services was identified by at least 25% of clients and staff at each program. These findings suggest that need, beyond a core of medical and ancillary services, is relative and best conceptualized as a mixture of need, demand, and supply. The need for a mix of "care" and "cure" services identified reflect the erratic disease trajectory experienced by some clients who move in and out of treatment as well as the vulnerability and marginalized lives of the clients served by these programs.

Acquired Immunodeficiency Syndrome↗

The clinical application of three screening tools for recognizing post-partum depression.

Postnatal depression is a major health issue for childbearing women world-wide, as it is not always identified early. This study aimed to evaluate the clinical application of three screening instruments for the early recognition of post-partum depression, the Postpartum Depression Prediction Inventory, the Postpartum Depression Screening Scale and the Edinburgh Postnatal Depression Scale, and to examine nurse interventions following use of the instruments. Data were collected at two points, at 28 weeks prenatal (107 women) and eight weeks postnatal (84 women). Results showed that 17% of the women scored significant symptoms of post-partum depression and 10-15% had a positive screen for major postnatal depression. There was a statistically significant correlation between the total score on the Postpartum Depression Screening Scale and the Edinburgh Postnatal Depression Scale. Of those eight women identified as being at risk, seven had received anticipatory guidance and five had received counselling by the nurses. The Postpartum Depression Prediction Inventory enabled nurses to identify women at risk of post-partum depression and offer interventions.

Adult↗

Self-reported health beliefs of government housing tenants.

Our aim was to provide a description of the self-reported health beliefs of a sample of Victorian public housing tenants, and to identify how gender, age and geographic location relate to these beliefs. Telephone interviews were conducted with a stratified random sample of 360 tenants, asking questions such as what they believe are the major health problems for men and women, what they do to keep healthy, and what makes it difficult to keep healthy. There were many differences in the beliefs held by older participants compared with those of younger participants. By asking about health in general, rather than specific aspects of health, this research identified the views about health which are most salient to participants, rather than those prompted by a survey on a particular disease or health behaviour. The health promotion implications of these findings are discussed.

Adult↗

The nature and severity of urinary incontinence in post-natal women.

This study investigated the frequency, nature and experience of urinary incontinence in post-natal women. Surveys were completed by 224 women, 50% of whom indicated that they had experienced accidental urine loss. The majority of women who had experienced any symptoms were moderately to greatly bothered by them. A variety of strategies were used to manage the problem; however, 42% of the women who experienced accidental urine loss had taken no action to ease the problem. Women received information about urinary incontinence and pelvic floor exercises from a variety of health care professionals, but this was not consistently provided. The implications of these findings are discussed.

Activities of Daily Living↗

The early detection of postpartum depression: midwives and nurses trial a checklist.

OBJECTIVE: To evaluate the use of a standard pen-and-paper test versus the use of a checklist for the early identification of women at risk of postpartum depression and to investigate the experiences of nurses in using the checklist. DESIGN: A prospective cohort design using repeated measures. SETTING: The booking-in prenatal clinic at a regional hospital in Victoria, Australia, and the community-based postpartum maternal and child health service. PARTICIPANTS: 107 pregnant women over 20 years of age. MAIN MEASURES: Postpartum Depression Prediction Inventory (PDPI), Postpartum Depression Screening Scale (PDSS), Edinburgh Postnatal Depression Scale (EPDS), demographic questionnaire, and data on the outcome from the midwives and nurses. RESULTS: The PDPI identified 45% of the women at risk of depression during pregnancy and 30% postpartum. The PDSS and EPDS both identified the same 8 women (10%), who scored highly for depression at the 8-week postpartum health visit. Nurses provided 80% of the women with anticipatory guidance on postpartum depression in the prenatal period and 46% of women at the 8-week postpartum health visit. Nurse counseling or anticipatory guidance was provided for 60% of the women in the prenatal period. CONCLUSION: The PDPI was found to be a valuable checklist by many nurses involved in this research, particularly as a way of initiating open discussion with women about postpartum depression. It correlated strongly with both the PDSS and the EPDS, suggesting that it is useful as an inventory to identify women at risk of postpartum depression.

Adult↗