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PubMed2002

Psycho-social well-being and general health status after surgical treatment for localized renal cell carcinoma.

OBJECTIVE: To comparatively assess the psychological, social well-being and general state of health in patients with stage 1 renal cell carcinoma (RCC) (according to 1997 TNM), who underwent either elective nephron sparing surgery (NSS) or radical nephrectomy. PATIENTS AND METHODS: We evaluated the health-related quality of life (HR-QoL) in 88 patients who underwent radical nephrectomy and in 56 treated with elective NSS. The measurement of the main QoL components has been made using domain-specific questionnaires tested and validated in Italian language. Each questionnaire has been self-administrated during follow-up (cross-sectional study). RESULTS: The two analysed group resulted perfectly comparable regarding age, gender, civil status, educational level, profession and mean follow-up. A low level anxiety has been documented in 11.4% of patients after radical nephrectomy and in 1.8% of those treated with an elective conservative surgery. The mean score difference between the two groups resulted statistically significant (p = 0.003). A mild depression has been recorded in 7% of patients who underwent radical nephrectomy and in 2.3% of NSS group. The mean score difference between the two groups was statistically significant (p = 0.01). The general health status was impaired in 12.5% of cases after radical nephrectomy and in 7% after elective NSS. Social problems were present in 18% of patients who underwent radical nephrectomy and in 18% of NSS group. There was no significant difference between radical and conservative group in terms of both General health Questionnaire and Social Problem Questionnaire mean scores. CONCLUSION: HR-QoL in patients who underwent surgery for RCC is not particularly negatively affected. Nevertheless, the comparative analysis of the results showed that, at a long term follow-up, radical surgery seems to eventually cause a more relevant negative impact on the psychological well-being than conservative surgery.

Anxiety↗
PubMed1998

[Health and social inequality in Europe: changes of the basic conditions for municipal health services].

Good health is not distributed equally, neither in life conditions--including the individual ability to act--nor according to the supply grid. These interrelations, shown in several empirical investigations, assume more importance in view of the groving tendency to social polarisation in the countries of Europe, different in fact in the single countries, but clear in respect of tendency: social exclusion does not only mean to have less financial resources but also social disadvantages in other realms of living, especially in health. Migration, not only from East to West, but also inside and between the countries of the European Union and inside of Eastern Europe too, is only an especially dear expression that social problems have their origin in international problems and casualities, but become visible in local and regional structures and thus in the responsibility of the municipalities. Globalisation, Europe etc., terms mostly connected with positive connotations, have not only a positive side, but also another one, namely, the re-regionalisation of social problems especially in the municipalities. Normally the municipalities have to counterbalance and to regulate the negative consequences of these European--and moreover international--changes of the structures, although their financial means are declining. The municipal health service is integrated in this contradictory constellation. To prevent irrational social and/or political developments, the reasons and possible strategies of reform policy will have to be discussed carefully.

Community Health Services↗
PubMed1998

Toward a new paradigm in substance abuse and other problem behavior prevention for youth: youth development and empowerment approach.

The purpose of this article is to 1) address a paradigm shift taking place in the field of substance abuse prevention directed for youth and 2) to introduce an innovative approach to substance abuse and other problem behavior prevention that reflects this shift in prevention paradigm. The new path introduced is youth development and empowerment (YD&E) approach. In order to establish a conceptual foundation for this approach, this article 3) reviews the theoretical advances made in the field of substance abuse prevention during the last three decades. This is followed by a conceptualization of the processes of implementing the YD&E program by 4) specifying the mechanism used for the empowering processes and by 5) identifying the structural components of the youth empowerment model that serve the empowering processes. It is hoped that this article serves as a conduit for an improved approach to adolescent substance abuse prevention and youth development that goes beyond, rather than against, the traditional risk-factor approach. In this new approach, youths are viewed as assets and resources to our community rather than social problems or community liabilities. The organizing concept of this new paradigm is: social, economic, and public opportunity denied to youth is equal to social problems imposed on youth by adults.

Adolescent↗
PubMed1982

[Social gynecologic problems of the older female].

An analysis was made of the situation of the aged woman, above 55 years of age, in the GDR, on the basis of sociogynaecological studies into 1,500 women. The studies were undertaken by means of semistandardised questionnaires and interviews. They included medical, psychological, familial, occupational, and social aspects. A comparison between the situation of aged women in socialist countries and that in capitalist countries has cast light at the gap between the two systems and illustrated the advantages of socialism.

Aged↗
PubMed1990

The impact of family interactions on recovery from stroke: help or hindrance?

The family networks of 47 geriatric stroke patients were examined for social supports and social problems as they related to well-being after hospital discharge. Structured interviews assessed positive and negative family interactions and patients' independence in activities of daily living (ADL), time use, personal adjustment, and cognitive functioning. After controlling for patients' medical status at hospital discharge, social supports were not associated with any of the outcomes examined. Social problems explained additional variance in personal adjustment and ADL independence.

