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1.
Laura Q. Rogers Kerry S. Courneya Phillip M. Anton Patricia Hopkins-Price Steven Verhulst Randall S. Robbs Sandra K. Vicari Edward McAuley 《Annals of behavioral medicine》2017,51(2):321-326
Background
Most breast cancer survivors do not meet physical activity recommendations. Understanding mediators of physical activity behavior change can improve interventions designed to increase physical activity in this at-risk population.Purpose
Study aims were to determine the 3-month Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention effects on social cognitive theory constructs and the mediating role of any changes on the increase in accelerometer-measured physical activity previously reported.Methods
Post-treatment breast cancer survivors (N = 222) were randomized to BEAT Cancer or usual care. Assessments occurred at baseline, 3 months (M3), and 6 months (M6). Adjusted linear mixed model analysis of variance determined intervention effects on walking self-efficacy, outcome expectations, goal setting, and perceived barrier interference at M3. Path analysis determined mediation of intervention effects on physical activity at M6 by changes in social cognitive constructs during the intervention (i.e., baseline to M3).Results
BEAT Cancer significantly improved self-efficacy, goals, negative outcome expectations, and barriers. Total path analysis model explained 24 % of the variance in M6 physical activity. There were significant paths from randomized intervention group to self-efficacy (β = 0.15, p < .05) and barriers (β = ?0.22, p < .01). Barriers demonstrated a borderline significant association with M6 physical activity (β = ?0.24, p = .05). No statistically significant indirect effects were found.Conclusions
Although BEAT Cancer significantly improved social cognitive constructs, no significant indirect effects on physical activity improvements 3 months post-intervention were observed (NCT00929617).2.
Navin Kaushal Ryan E. Rhodes John C. Spence John T. Meldrum 《Annals of behavioral medicine》2017,51(4):578-586
Background
The promotion of physical activity (PA) is paramount to public health, yet interventions in the social cognitive tradition have yielded negligible improvements. The limited progression may be due to an overreliance on intention as the proximal determinant of behavior and a lack of consideration of implicit/automatic processes. The purpose of this study was to examine the impact of a habit formation intervention on PA over 8 weeks in a two-arm parallel design, randomized controlled trial.Methods
Participants (n = 94) were new gym members with the intention to engage in PA but below international PA guidelines at baseline, who were randomized into a control or habit experimental group. The experimental group attended a workshop (at baseline) and received a follow-up booster phone call at week 4. The primary outcome of the study was minutes of moderate-vigorous intensity PA (MVPA) at week 8. The secondary outcome was a manipulation check to determine if the experimental group effectively incorporated habit-building constructs (cues and practice consistency).Results
The experimental group showed a significant increase in MVPA after 8 weeks in both accelerometry (d = 0.39, p = .04) and self-report (d = 0.53, p = .01) compared with the control group. The experimental group also showed an increase in use of cues (d = 0.56, p < .001) and practice consistency (d = 0.40, p = .01) at week 8.Conclusion
The results contribute to the initial validity of increasing PA through a focus on preparation cues and practice consistency. Future research should replicate these findings and extend the duration of assessment to evaluate whether PA changes are sustained. Registered Trial Number NCT027851073.
Christina M. Thornton Jacqueline Kerr Terry L. Conway Brian E. Saelens James F. Sallis David K. Ahn Lawrence D. Frank Kelli L. Cain Abby C. King 《Annals of behavioral medicine》2017,51(2):159-169
Background
Studies identifying correlates of physical activity (PA) at all levels of the ecological model can provide an empirical basis for designing interventions to increase older adults’ PA.Purpose
Applying ecological model principles, this study concurrently examined individual, psychosocial, and environmental correlates of older adults’ PA to determine whether built environment factors contribute to PA over and above individual/demographic and psychosocial variables.Methods
Using a cross-sectional observational design, 726 adults, aged ≥66 years, were recruited from two US regions. Explanatory variables included demographics, self-efficacy, social support, barriers, and environmental variables measured by using geographic information systems (GIS) and self-report. Outcomes included reported walking for errands and leisure/exercise and accelerometer-measured daily moderate to vigorous PA (MVPA). Analyses employed mixed-model regressions with backward elimination.Results
For daily MVPA, the only significant environmental variable was GIS-based proximity to a park (p < 0.001) after controlling for individual/demographic and psychosocial factors. Walking for errands was positively related to four environmental variables: reported walking/cycling facilities (p < 0.05), GIS-based intersection density (p < 0.01), mixed land use (p < 0.01), and private recreation facilities (p < 0.01). Walking for leisure/exercise was negatively related to GIS-based mixed land use (p < 0.05). Non-Hispanic white race/ethnicity, self-efficacy, and social support positively related to all three PA outcomes (p < 0.05).Conclusions
Correlates of older adults’ PA were found at all ecological levels, supporting multiple levels of influence and need for multilevel interventions. Environmental correlates varied by PA outcome. Walking for errands exhibited the most environmental associations.4.
