Psychological Distress and Self-Care Engagement: Healing After a Cardiac Intervention

Silencing the self, a relational concept, occurs when individuals overvalue others' standards, self-sacrifice their needs for others, inhibit self-expression, and experience a sense of dividedness between their inner and outer self. Given the emerging literature highlighting the importance of relational beliefs and experiences in coronary heart disease, the contribution of a concept such as self-silencing to the cardiac healing process is valuable to consider. This study investigated self-silencing dimensions, psychological distress (anxiety and depressive symptoms), and self-care engagement after a serious cardiac event. Forty women and 80 men attending a rehabilitation program completed a series of questionnaires six months post-cardiac intervention. Multivariate regression analyses were performed to examine the role of self-silencing after the influence of cardiac health and sociodemographics were taken into account. Self-silencing was positively associated with anxiety and depressive symptoms for both sexes. For self-care engagement, sex interacted with some of the silencing dimensions. The findings were interpreted in the context of participants' attendance in a rehabilitation program. Women who are self-silencing may benefit from the self-care expectations associated with a cardiac program whereas for men, even engaging in cardiac self-care may be perceived as self-silencing.     

Predicting Residential Treatment Outcomes for Emotionally and Behaviorally Disordered Youth: The Role of Pretreatment Factors

This study examined outcomes with 170 children and youth admitted to residential treatment with complex mental health problems. Overall, outcomes at 2 years post-treatment was predicted by children and youth's behavioral pretreatment status reflected in lower internalizing and externalizing behavior at admission. These findings recognize a cluster of variables upon admission that are differentially predictive of specific outcomes. Higher school participation/achievement and an absence of witnessing interparental abuse predicted educational status. Family status was predicted at admission by higher family functioning, being younger in the family, and children and youth who had poor community behavior. The results are discussed as they relate to pretreatment screening and the need to evaluate service outcomes.     

Treatment Theory,Intervention Specification,and Treatment Fidelity in Assistive Technology Outcomes Research

ABSTRACT

Recent reports in the rehabilitation literature have suggested that treatment theory, intervention specification, and treatment fidelity have important implications for the design, results, and interpretation of outcomes research. At the same time, there has been relatively little discussion of how these concepts bear on the quality of assistive technology (AT) outcomes research. This article describes treatment theory, intervention specification, and treatment fidelity as interconnected facets of AT outcome studies that fundamentally affect the interpretation of their findings. The discussion of each is elucidated using case examples drawn from the AT outcomes research literature. Recommendations are offered for strengthening these components of AT outcomes research.     

Evaluation of an Online Education and Support Intervention for Adolescents With Diabetes

The current study evaluated an online education and support website intervention for adolescents with Type 1 diabetes. Participants were enrolled in an 8-week, online program addressing diabetes-related issues for adolescents. The evaluation comprised an intervention trial in which participants were assigned to an intervention or control group, and pre- and post-intervention measures of social support were administered. Outcomes indicated interventional gains approaching significance in participants' quality of relationships with others external to their family. Post-intervention qualitative interviews with intervention group participants identified beneficial impacts of decreased isolation, knowledge gain, and normalization of experience. Findings suggest that online information and support is an important resource in augmenting clinical care. Implications and recommendations for clinical practice are discussed.     

What Are Adults With Inflammatory Bowel Disease (IBD) Eating? A Closer Look at the Dietary Habits of a Population‐Based Canadian IBD Cohort

Background: A comprehensive study of what individuals with inflammatory bowel disease (IBD) are eating that encompasses food avoidance, dietary sugar consumption, and a comparison with the non‐IBD Canadian population has not been documented. The aim was to analyze these interrelated dietary components. Methods: Food avoidance and sugar intake data were collected from 319 patients with IBD enrolled in the University of Manitoba IBD Cohort Study. Diets of those with IBD (n = 256) were compared with a matched, non‐IBD Canadian cohort using the nutrition questions obtained from the Canadian Health Measures Survey (CHMS). Results: Food avoidance among IBD is prevalent for alcohol, popcorn, legumes, nuts, seeds, deep‐fried food, and processed deli meat, with a higher prevalence among those with active IBD. Patients with active IBD also consumed significantly more portions of sports drinks and sweetened beverages compared with those with inactive disease. Compared with the non‐IBD Canadian population, patients with IBD consume significantly less iron‐rich food but more milk. Conclusions: Food avoidance is common among those with IBD but may be due more to personal preferences, while sugar‐laden beverages may be displacing other foods higher in nutrients. The overall diet of patients with IBD differed from that of the non‐IBD Canadian population, but deficiencies were observed in both groups. Considering malnutrition among persons living with IBD, nutrition education by trained dietitians as part of the IBD team is imperative to address food avoidance and overall balance nutrition as part of treating and preventing nutrition deficiencies.     

Families of Children with Serious Emotional Disorder: Maternal Reports on the Decision and Impact of Their Child's Placement in Residential Treatment

Findings are reported regarding maternal experiences of their seriously emotionally disordered child both prior to and following a stay in a residential children's mental health treatment facility. Prior to placement, these parents had exhausted all nonresidential forms of intervention and, increasingly, became concerned not only for their identified child's welfare, but also for that of themselves and other siblings in the home. Regardless of whether their child's stay in residential treatment yielded positive or negative treatment outcomes, these parents unilaterally viewed the intensive short-term treatment of their child as an extremely valuable and necessary service. Parental recommendations for improvement in residential services include a reduced waitlist period, availability of services to children at a younger age, more parental education regarding effective child management strategies, and increased support for caregivers. The results are discussed as they relate to policy and practice for residential treatment providers.     

Decision-making role preferences and information needs: a comparison of colorectal and breast cancer

Objective  An exploratory study has been carried out to examine decision-making role preferences and information needs for a sample of people with colorectal cancer ( n =48). The work replicated a larger study carried out for women with breast cancer ( n =150), and this paper compares and contrasts findings for both disease groups.
Design  A cross-sectional design was employed, involving structured interviews. The main variables investigated were decision-making preference (using a decisional role preference card sort), perceived decisional role and information need (using an information needs questionnaire).
Results  The majority (78%) of the colorectal cancer patients preferred to play a passive role in decision making, in contrast to 52% of women with breast cancer in previous work. Eighty per cent of the colorectal sample and 61% of the women with breast cancer perceived that the doctor had made treatment decisions. Priority information needs for both groups related to cure, spread of disease and treatment options.
Conclusions  The two most striking findings from the comparison between the two disease groups relate to the differences in decision-making role preferences and the similarities in information needs. The process of involving people with colorectal cancer in treatment decision making warrants further investigation. The similarity in information needs of the two disease groups has implications for health care professionals providing information to people with cancer.