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PubMed2002

Rabeprazole improves health-related quality of life in patients with erosive gastroesophageal reflux disease.

The purpose of this study was to assess the effect of rabeprazole 20 mg once a day on patient-reported health-related quality of life in routine clinical practice. Patients with erosive gastroesophageal reflux disease participating in an open-label, 8-week study completed the SF-36 Health Survey before and after treatment with rabeprazole. For all SF-36 scales, there was a statistically significant (p < or = 0.007) improvement in mean scores from baseline to week 8. Improvements in each of the subscales, except for physical functioning, general health, and mental health, were at least 5% in magnitude, a level considered clinically meaningful. Furthermore, while baseline scores were significantly poorer than general United States population scores, follow-up scores for four of the subscales (role limitations due to physical problems, social functioning, role limitations due to emotional problems, and mental health) were comparable to general population scores. In conclusion, rabeprazole significantly improved health-related quality of life in erosive gastroesophageal reflux disease patients and restored social functioning and emotional well-being to levels comparable to those observed in the United States general population.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1983

Vocational adjustment after total laryngectomy.

In-depth interviews were conducted with 60 laryngectomy patients. Data were collected on postsurgical rehabilitation in terms of employment, speech, and social functioning. Analysis of the data indicated that only one-third of the respondents were working fulltime or parttime. Twenty-six (43%) of the respondents were retired or not working, due to their health. Employment after surgery was not statistically related to the other measures of rehabilitation success that indicated levels of social functioning in general. In addition, most of the respondents did not cite employer discrimination as their reason for not working. Failure to work after surgery appeared in most cases to be initiated by the respondent, and did not indicate a failure to achieve a high level of rehabilitation in other areas of functioning.

Adult↗
PubMed1988

Relationship between depression and agitation in nursing home residents.

Nursing staff and social workers independently rated the manifestations of agitation and depression in 408 nursing home residents. The role of dementia was also investigated. The relationship between agitation (3 factors: aggressive, physically nonaggressive, and verbally agitated) and depression (2 factors: social functioning and depressed affect) was examined. While residents who manifested either aggressive behavior (e.g., hitting, cursing) or physically nonaggressive behaviors (e.g., general restlessness, pacing) tended to be more cognitively impaired, aggressive behaviors were negatively related to the social functioning aspect of depression, and physically nonaggressive behaviors were not related to either aspect of depression. Verbally agitated individuals were more cognitively intact and displayed depressed affects. It is conceivable that depressed affect was perceived only in verbally agitated residents since these persons were able to communicate their depression to caregivers. This result raises questions concerning the meaningfulness of depression measurements in noncommunicative residents.

Aged↗
PubMed1994

A study of the unidimensionality and cumulativeness of the MOS Short-form General Health Survey.

The unidimensionality and cumulativeness of the subscales Health Perceptions, Mental Health, Physical Pain, and Social Functioning of the MOS Short-form General Health Survey were investigated using the Mokken Scale Analysis for Polychotomous Items (MSP). From the analyses, two unidimensional, cumulative subscales appeared, Health Perceptions including the item on Social Functioning, and Mental Health. Both subscales met the requirements of the Mokken model, with the first scale being a 'moderately strong' hierarchical scale (H = 0.49, rho = 0.89) and the second a 'weak' hierarchical scale (H = 0.38, rho = 0.85).

Activities of Daily Living↗
PubMed1996

Social support as a mediator in the relation between functional status and quality of life in older adults.

The relations among physical functioning, social support, depressive symptoms, and life satisfaction were examined in a national sample of 4,734 adults age 65 and older. Regression analyses were used to examine the relative importance of objective and subjective support measures in understanding the relation between physical impairment and quality of life. Impairment was associated with fewer friendship contacts, fewer family contacts, less perceived belonging support, and less perceived tangible aid, but only measures of perceived support predicted depressive symptomatology. A structural equation modeling approach was then used to explore the mediational role of perceived social support in the relation between impairment and quality of life variables. Results are consistent with the hypothesis that lower reported social support is an important reason for decreases in life satisfaction and increases in depressive symptoms found among older adult populations. Implications for understanding the role of social support in attenuating the effects of physical disability in older adults are discussed.

Activities of Daily Living↗
PubMed1998

Randomised controlled trial of compliance therapy. 18-month follow-up.