Marlene N. Silva David Sánchez-Oliva Jennifer Brunet Geoffrey C. Williams Pedro J. Teixeira Antonio L. Palmeira 《Annals of behavioral medicine》2017,51(5):707-717
Background
Research into the factors associated with the use of different motivational strategies by exercise professionals is of empirical and practical utility.Purpose
Grounded in self-determination theory, this study sought to analyze putative antecedents, mediators, and work-related well- and ill-being consequences of two types of motivational strategies reported by exercise professionals.Methods
Participants were 366 exercise professionals (193 males; experience = 7.7 ± 5.8 years). Questionnaires assessing psychological need satisfaction frustration, self-determined work motivation, motivational strategies (need-supportive vs. controlling), emotional exhaustion, and personal accomplishment were completed online. Path analysis was used to test the hypothesized model.Results
Model with good fit [χ 2 (5) = 9.174, p> .05; CFI = .984; TLI = .936; RMSEA = .048; SRMR = .022] showed need satisfaction as positively associated with supportive strategies and personal accomplishment (β between .267 and .399) and negatively with emotional exhaustion (β = ?.145). Need frustration was negatively associated with work motivation and personal accomplishment (β = ?.315; ?.176), and positively with controlling strategies and emotional exhaustion (β = .195; .226). Furthermore, supportive strategies and work motivation were positively associated with personal accomplishment (β = .134; .184), whereas controlling strategies were positively associated with emotional exhaustion (β = .178).Conclusions
Findings have theoretical implications, providing evidence of need satisfaction and frustration as being differently associated with work-related motivation, type of strategies used, and work-related emotional outcomes. Practical implications convey the importance of these variables in relation to the standard of motivational strategies provided and their role on work-related well- and ill-being indicators.5.
Objective
To assess the effects of PR-fampridine on cognitive functioning, fatigue and depression in patients with multiple sclerosis (PwMS).Methods
Thirty-two PwMS were included in this trial. Cognitive performance was assessed in an open-label and randomized double-blind, placebo-controlled study design using a comprehensive neuropsychological test battery as well as questionnaires examining depression and fatigue.Results
We found significant improvements in cognitive measures assessing alertness (tonic alertness, p = 0.0244 and phasic alertness, p = 0.0428), psychomotor speed (p = 0.0140) as well as verbal fluency (p = 0.0002) during open-label treatment with PR-fampridine. These effects of performance were paralleled by patients’ perception of reduced fatigue (physical, p = 0.0131; cognitive, p = 0.0225; total, p = 0.0126). Fampridine-induced improvements in phasic alertness (p = 0.0010) and measures of fatigue (physical, p = 0.0014; cognitive, p = 0.0003; total, p = 0.0005) were confirmed during randomized, double-blind, placebo-controlled assessment in the second year. In addition, we found positive effects of PR-fampridine on depressive symptoms (p = 0.0049). We demonstrated persisting beneficial effects of PR-fampridine on fatigue in PwMS over a period of more than 2 years. Drug responsiveness regarding cognitive performance and fatigue was not limited to walking responders.Conclusions
Our data demonstrate significant positive effects of treatment with PR-fampridine over 2 years on different cognitive domains as well as fatigue and depression in a cohort of PwMS. These findings imply that PR-fampridine should be considered as symptomatic treatment improving aspects of cognition, fatigue and depression in PwMS.6.