Activities of Daily Living↗
PubMed2005

Mental health in the Dutch population and in general practice: 1987-2001.

BACKGROUND: In the last 15 years, both the demand for and supply of specialised mental health care increased considerably in the Netherlands. Increased demand may reflect a change in psychological morbidity, but may also be a consequence of increased supply. Specialised health care in the Netherlands is accessible only through referral by a GP, and so it is important to consider the role of primary care in the diagnosis of mental health problems. AIM: The aim of this study is to achieve a better understanding of the development of mental health status in the Dutch population and the consequent help-seeking behaviour in primary care. METHOD: Using two comparable morbidity studies carried out in the Dutch population and in primary care, we compared data from 1987 and 2001 to assess the following: possible differences in mental health between 1987 and 2001; possible differences in prevalence of mental disorder as diagnosed by GPs in 1987 and 2001; possible differences in the sociodemographic determinants of mental health and mental disorder in primary care between 1987 and 2001. RESULTS: Our results show an increase in mental and social problems in the population between 1987 and 2001. However, GPs diagnosed fewer patients as having a mental disorder in 2001 than they did in 1987. The risk of mental disorders or social problems in several sociodemographic groups remained largely the same, as did the chance of receiving a psychological or social diagnosis. CONCLUSION: We conclude that, while mental disorder in the population is increasing, the role of primary care has changed. Although GPs diagnose a lower percentage of mental problems as such, they refer an increasingly larger proportion of these to secondary care.

Adolescent↗
PubMed1990

A measure of relational competence for community-dwelling elderly.

A measure of relational competence was developed to assess the skills necessary for peer friendship development among the elderly. Participants were required to respond to a series of social problem vignettes that were constructed to tap empathy, assertion, and role-taking skills. Validation data were collected as part of a larger project designed to establish indigenous, elderly peer-support telephone dyads among low-income, community-dwelling elderly women. Results indicated that the measure of relational competence was related to initial friendship formation, telephone conversational skills, and rated social competence as determined by judges' ratings of 2 telephone conversations between participants and staff members. The research illustrates the usefulness of moving away from trait conceptions of social competence to a more focused consideration of particular task demands and the skills needed to solve age-linked social problems.

Activities of Daily Living↗
PubMed2004

Trauma and coping in Somali and Oromo refugee youth.

PURPOSE: To describe war-related trauma history, immigration factors, problems, and coping of Somali and Oromo refugee youth. METHODS: Analysis of a subset of participants (N = 338) aged 18-25 years from a population-based survey of Somali and Oromo refugees conducted in 2000-2002. Data included trauma history, life situation, and scales for physical (Cronbach alpha =.69), psychological (alpha =.56), and social problems (alpha =.69). Data were analyzed using Chi-square and Mann-Whitney U tests. RESULTS: Average emigration age was 14.8 years, with 4.2 years in transit and 2.0 years in the United States; 60% reported plans to return home to live. Two-thirds (66%) had less than a high school education, 49% had English language problems, 49% were employed (38% female vs. 57% male); 70% were single, with Somali females more likely than Oromo to be partnered and mothers (39% vs. 19%). There were significant ethnicity/gender differences for all problem scales. More females reported feeling alone (24% vs. 61%, p <.001). Youth with symptoms of posttraumatic stress syndrome reported more traumatic events (mean number of events: 28 vs.16). Trauma history was strongly associated with physical, psychological, and social problems. Most frequent strategies to combat sadness were praying (55.3%), sleeping (39.9%), reading (32.3%), and talking to friends (27.8%). CONCLUSIONS: Many young Somali and Oromo immigrants to the United States experience life problems associated with war trauma and torture, but many others are coping well. The findings suggest a need to develop age-appropriate strategies to promote the health of refugee youth to facilitate their successful adaptation to adult life in the United States.

Adaptation, Psychological↗
PubMed1981

Present outlook in bronchiectasis: clinical and social study and review of factors influencing prognosis.

One hundred and sixteen patients with proven bronchiectasis diagnosed at least five years previously were studied to determine the clinical outcome, change in pulmonary function, and degree of social disability. Twenty-two patients had died and the mean duration of follow-up in the survivors was 14 years. The patients who died were characterised by a poorer initial ventilatory capacity than the survivors and cor pulmonale was present in 37% at the time of death. The survivors showed a tendency for improvement in symptoms whether treated surgically or medically. Thirty per cent were better than at diagnosis while only 11% were worse. Measurements of FEV1 and FVC were made at diagnosis and at review, mild airways obstruction being the predominant abnormality. The change in pulmonary function was expressed as the decline in FEV1 in ml/yr. The decline in FEV1 was no greater than expected in 80% of patients and in a further 15% was of the order seen in cigarette smokers with mild airways obstruction. Poor ventilatory capacity was therefore not an important limitation in these patients. Of the survivors 77% had a good work record with less than two weeks loss of work annually from chest illness. The spouses of all married patients were interviewed at home by a trained social worker. Fifty per cent reported no social problem but 46% of spouses found the patient's cough distasteful and 29% of couples had experienced difficulties with normal sexual life. Seven per cent of the patients were severely disabled. While the overall prognosis of our patients was good a minority still have severe physical and social problems as a result of bronchiectasis.