BACKGROUND: A randomised controlled trial was conducted in an acute treatment setting to examine the effectiveness of compliance therapy, a brief pragmatic intervention targeting treatment adherence in psychotic disorders, based on motivational interviewing and recent cognitive approaches to psychosis. METHOD: Seventy-four patients with psychotic disorders according to DSM-III-R criteria recruited from consecutive admissions to an acute in-patient unit, received 4-6 sessions of either compliance therapy or non-specific counselling, and were followed-up over 18 months. The principal outcome measures were observer-rated compliance, attitudes to treatment, insight and social functioning. RESULTS: Significant advantages were found for the compliance therapy group post-treatment on measures of insight, attitudes to treatment and observer-rated compliance which were retained over the follow-up period. Global social functioning improved relatively more over time in the compliance therapy group compared with the control group. Survival in the community prior to readmission was significantly longer in the compliance therapy group. CONCLUSIONS: The results support the effectiveness of compliance therapy in improving functioning and community tenure after an acute psychotic episode.

Acute Disease↗
PubMed2004

Cross-cultural differences in psychosocial adaptation to isolated and confined environments.

INTRODUCTION: Differences in patterns of psychosocial adaptation under conditions of prolonged isolation and confinement in Antarctica were examined to determine the extent to which they were influenced by national culture in general and the individualist-collectivist orientation of national cultures in particular. METHODS: The Profile of Mood States and measures of structural and functional social support were administered over an 8-mo period (March through October) to 13 winter-over crews from 5 nations operating research stations in the Antarctic: United States (3 crews, n = 77), Poland (3 crews, n = 40), Russia (3 crews, n = 34), China (3 crews, n = 40), and India (1 crew, n = 26). RESULTS: Americans at South Pole Station reported significant increases in fatigue and anxiety and a significant decrease in vigor over the winter. During the same period, Russians at Vostok Station reported significant decreases in depression, anxiety, and confusion, and Indians at Maitri Station reported a significant decrease in anger. A significant decrease in social interaction with fellow crewmembers occurred at South Pole Station, Vostok Station, and Poland's Arctowski Station. Several differences were also observed between the five stations in correlations between mood scores and measures of structural and functional social support. An individualistic cultural orientation was significantly associated with low social support and low negative mood. CONCLUSION: Cultural background is associated with mood and social support as well as changes in these measures during the austral winter. Cultural differences in patterns of psychosocial adaptation must be considered in the formation and training of multinational crews for long duration missions in space.

Adaptation, Psychological↗
PubMed2002

Clinical relevance of electroconvulsive therapy (ECT) in adolescents with severe mood disorder: evidence from a follow-up study.

Given the limited knowledge on the long-term outcome of adolescents who receive electroconvulsive therapy (ECT), the study aimed to follow-up adolescents treated with ECT for severe mood disorder. Eleven subjects treated during adolescence with bilateral ECT for psychotic depression (n = 6) or mania (n = 5), and ten psychiatric controls matched for sex, age, school level, and clinical diagnosis, completed at least 1 year after treatment a clinical and social evaluation. Mean duration between time of index episode and time of follow-up evaluation was 5.2 years (range 2-9 years). At follow-up: (1) all patients except two in the control group received a diagnosis of bipolar disorder. (2) Fifteen patients had had more than one episode of mood disorder. (3) The two groups did not differ in social functioning nor school achievement. (4) Impact on school achievement was related to the severity of the mood disorder rather than ECT treatment. The results suggest that adolescents given ECT for bipolar disorder, depressed or manic, do not differ in subsequent school and social functioning from carefully matched controls.

Achievement↗
PubMedDate not supplied

Quality of life and pain in patients with recurrent breast and gynecologic cancer.

Pain is a central factor affecting quality of life for the cancer patient. This descriptive study was designed to explore the relationship between pain and several factors affecting quality of life. The factors explored included physical and social functioning, emotional health, and spiritual commitment in women with recurrent breast or gynecologic cancer. Pain frequency, amount, and interference with activities were found to correlate more strongly with objective measures of quality of life (i.e., physical and social functioning) than subjective measures (i.e., psychological or spiritual dimensions).

Adult↗
PubMed1996

Quality of life studies in chemotherapy-induced emesis.

Health-related quality of life (HQL) was assessed before and after either moderately or highly emetogenic chemotherapy. When the pretreatment HQL in patients who did not vomit after chemotherapy (n = 203) was compared to those who vomited (n = 230), it was found that patients who did not vomit had better physical, role, and social function scores as well as a better global quality of life score than did patients who had one or more episodes of vomiting. Furthermore, in patients who did not vomit, the pretreatment fatigue and anorexia scores were better than in patients who did vomit. Thus, pretreatment HQL scores appear to have value in predicting which patients will experience chemotherapy-induced emesis. In the week following chemotherapy, HQL change scores from prechemotherapy values for cognitive function, global quality of life, fatigue, anorexia, insomnia and dyspnea were significantly worse in the group experiencing emesis than in the group who remained completely free of emesis. There were no differences in physical, role, emotional and social function attributable to chemotherapy-induced vomiting.