Ari J. Elliot Nicholas A. Turiano Benjamin P. Chapman 《Annals of behavioral medicine》2017,51(2):240-250
Background
Socioeconomic health disparities research may benefit from further consideration of dispositional factors potentially modifying risk associated with low socioeconomic status, including that indexed by systemic inflammation.Purpose
This study was conducted to investigate interactions of SES and the Five-Factor Model (FFM) personality traits in predicting circulating concentrations of the inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP).Method
Using a sample of middle-aged and older adults from the Midlife in the United States Survey (MIDUS) biomarker project (N = 978), linear regression models tested interactions of each FFM trait with a composite measure of SES in predicting IL-6 and CRP, as well as the explanatory role of medical morbidity, measures of adiposity, and health behaviors.Results
SES interacted with conscientiousness to predict levels of IL-6 (interaction b = .03, p = .002) and CRP (interaction b = .04, p = .014) and with neuroticism to predict IL-6 (interaction b = ?.03, p = .004). Socioeconomic gradients in both markers were smaller at higher levels of conscientiousness. Conversely, the socioeconomic gradient in IL-6 was larger at higher levels of neuroticism. Viewed from the perspective of SES as the moderator, neuroticism was positively related to IL-6 at low levels of SES but negatively related at high SES. Interactions of SES with both conscientiousness and neuroticism were attenuated upon adjustment for measures of adiposity.Conclusions
Conscientiousness may buffer, and neuroticism amplify, excess inflammatory risk associated with low SES, in part through relationships with adiposity. Neuroticism may be associated with lower levels of inflammation at high levels of SES.7.
Amy E. Richardson Geraldine Tennant Randall P. Morton Elizabeth Broadbent 《Annals of behavioral medicine》2017,51(5):629-641
Background
Research is yet to investigate whether psychological interventions delivered early after diagnosis can benefit patients with head and neck cancer (HNC).Purpose
The aim of this study was to investigate the effectiveness of a brief self-regulatory intervention (targeting illness perceptions and coping) at improving HNC patient health-related quality of life (HRQL).Methods
A pilot randomized controlled trial was conducted, in which 64 patients were assigned to receive three sessions with a health psychologist in addition to standard care or standard care alone. Participants completed questionnaires assessing HRQL, general distress, and illness perceptions at baseline and again 3 and 6 months later.Results
Compared to the control group, patients who received the intervention had increased treatment control perceptions at 3 months (p = .01), and increased social quality of life at 6 months (p = .01). The intervention was particularly helpful for patients exhibiting distress at baseline.Conclusion
A brief psychological intervention following HNC diagnosis can improve patient perceptions of treatment and social quality of life over time. Such interventions could be targeted to patients who are distressed in order to confer the greatest benefit.Trial Registration Number
12614000813684.8.
Francis Vergunst Jorun Rugkåsa Constantinos Koshiaris Judit Simon Tom Burns 《Social psychiatry and psychiatric epidemiology》2017,52(11):1375-1384
Purpose
Community treatment orders (CTOs) are widely used internationally despite a lack of evidence supporting their effectiveness. Most effectiveness studies are relatively short (12-months or less) and focus on clinical symptoms and service data, while a little attention is given to patients’ social outcomes and broader welfare. We tested the association between the duration of CTO intervention and patients’ long-term social outcomes.Methods
A sub-sample (n = 114) of community-based patients from the Oxford Community Treatment Order Evaluation Trial (OCTET) were interviewed 48 months after randomisation. Multivariate regression models were used to examine the association between the duration of the CTO intervention and social outcomes as measured by the social network schedule, Objective Social Outcomes Index, Euro-Qol EQ-5D-3L (EQ-5D), and Oxford Capabilities Questionnaire for Mental Health.Results
No significant association was found between the duration of CTO intervention and social network size (IRR = 0.996, p = .63), objective social outcomes (B = ?0.003, p = .77), health-related quality of life (B = 0.001, p = .77), and capabilities (B = 0.046, p = .41). There were no between-group differences in social outcomes when outcomes were stratified by original arm of randomisation. Patients had a mean of 10.2 (SD = 5.9) contacts in their social networks, 42% of whom were relatives.Conclusions
CTO duration was not associated with improvements in patients’ social outcomes even over the long term. This study adds to growing concerns about CTO effectiveness and the justification for their continued use.9.
