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Journal articles on the topic 'Chronically interviewed'
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1
Viney, Linda L., and Mary Westbrook. "Is There a Pattern of Psychological Reactions to Chronic Illness Which is Associated with Death." OMEGA - Journal of Death and Dying 17, no. 2 (1987): 169–81. http://dx.doi.org/10.2190/1m6q-28jd-648d-vdwc.
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In order to identify any pattern of psychological reactions to illness associated with later death, interview material from a sample of chronically ill people who died within months of being interviewed was compared with similar material from a sample of chronically ill people who did not die, as well as from a group of healthy people who did not die. The samples were matched for sex and age, and, where appropriate, for degree of disability and type of chronic illness. The comparisons were made by means of content analysis scales which were applied to a recorded segment of the interviews. A characteristic pattern of reactions among the chronically ill people who were later to die was established. This pattern included little uncertainty or directly expressed anger but much depression, guilt, and fear of bodily damage, together with many good feelings. In personal construct psychology terms, their construct systems were enabling them to anticipate what was happening to them more effectively than might have been expected.
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Luz, Elisabete Lamy, and Marta Lima Basto. "The opinion of patients with COPD: the process of becoming chronically sick." Ciência & Saúde Coletiva 18, no. 8 (2013): 2221–28. http://dx.doi.org/10.1590/s1413-81232013000800006.
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Many earlier studies have contributed to a general understanding of the symptoms and signs of chronic obstructive pulmonary disease (COPD), yet very little is known about the transition from a healthy to a chronically sick individual. The scope of this study was to understand how people live with their chronic illness, using Grounded Theory¹. Twenty-two participants with COPD were interviewed. Findings revealed "the basic social process" of becoming sick with COPD: The significance of living with COPD; Stages of becoming a sick individual; Strategies for management of the process used by participants. The conclusion reached is that understanding the process of "becoming sick" from the person's perspective assists nurses to develop personalized interventions with individuals suffering from COPD, focussing on the subject of care.
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Piette, John D., Ann Marie Rosland, Maria Silveira, Mohammed Kabeto, and Kenneth M. Langa. "The case for involving adult children outside of the household in the self-management support of older adults with chronic illnesses." Chronic Illness 6, no. 1 (2010): 34–45. http://dx.doi.org/10.1177/1742395309347804.
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Objectives: This study sought to (1) identify barriers to spousal support for chronic illness self-care among community-dwelling older adults; and (2) describe the potential availability of self-care support from adult children living outside of the household. Methods: Nationally representative US sample of chronically ill adults aged 51+ were interviewed as part of the Health and Retirement Study (N = 14,862). Both participants and their spouses (when available) reported information about their health and functioning. Participants also reported information about their contact with adult children and the quality of those relationships. Results: More than one-third (38%) of chronically ill older adults in the US are unmarried; and when spouses are available, the majority of them have multiple chronic diseases and functional limitations. However, the vast majority of chronically ill older adults (93%, representing roughly 60 million Americans) have adult children, with half having children living over 10 miles away. Most respondents with children (78%) reported at least weekly telephone contact and that these relationships were positive. Roughly 19 million older chronically ill Americans have adult children living at a distance but none nearby; these children are in frequent telephone contact and respondents (including those with multiple chronic diseases) report that the relationships are positive. Discussion: As the gap between available health services for disease management and the need among community-dwelling patients continues to grow, adult children—including those living at a distance—represent an important resource for improving self-care support for people with chronic diseases.
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Noh, Hyunjin, Anne Halli-Tierney, Lewis Lee, and Temilade Aladeokin. "ASSOCIATION BETWEEN LEVEL OF PAIN AND DEPRESSION AMONG CHRONICALLY ILL OLDER ADULTS IN RURAL ALABAMA." Innovation in Aging 3, Supplement_1 (2019): S261—S262. http://dx.doi.org/10.1093/geroni/igz038.975.