Antiemetics↗
PubMed1996

[Quality of life of the patients with diabetes mellitus and risk factors ].

Quality of life is a comprehensive index for judging individual's physiological, psychological and social function and living condition. There were 143 patients with diabetes mellitus, based on WHO diagnosis standard, hospitalized' in PLA general hospital participated in the study. Investigation instrument included 156 questions (3 aspects) in total. The content of quality of life consisted of 14 items, covering physiological, psychological, social function and living conditions. The results showed that many abnormal changes of quality of life were found in the patients with diabetes mellitus. AMong them the impaired memory and concentration were most obvious. And less important changes were abnormal emotional reactions, reducing of entertainment activities, social adaptation and work ability. The age, degree of education, condition of the illness, complications, social and family background had effects on the quality of life.

Activities of Daily Living↗
PubMed1997

Evidence for an important social role of allogrooming in a platyrrhine primate

Allogrooming behaviour was analysed in a wild group of tufted capuchin monkeys, Cebus apellain Iguazu National Park, Argentina. Evidence is provided that allogrooming in this platyrrhine species serves an important social function, as has been demonstrated for catarrhine primates. Using ad libitum sampling, 654 grooming sessions were recorded during 740 contact hours with one group. Seasonal variation was found in daily time allocation to allogrooming and the mean duration and reciprocity of sessions. Individual dominance rank was an important determinant of grooming relationships. The dominant male and female were the most actively involved in grooming. Among adults, dominant individuals were involved in more sessions than were subordinate individuals. The females maintained strong grooming relationships with each other and tended to reciprocate more within sessions than did males. Oestrous females engaged in more grooming bouts with adult males than did non-oestrous females. Females with newborn infants were attractive social partners for the remaining members of the group. A social function for allogrooming in Cebus is indicated by the close relationship between allogrooming, the social system and coalition formation, and by the changes in quantity and direction of grooming in response to oestrous behaviour and to the birth of infants.

Journal Article↗
PubMed2000

Rating depressed patients: observer- vs self-assessment.

An overview of the rating scale literature reveals that the clinician now has many validated rating scales to choose from to assess his patient's condition. In general terms, it is the observer-rating scales that should be used as the principal outcome criterion in depressive disorders, both in general practice and in drug-related trials. However, self-rating scales can provide important additional information for therapy evaluation. They also provide a measure of the patient's perception of his own illness and recovery, which is not possible with observer ratings. Self-rating scales are designed for frequent use and to be sensitive to the change brought about by therapy and its time course. Observer ratings can also show sensitivity for change, and these compare well with the self-rating measures. The multimethod approach, including both observer- and self-rating scales, and covering different domains such as psychopathological symptoms, social functioning, etc. , is the preferred method for assessing patients. Using this approach, clinicians are able to build up complete profiles of their patients' illnesses and make full assessments of the efficacy of treatment and their return to normal social functioning.

Depressive Disorder↗
PubMed2003

Doctor-patient communication: results of a four-year prospective study in rectal cancer patients.

PURPOSE: The purpose of the study was to examine the effect of communication on rectal cancer patients' quality of life over four years. Previous studies have either used short follow-up periods or examined only certain aspects of quality of life, such as anxiety and depression. METHODS: In a prospective, observational study, rectal cancer patients, recruited by clinicians over a two-year period, were sent questionnaires over four years. The clinical details of these patients were recorded by the Munich Cancer Registry. The psychological scores from the European Organization for Research and Treatment of Cancer QLQ-C30 and CR38 were the main outcome variables. RESULTS: Thirty-nine percent of the sample reported that some aspect of the communication they received was unclear (incomprehensible or too little). More than 60 percent wished to speak more with their physician. Younger patients and those in larger hospitals were more likely to report unclear communication (P < 0.05). Analyses of covariance, controlled for age, gender, adjuvant therapy, stoma, education, clinic, and comorbidity, demonstrated that role, emotional, and social functioning scores were consistently lower in patients reporting unclear communication. Additionally, these patients experienced more problems sleeping, poorer body image, more financial worries, and a worse future perspective. Repeated measures analyses indicated that sleeping problems and emotional and social functioning difficulties persisted for at least three years. CONCLUSION: Reports of unclear communication were associated with poorer quality of life in rectal cancer patients without disease progression.

Adult↗
PubMed1994

The effect of personality disorder on clinical outcome, social networks and adjustment: a controlled clinical trial of psychiatric emergencies.