Objective
Caregiver burden is a recognised consequence of caring for a patient with neurodegeneration. Amyotrophic lateral sclerosis (ALS) differs from other neurodegenerations by its rapid progression and impairment of motor, cognitive, and behavioural function, which contribute to caregiver burden. However, longitudinal factors that determine the extent of caregiver burden, and in particular the impact of psychological distress among caregivers, have not been fully established.Methods
Patients with ALS (n = 85) and their primary caregivers (n = 85) completed three serial evaluations. Caregiver burden was measured using the Zarit Burden Interview (ZBI). Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). The Edinburgh Cognitive-Behavioural ALS Screen (ECAS) was used to determine cognitive function in patients. The ALS Functional Rating Scale (ALSFRS-R) measured disease progression.Results
Using the ZBI, caregivers were categorised as high or low burden. In the low burden group, anxiety scores from the HADS predicted caregiver burden (r = 0.410, F = 3.73, p = 0.033), whereas the depression sub-score from the HADS was predictive of caregiver burden in the high burden group (r = 0.501, F = 5.87, p = 0.006) for cross-sectional analyses. Longitudinally, an elevated score on the HADS at Time 1 was the largest predictor of caregiver burden across serial assessments.Conclusion
In a patient cohort with relatively preserved cognitive function (65%), anxiety and depression at Time 1, as measured by the HADS, were the best predictors of caregiver burden at Time 3. This observation provides a mechanism by which caregiver burden can be identified by health-care professionals and a stepped care programme of intervention initiated.10.
Jennifer Fillo Stephanie Brooks Holliday Amy DeSantis Anne Germain Daniel J. Buysse Karen A. Matthews Wendy M. Troxel 《Annals of behavioral medicine》2017,51(6):879-889
Background
Emerging research has begun to examine associations between relationship functioning and sleep. However, these studies have largely relied on self-reported evaluations of relationships and/or of sleep, which may be vulnerable to bias.Purpose
The purpose of the study was to examine associations between relationship functioning and sleep in military couples. This is the first research to examine associations between observed relationship behaviors and subjective and polysomnographically measured sleep in a sample at-risk for both sleep and relationship problems.Methods
The sample included 35 military veterans and their spouses/partners. Marital functioning was coded from a videotaped conflict interaction. Analyses focused on behavioral codes of hostility and relationship-enhancing attributions. Sleep was assessed via self-report and in-home polysomnography.Results
Greater hostility was associated with poorer sleep efficiency for oneself (b = ?0.195, p = .013). In contrast, greater relationship-enhancing attributions were associated with higher percentages of stage N3 sleep (b = 0.239, p = .028). Partners’ hostility was also positively associated with higher percentages of stage N3 sleep (b = 0.272, p = .010). Neither hostility nor relationship-enhancing attributions was associated with self-reported sleep quality, percentage of REM sleep, or total sleep time.Conclusions
Both partners’ positive and negative behaviors during conflict interactions were related to sleep quality. These findings highlight the role that effective communication and conflict resolution skills may play in shaping not only the marital health of veterans and their spouses but also the physical health of both partners as well. Understanding the links between relationship functioning and sleep may be important targets of intervention in the aftermath of war.11.