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Abstract Pain and depression, two of the common symptoms among chronically ill older adults, have been found to be related in various populations; however, further knowledge is needed about their relationships and moderating factors among community-dwelling, chronically ill older adults, particularly in lower-income, rural areas with limited healthcare resources. Therefore, this study aimed to examine the association between pain level and depression among chronically ill older adults in rural areas. A total of 100 residents of a rural county in West Alabama, who are 55+ and have chronic illnesses and pain, were recruited from four community senior centers and were interviewed using a structured questionnaire. Pain levels were assessed by the Philadelphia Geriatric Center (PGC) Pain Scale, and depression by an abbreviated version of the Center for Epidemiologic Studies Depression Scale (CES-D). Bivariate correlation and multivariate analysis were conducted. The correlation between pain and depression was significantly positive (r = .35, p < .001). The results of the model indicated that pain scores and other control variables explained approximately 18 percent of the variance in depression. The multivariate analysis results confirmed that those who had higher pain scores were significantly likely to have increased depression scores (b = 4.97, SE = 1.52, p < .01). Education marginally significantly moderated the relationship between pain and depression (p = .059). The previously reported positive pain-depression relationship exists among chronically ill older adults in rural areas, calling for tailored interventions to reduce their pain and its impact on depression.
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Sanderson, Brittney, and Doug Henry. "Learning from Parents of Children with Childhood Asthma." Practicing Anthropology 41, no. 1 (2019): 43–47. http://dx.doi.org/10.17730/0888-4552.41.1.43.
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Abstract Families of children with asthma have to shoulder immense burdens as part of care, and yet the social science literature on their experiences is not well developed or up-to-date. As part of a class project in Anthropology and Public Health, we interviewed eleven parents about their experiences with a chronically ill child and uncovered important themes about emotions, learning, assessments of risk, and control. We assert that asking parents about their experiences providing and monitoring and care can provide important data that could inform asthma management programs in the establishment of better support, education, and care.
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Parrón, T., AF Hernández, A. Pla, and E. Villanueva. "Clinical and biochemical changes in greenhouse sprayers chronically exposed to pesticides." Human & Experimental Toxicology 15, no. 12 (1996): 957–63. http://dx.doi.org/10.1177/096032719601501203.
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1 This study was conducted with the aim of evaluating the impact on health produced by the use of different types of pesticides in greenhouses. It is based on the need to practice and develop biological monitoring techniques to assess exposure and predict health risk in workers occupationally exposed to pesticides. 2 Two groups of greenhouse workers with either high or low exposure to a combination of pesticides was taken in Almeria, a Spanish province where cultures under plastic are very extended. 3 One hundred and five sprayers were interviewed to collect information about symptoms and signs related to past exposures. Each pesticide sprayer was exam ined by a physician, and a blood sample was drawn for plasma and red blood cell cholinesterases, complete blood count, and liver and renal function tests. 4 Exposure of workers to a combination of pesticides resulted in 37% of the workers showing toxic signs and symptoms. The main toxic effects observed were a high incidence of spontaneous abortion, depression, and certain neurologic disorders like headache, tremor and paraesthesia. 5 The major analytical change was a decrease of the mean corpuscular haemoglobin concentration in 38% of the cases. However, no significant decrease in both serum and erythrocyte cholinesterase activities was observed. 6 The sprayers were not usually aware of the potential hazards of pesticides and did not try their best to maintain personal hygiene.
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White, Colin P., Gerilynn Hirsch, Sunil Patel, Fatin Adams, and Kevork M. Peltekian. "Complementary and Alternative Medicine Use by Patients Chronically Infected with Hepatitis C Virus." Canadian Journal of Gastroenterology 21, no. 9 (2007): 589–95. http://dx.doi.org/10.1155/2007/231636.
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Complementary and alternative medicine (CAM) is becoming increasingly popular in North America. The use of CAM is also popular in patients with chronic liver disease but is not well documented. The extent of use of CAM in chronic hepatitis C virus (HCV) infected patients was determined, and the demographic and clinical data between users and nonusers of CAM was compared.Seventy-six patients (30% female) with chronic HCV were interviewed. The mean age was 43±8 years. Current use of CAM for HCV was reported by 35 of 76 patients (46%). Eighteen of 76 patients within this group used herbal supplements (24%). The most commonly used herb wasSilybum marianum(milk thistle), reported by 10 of 76 patients (13.2%). Commonly reported benefits of CAM use included reduction in fatigue, boost in the immune system and improved gastrointestinal function. No adverse effects of CAM use were reported. In the present study, four of 18 patients (22%) with chronic liver disease taking herbal therapies were on herbs that increased bleeding time.The use of CAM in chronic HCV patients is significant. Patients should be asked specifically about their use of CAM. CAM use may have implications affecting conventional treatment and management of HCV.
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Spieker, Susan J., Lillian Bensley, Robert J. McMahon, Hellen Fung, and Eric Ossiander. "Sexual abuse as a factor in child maltreatment by adolescent mothers of preschool aged children." Development and Psychopathology 8, no. 3 (1996): 497–509. http://dx.doi.org/10.1017/s0954579400007239.