Adolescent↗
PubMed1993

Do psychiatric patients know what is good for them?

The paper reports the findings of a medical audit exercise which monitored 192 consecutive psychiatric admissions. Approximately two-thirds of patients, consultants and referrers provided information on admission objectives and the degree to which they were attained. One-third of the patients furnished information on social problems and satisfaction with treatment. Sanctuary was rated as an important admission objective by patients but neglected by consultants and referrers. Patient satisfaction with treatment was significantly correlated with attainment of patient as well as consultant objectives, and negatively correlated with social problems. Agreement between consultant and patient on admission objectives was inversely related to both duration of contact with psychiatric services and number of previous admissions suggesting that congruence with consultants may be lost over time. The limitations imposed by variable response rates are acknowledged. It is concluded that serious note should be taken of psychiatric patients' own treatment objectives.

Decision Making↗
PubMedDate not supplied

Alcohol related problems in elderly people--a prospective study.

Alcohol related problems in elderly people are often difficult to diagnose because of denial and non specific presentation in this age group. This study examines the factors related to alcohol abuse in elderly people referred to a psychiatry of old age service over a six month period. Patients were specifically screened for alcohol related psychiatric, physical and social problems. Of the 150 patients referred, 23 (15%) had alcohol related problems, with 12 (52%) denying any history of alcohol abuse/dependence. The majority were female (15/23, 65%), of which 10 were late-onset drinkers. Loneliness was found to be a contributory factor in 10 (43%) patients. A large proportion of patients had physical, psychiatric and social problems related to alcohol. Twenty one patients (91%) required psychiatric follow-up. In conclusion, this study confirms elderly peoples vulnerability to the destructive effects of alcohol.

Aged↗
PubMed2002

Application of chaos theory to solving the problems of social and environmental decline in Lesotho.

This paper examines the definition of chaos theory and its use in different circumstances. The paper explains that environmental crisis is complex, chaotic and unstable and will remain so unless actions are taken to reverse the trend. It further suggests that chaos theory could be used to interpret the crisis and help identify solutions. By recommending the application of chaos theory to the environmental problems in Lesotho, the paper explores some of the key issues that contribute to and perpetuate the environmental situation, for example, the current land tenure system and the problem of overgrazing. In addition, it identifies appropriate and realistic government policies that could be implemented to address the environmental degradation in the country. The paper concludes that the application of chaos theory may be unable to help solve the environmental crisis in Lesotho unless there is political will and commitment and collective effort from all stakeholders, coupled with an attitudinal change.

Agriculture↗
PubMed1996

Screening for social and environmental problems in a VA primary care setting.

Social workers are in an ideal position to identify and treat social and environmental problems early in the continuum of care. Information on these problems will facilitate informed decision making on the development and reallocation of resources to better meet patients needs. This study assessed the social and environmental problems of 132 patients seen in a primary care clinic at a university-affiliated Veterans Affairs (VA) medical center. The most prevalent social problems were financial difficulties, personal stress, family problems, legal concerns, and employment concerns. When asked, nearly one-third of all respondents requested social work services or information about services related to their problems. The findings suggest a clear need for social work interventions in VA primary care clinics that focus on both psychosocial problems.

Adult↗
PubMed1999

Checkered Expectations: Predictors of Approval of Opening a Casino in the Niagara Community.

This paper reports on the findings of a survey prior to the opening of a casino in Niagara Falls, Ontario (N= 1002 adults) on approval of the casino, expectations regarding the impact of the casino, attitudes toward gambling, gambling behaviour, and demographic information. The respondents generally had a positive attitude towards gambling. The expectations of community impact clustered into 3 factors: negative social consequences (crimes, addiction), negative environmental consequences (litter, noise, traffic), and positive economic consequences (jobs, stores, income). The majority of respondents expected economic benefits from the casino as well as a decrease in the environmental quality of the city. Expectations regarding social problems were mixed with a majority expecting an increase in serious crimes, but only a minority expecting an increase in people on welfare. Covariance structure modelling revealed that a positive attitude towards gambling and expecting economic benefits were positively related to approval of the casino, and expecting social problems was negatively related to approval. Given that more than seven in ten respondents supported the opening of the casino, the expected economic benefits coupled with a generally positive attitude towards gambling, apparently outweighed concerns about problems associated with gambling.

Journal Article↗