Kirsten Hauber Albert Eduard Boon Robert Vermeiren 《Child and adolescent psychiatry and mental health》2017,11(1):58
Objective
To examine changes in personality disorders and symptomology and the relation between personality disorder variables and treatment outcomes in an adolescent sample during partial residential mentalization based treatment.Methods
In a sample of 62 (out of 115) adolescents treated for personality disorders, assessment was done pre- and post-treatment using the Structured Clinical Interview for DSM personality disorders and the Symptom Check List 90.Results
Significant reductions in personality disorder traits (t = 8.36, p = .000) and symptoms (t = 5.95, p = .000) were found. During pre-treatment, 91.8% (n = 56) of the patients had one or more personality disorders, compared to 35.4% (n = 22) at post-treatment. Symptom reduction was not related to pre-treatment personality disorder variables.Conclusion
During intensive psychotherapy, personality disorders and symptoms may diminish. Future studies should evaluate whether the outcomes obtained are the result of the treatment given or other factors.12.
Yhojan Rodríguez Manuel Rojas Carolina Ramírez-Santana Yeny Acosta-Ampudia Diana M. Monsalve Juan-Manuel Anaya 《Clinical autonomic research》2018,28(2):211-214
Purpose
To determine if autonomic symptoms are associated with previous Zika virus infection.Methods
Case–control study including 35 patients with Zika virus infection without evidence of neurological disease and 105 controls. Symptoms of autonomic dysfunction were assessed with the composite autonomic symptom scale 31 (COMPASS-31).Results
Patients with previous Zika virus infection had significantly higher COMPASS-31 score than controls regardless of age and sex (p = 0.007). The main drivers for the higher scores where orthostatic intolerance (p = 0.003), secretomotor (p = 0.04) and bladder symptoms (p < 0.001).Conclusion
Zika virus infection is associated with autonomic dysfunction. The mechanisms remain to be elucidated.13.
Jamie M. Jacobs Kelly M. Shaffer Ryan D. Nipp Joel N. Fishbein James MacDonald Areej El-Jawahri William F. Pirl Vicki A. Jackson Elyse R. Park Jennifer S. Temel Joseph A. Greer 《Annals of behavioral medicine》2017,51(4):519-531
Background
Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress.Purpose
The aim of the study is to investigate the interrelationship of distress in patient-caregiver dyads at the time of newly diagnosed incurable cancer.Methods
From May 2011 to July 2015, within 8 weeks of diagnosis of advanced lung or noncolorectal gastrointestinal cancer, 350 patients and 275 family caregivers were enrolled in a randomized controlled trial of early palliative care. Actor–partner interdependence modeling was used to examine relationships between dyad’s self-reported anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale at baseline.Results
Comparing patients with caregivers, patients reported more depressive symptoms (M diff = .84; t[274] = 3.17, p = .002, d = .22) and caregivers reported more anxiety symptoms (M diff =1.62, t[274] = 4.91, p < .001, d = .39). Dyads’ anxiety symptoms were positively associated, as were depressive symptoms (rs = .21, ps ≤ .001). Actor–partner interdependence modeling showed that patients’ anxiety symptoms were positively associated with their own depressive symptoms, with an equal effect for caregivers (actor effect βs = 0.52, ps < .001). Patients’ own anxiety was concurrently positively associated with their caregivers’ depressive symptoms, with an equal effect for caregivers to patients (partner effect βs=0.08, ps=.008).Conclusions
In the context of newly diagnosed incurable cancer, caregivers experience more pronounced anxiety, while patients report greater depressive symptoms. Findings indicate that anxiety and depressive symptoms are interrelated among dyads facing newly diagnosed incurable disease. Results emphasize the importance of addressing distress in both patients and caregivers. Future research should discern when dyadic versus individual psychosocial interventions would be optimal.Trial Registration Number
The trial was registered with the ClinicalTrials.gov database (NCT02349412) https://clinicaltrials.gov/ct2/show/NCT02349412.14.