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AbstractWe examined the role of a history of sexual abuse as a predictor of child maltreatment by adolescent mothers in a prospective study of 104 mother-child dyads. Mothers were interviewed about any experienced abuse, and the mother-child dyads were observed in a teaching interaction and in the Strange Situation when the children were 1 year old. Three and a half years later, the mothers were interviewed about their Child Protective Service (CPS) contacts since the birth of their children. The percentage of mothers reporting CPS contacts for their own children was 15.4%, 38.5%, and 83.3%, respectively, for those mothers with no history of sexual abuse, a history of a single incident or brief duration of sexual abuse, and those mothers with a history of chronic sexual abuse (median 24 months duration; test of increasing trend significant atp< .000009). Mothers who reported having been chronically sexually abused as children were significantly more likely to have CPS contacts for their own children, after controlling for history of physical abuse, quality of early teaching interactions, and infant attachment security (both of which also predicted CPS contacts), race, IQ, welfare status at 1 year postpartum, and history of foster care.
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Gasperė, Renata Kudukytė, and Aleksandras Kriščiūnas. "INTEGRUOTŲ SLAUGOS IR PSICHOSOCIALINIŲ PASLAUGŲ POREIKIS NAMUOSE SLAUGOMIEMS SUNKIOS BŪKLĖS PACIENTAMS IR JŲ ŠEIMOS NARIAMS. ATVEJO ANALIZĖ VŠĮ CENTRO POLIKLINIKOJE." Sveikatos mokslai 25, no. 1 (2014): 15–23. http://dx.doi.org/10.5200/sm-hs.2015.002.
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Aging population in Lithuania determinates the demand for integrated services, oriented in solving problems of senior, disable citizens and growing needs of home nursing. At the present time, Lithuania are only at the beginning of analysis for demand of integrated health care as well as nursing and psychosocial services for long care patients. Although more and more attention are paid for management of providing integrated nursing and psychosocial help for chronically ill patients at home, the real patient care burden still lies with patients family. The lack of attention for the needs of patient’s relatives in health care and psychosocial services was noticed. Public institution Centro poliklinika is the almost the only institution in Vilnius, providing integrated home nursing, palliative medicine and social services. This article assess the integrated nursing and psychosocial services demands for Centro poliklinika chronically ill patients and their relatives. The survey was conducted in 2013, by implementing public health program “Ensuring of safe environment at home for patients and social, psychological and spiritual help for their relatives”. 431 chronic severe disease patients with a specific set of permanent nursing or palliative care needs, as well as 220 of their family members were interviewed. It was found that the chronically ill, long term home nursed patients need an integrated comprehensive support and care provided by a multidisciplinary team of specialists, using a specific patient case management principles in organizing and providing diverse on the individual patient and his family members‘ needsoriented services. Psychosocial services are not organized for the patient‘s relatives in Lithuania, however, study has showed that patients‘ family members who are constantly taking care of them, particularly needs recreational services allowing them to rest from the day to day care of the patient.
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Chew, Chii-Chii, Amar-Singh HSS, Huan-Keat Chan, and Mohamed Azmi Hassali. "Medication Safety at Home: A Qualitative Study on Caregivers of Chronically Ill Children in Malaysia." Hospital Pharmacy 55, no. 6 (2019): 405–11. http://dx.doi.org/10.1177/0018578719851719.
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Introduction: Medication errors are more likely to occur in chronically ill children, who are highly dependent on caregivers for medication administration. This study aimed to explore the issues related to medication safety among pediatric outpatients in Malaysia from the caregivers’ perspective. Methods: This was a qualitative study conducted between May and June 2018 at a pediatric clinic of a regional referral hospital. Caregivers of children who (1) were under 6 years of age and (2) had hypothyroidism, epilepsy, thalassemia, asthma, or other chronic diseases were recruited via purposive sampling. Each selected disease was represented by at least 3 caregivers, who were identified from the medical records of their children. Face-to-face interviews were conducted with each of them, facilitated by a semi-structured interview guide. All the interviews were audio-recorded, transcribed verbatim, and analyzed using the thematic analysis approach. Results: A total of 15 mothers with a median age of 34 years were interviewed. Three themes emerged from the interviews: (I) actual experiences with medication errors, (II) underlying risk factors for medication errors, and (III) recommendations to improve medication safety. Several cases of administration errors, including missed doses and self-decided dose adjustment, were detected. Furthermore, the caregivers were found to have inadequate understanding of the medications in general. Conclusions: While children were shown to be consistently exposed to medication errors at home in Malaysia, the recommendations of the caregivers, including the use of written instructions and a diary, could be effective strategies to improve the out-of-hospital medication safety in children.