One hundred psychiatric emergencies presenting to an inner London teaching hospital had formal assessments of psychopathology, personality disorder (using both ICD-10 and the Personality Assessment Schedule), social networks and social functioning before being randomly assigned to a multidisciplinary community-based team (Early Intervention Service (N = 48) or conventional hospital-based psychiatric services (N = 52) and treated for a period of 12 weeks. The ICD-10 classification yielded a higher proportion (50%) of personality disordered patients than the Personality Assessment Schedule (34%) and those from ethnic minorities (mainly Afro-Caribbean) and upper social classes had a lower incidence of personality disorder. Social networks were smaller in personality disordered patients and there were fewer attachment figures. Improvement in social function, and to a lesser extent with depressive symptomatology, was better in patients with no differences were found between the numbers and duration of social contacts in the two services and it is concluded that the better outcome in the community-treated patients was independent of changes in social networks.

Community Mental Health Services↗
PubMed2003

[An Experience of a Clubhouse run by Families and Volunteers for Schizophrenia Rehabilitation].

OBJECTIVE: To test the efficacy of a non-governmental psychosocial rehabilitation program (Psychosocial Rehabilitation Clubhouse), which was developed by the authors and thought to be easy to put into practice for patients with schizophrenia. METHOD: Patients with schizophrenia (n: 14) were serviced at "Izmit Our Garden Solidarity Foundation of Families of Patients with Schizophrenia" for 8 months. Rehabilitation services were conducted wholly by families and volunteers, and run by a volunteer psychologist. Program included daily activities, cultural, leisure and social activities, one day in a week. Patients were assessed by using the Quality of Life Scale (QLS), Social Functioning Scale (SFS), Global Assessment Scale (GAS), and Positive and Negative Syndrome Scale (PANNS) at baseline and at the end of the study. RESULTS: All patients (n:14) completed the program with 73% mean presence in the activities. Increase of the social functioning and the good clinical outcome was observed in patients. The results of the scales were as follows: SFS at baseline 105.1+/-20.6, in the end 133.7+/-17.1, (p<0.001); GAS at baseline 53.4+/-10.5, in the end 66.0+/-8.1, (p<0.001); QLS at baseline 62.8+/-17.4, in the end 93.4+/-19.8, (p<0.001); and PANSS in the baseline 70.3+/-16.9, in the end 61.9+/-16.5, (p<0.002). CONCLUSION: Psychosocial clubhouse rehabilitation program run by patients' families and volunteers in a small foundation environment, which is the first trial in Turkey, has been carried out successfully.

Adult↗
PubMed2005

[More social exclusion of chronically ill patients with lower incomes].

OBJECTIVE: To determine whether income is connected with the variation in the social exclusion of chronically ill patients. DESIGN: Descriptive. METHOD: In 223 chronically ill patients that had been detected via patients' associations, general practitioners and outpatient clinics, a structured interview was administered during a home visit 4 times during a period of 7 months (October 2003-April 2004). Due to dropouts, the actual number of patients interviewed at each of the 4 times was 223, 176, 143 and 105, respectively. Social exclusion was measured with the aid of the 'Autonomy outside the home' subscale of the 'Impact on participation and autonomy' questionnaire. The possible total score varied from 5 (little social exclusion) to 25 (much social exclusion). In order to explain a possible effect of income, various other patient characteristics were added to the analysis model: type of primary disease (rheumatism, multiple sclerosis, pulmonary emphysema, other), duration of the primary disease, comorbidity, educational level, whether or not the patient was employed or engaged in volunteer work, whether or not the patient lived together with a partner, the self-rated health, physical functioning, social functioning, mental functioning, and the subjective pain. The data were analysed by means of multilevel repeated regression analysis. RESULTS: A low income was associated with social exclusion at all 4 times of measurement. The regression coefficient of income was -1.47 (95% CI: -2.28- -0.65), indicating that the score on the scale for social exclusion decreased by 1.47 for every euro 544,- (= 1 x SD) increase in net monthly income. This relationship could not be explained by the other patient characteristics, not even by a low educational level. CONCLUSION: The supportive care intended for the prevention of social exclusion of chronically ill patients should be concentrated sufficiently on those who have too little income to organise such care for themselves.

Adolescent↗
PubMed1977

Hospital vs community (foster) care for psychiatric patients.

The aim of this study was to determine the effectiveness of foster care preparation and placement. Five hundred seventy-two patients from five hospitals were randomly assigned to foster care preparation (experimentals) or continued hospitalization (controls). They were studied before assignment, at placement of experimental subjects, and four months later regarding social functioning, mood, activity, and overall adjustment. Hospitals averaged two months preparing experimental subjects, resulting in 73% placed in foster care. Little change was observed between referral and placement. However, four months after placement, experimental subjects were significantly improved over controls, particularly in social functioning and adjustment. After four months, 88% of the foster care subjects were in the community. Findings suggest that attention should be given to selection criteria, that lengthy preparation may be unnecessary, and that foster care is superior to hospitalization for patients who cannot return to their own homes.

Emotions↗