Liza S. Rovniak Lan Kong Melbourne F. Hovell Ding Ding James F. Sallis Chester A. Ray Jennifer L. Kraschnewski Stephen A. Matthews Elizabeth Kiser Vernon M. Chinchilli Daniel R. George Christopher N. Sciamanna 《Annals of behavioral medicine》2016,50(6):885-897
Background
Social networks can influence physical activity, but little is known about how best to engineer online and in-person social networks to increase activity.Purpose
The purpose of this study was to conduct a randomized trial based on the Social Networks for Activity Promotion model to assess the incremental contributions of different procedures for building social networks on objectively measured outcomes.Methods
Physically inactive adults (n = 308, age, 50.3 (SD = 8.3) years, 38.3 % male, 83.4 % overweight/obese) were randomized to one of three groups. The Promotion group evaluated the effects of weekly emailed tips emphasizing social network interactions for walking (e.g., encouragement, informational support); the Activity group evaluated the incremental effect of adding an evidence-based online fitness walking intervention to the weekly tips; and the Social Networks group evaluated the additional incremental effect of providing access to an online networking site for walking as well as prompting walking/activity across diverse settings. The primary outcome was mean change in accelerometer-measured moderate-to-vigorous physical activity (MVPA), assessed at 3 and 9 months from baseline.Results
Participants increased their MVPA by 21.0 min/week, 95 % CI [5.9, 36.1], p = .005, at 3 months, and this change was sustained at 9 months, with no between-group differences.Conclusions
Although the structure of procedures for targeting social networks varied across intervention groups, the functional effect of these procedures on physical activity was similar. Future research should evaluate if more powerful reinforcers improve the effects of social network interventions.Trial Registration Number
The trial was registered with the ClinicalTrials.gov (NCT01142804).15.
Anne M. Teitelman Scarlett L. Bellamy John B. JemmottIII Larry Icard Ann O’Leary Samira Ali Zolani Ngwane Monde Makiwane 《Annals of behavioral medicine》2017,51(2):170-178
Background
Intimate partner violence directed at women by men continues to be a global concern. However, little is known about the factors associated with perpetrating intimate partner violence among heterosexual men.Purpose
History of childhood sexual abuse and other sociodemographic variables were examined as potential factors associated with severe intimate partner violence perpetration toward women in a sample of heterosexual men in South Africa.Methods
Longitudinal logistic generalized estimating equations examined associations of childhood sexual abuse and sociodemographic variables at baseline with intimate partner violence perpetration at subsequent time points.Results
Among participants with a steady female partner, 21.81 % (190/ 871) reported perpetrating intimate partner violence in the past year at baseline. Having a history of childhood sexual abuse (p < .001), binge drinking (p = .002), being employed (p = .050), and more difficulty controlling sexual impulses in order to use a condom (p = .006) at baseline were associated with self-reported intimate partner violence perpetration in the past year at subsequent time points.Conclusions
With high levels of recent severe physical and/or sexual intimate partner violence perpetration in South Africa, comprehensive interventions are urgently needed. To more fully address gender-based violence, it is important to address associated factors, including exposure to childhood sexual abuse that could impact behavior later in life and that have long-lasting and deleterious effects on men and their female partners.16.
Jinhua Zheng Xinglong Yang Yalan Chen Quanzhen Zhao Sijia Tian Hongyan Huang Yanming Xu 《Clinical autonomic research》2017,27(2):103-106
Purpose
To compare the order of presentation of bladder and motor symptoms between multiple system atrophy phenotypes.Methods
Medical records were retrospectively reviewed in 144 patients.Results
Bladder symptoms occurred either before or within 12 months after onset of motor symptoms in significantly more patients with the cerebellar phenotype than the parkinsonian phenotype (80 vs. 53%, p = 0.003); similar results were observed for urinary incontinence (79 vs. 45%, p = 0.001).Conclusions
Urinary dysfunction is more likely to appear either before or shortly after motor symptoms in the cerebellar phenotype than in the parkinsonian phenotype.17.
Barbara H. Brumbach Wendy C. Birmingham Watcharaporn Boonyasiriwat Scott Walters Anita Y. Kinney 《Annals of behavioral medicine》2017,51(5):694-706
Background
Understanding the pathways by which interventions achieve behavioral change is important for optimizing intervention strategies.Purpose
We examined mediators of behavior change in a tailored-risk communication intervention that increased guideline-based colorectal cancer screening among individuals at increased familial risk.Methods
Participants at increased familial risk for colorectal cancer (N = 481) were randomized to one of two arms: (1) a remote, tailored-risk communication intervention (Tele-Cancer Risk Assessment and Evaluation (TeleCARE)) or (2) a mailed educational brochure intervention.Results
Structural equation modeling showed that participants in TeleCARE were more likely to get a colonoscopy. The effect was partially mediated through perceived threat (β = 0.12, p < 0.05), efficacy beliefs (β = 0.12, p < 0.05), emotions (β = 0.22, p < 0.001), and behavioral intentions (β = 0.24, p < 0.001). Model fit was very good: comparative fit index = 0.95, root-mean-square error of approximation = 0.05, and standardized root-mean-square residual = 0.08.Conclusion
Evaluating mediating variables between an intervention (TeleCARE) and a primary outcome (colonoscopy) contributes to our understanding of underlying mechanisms that lead to health behavior change, thus leading to better informed and designed future interventions.Trial Registration Number
ClinicalTrials.gov, NCT01274143.18.
Kelly M. Shaffer Jamie M. Jacobs Jessica N. Coleman Jennifer S. Temel Jonathan Rosand Joseph A. Greer Ana-Maria Vranceanu 《Neurocritical care》2017,27(2):180-186
Background
Anxiety and depression are common among patients with acute illness and their families. In oncology, psychosocial services addressing these symptoms are increasingly part of regular practice. Less is known about psychiatric distress among patients with acute neurological injury (ANI) and their family caregivers. To highlight this inequity in psychosocial intervention across medical services, we compared anxiety and depressive symptomatology shortly following diagnosis among patients facing incurable cancer or ANI and their family caregivers.Methods
Recruited from the same hospital, participants were patients within 8 weeks of receiving a diagnosis of incurable cancer (N = 350) and their family caregivers (N = 275; total patient/caregiver dyads = 275) and patients hospitalized in the Neuroscience ICU in the past 2 weeks (N = 81) and their family caregivers (N = 95; total dyads = 75). Participants reported anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale. Symptomatology was compared across illnesses using independent samples t-tests and multiple regressions controlling for differences in sample demographics.Results
Patients with ANI (M = 6.90) reported greater anxiety symptoms than those with cancer (M = 5.31, p < .001), while caregivers for patients with ANI (M = 5.45) reported greater depressive symptoms than caregivers for patients with cancer (M = 3.81, p < .001). Results remained when controlling for demographic differences between samples.Conclusion
This is the first cross-comparison of psychiatric distress in patients and family caregivers affected by two distinct, life-threatening illnesses early in the illness trajectory. Findings support the priority of addressing psychiatric distress among patients with ANI and their family caregivers, as has been emphasized in the psychosocial oncology field.19.
Paul N. Pfeiffer Marcia Valenstein Dara Ganoczy Jennifer Henry Steven K. Dobscha John D. Piette 《Social psychiatry and psychiatric epidemiology》2017,52(2):183-191
Background
Following discharge, patients hospitalized for depression are at high risk for poor retention in outpatient care and adverse outcomes.Aims
Pilot tests a post-hospital monitoring and enhanced support program for depression.Method
48 patients at a Veterans Affairs Medical Center discharged following a depression-related inpatient stay received weekly visits or phone calls for 6 months from their choice of either a family member/friend (n = 19) or a certified peer support specialist (n = 29). Participants also completed weekly automated telephone monitoring calls assessing depressive symptoms and antidepressant medication adherence.Results
Over 90% of participants were more satisfied with their care due to the service. The mean change from baseline to 6 months in depression symptoms was ?7.9 (p < 0.05) according to the Patient Health Questionnaire and ?11.2 (p < 0.05) according to the Beck Depression Inventory-II for those supported by a family member/friend, whereas those supported by a peer specialist had mean changes of ?3.5 (p < 0.05) and ?1.7 (p > 0.10), respectively.Conclusions
Increased contact with a chosen support person coupled with automated telephone monitoring after psychiatric hospitalization is an acceptable service for patients with depression. Those who received the service, and particularly those supported by a family member/friend, experienced reductions in symptoms of depression.20.
Rebecca M. Puhl Diane M. Quinn Bradley M. Weisz Young J. Suh 《Annals of behavioral medicine》2017,51(5):754-763