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Houck, Gail M., and Carrie Perri. "A Support Group for Absentee Middle School Students." Journal of School Nursing 18, no. 4 (2002): 201–5. http://dx.doi.org/10.1177/10598405020180040801.
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For this practice improvement project, an interview guide was developed to identify chronically absent middle school students’ reasons for school absence. Of the 17 students interviewed, 82% ( n = 14) identified illness as the reason for absence, although they rarely saw a health care provider. The students all shared dreams for the future; 50% involved further education, and 50% involved job training. A support group intervention was offered to the 17 students during spring term. Only three students were able to participate in a weekly group meeting for 5 weeks. Two of the three students were depressed and referred to their health care providers for evaluation. The topics presented to the group included being sick and options available, setting weekly attendance goals, identifying depressive symptoms and what they mean, and likes and dislikes about school. The support group occurred late in the school year, so its effect on attendance was not determined.
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Houck, Gail M., and Carrie Perri. "A Support Group for Absentee Middle School Students." Journal of School Nursing 18, no. 4 (2002): 201–5. http://dx.doi.org/10.1177/10598405020180040901.
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For this practice improvement project, an interview guide was developed to identify chronically absent middle school students’ reasons for school absence. Of the 17 students interviewed, 82% ( n = 14) identified illness as the reason for absence, although they rarely saw a health care provider. The students all shared dreams for the future; 50% involved further education, and 50% involved job training. A support group intervention was offered to the 17 students during spring term. Only three students were able to participate in a weekly group meeting for 5 weeks. Two of the three students were depressed and referred to their health care providers for evaluation. The topics presented to the group included being sick and options available, setting weekly attendance goals, identifying depressive symptoms and what they mean, and likes and dislikes about school. The support group occurred late in the school year, so its effect on attendance was not determined.
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Arshad, Misbah, and Bushra Bibi. "A Qualitative Study of Dyadic Coping among Couples Dealing with Burden of Chronic Illness." Global Social Sciences Review V, no. III (2020): 191–201. http://dx.doi.org/10.31703/gssr.2020(v-iii).21.
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The present qualitative study aimed in-depth exploration of dyadic coping among couples dealing with chronic illness. There were 12 couples (six females and six males) with chronic illness and their healthy partners were interviewed. The in-depth interviews were conducted through interview guide based on Systematic Transactional Model (STM) (Bodenmann, 1995) and lived experiences of participants. The results were analyzed by using (Braun & Clarke, 2006) method of thematic analysis. The results revealed that female diagnosed partners showed less supportive dyadic coping to deal with physical and emotional burden of their chronic illnesses as compared to chronically ill male partners. However, the economic hardships is equally stressful for both members of the couples resulted in negative dyadic coping. The therapeutic assistance should be given to improve the dyadic coping among couples to deal with burden of chronic illness and live with better quality of life.
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Caldeira, Rebeca de Barros, Anita Liberalesso Neri, Samila Sathler Tavares Batistoni, and Meire Cachioni. "Variables associated with the life satisfaction of elderly caregivers of chronically ill and dependent elderly relatives." Revista Brasileira de Geriatria e Gerontologia 20, no. 4 (2017): 502–15. http://dx.doi.org/10.1590/1981-22562017020.160177.
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Abstract Objective: to compare the life satisfaction of family caregivers, taking into account their gender, age, time since starting care, health, religion, perceived burden and quality of life, and the level of physical and cognitive dependence of the elderly person receiving care, and to investigate the associations between these variables and low life satisfaction. Methods: a total of 148 caregivers in Indaiatuba and Campinas, in the state of São Paulo, Brazil, selected using the convenience method, were interviewed at home, in private medical clinics and outpatient units, using questionnaires about the sociodemographic characteristics, health conditions, time since starting care, scales of life satisfaction, religiosity, perceived burden and quality of life of the caregiver, and the physical and mental health of the elderly person receiving care. Descriptive, Multivariate and Univariate Logistic Regression analysis were used. Results: caregivers who exhibited low life satisfaction included more frail individuals, with three or more chronic diseases and depression, greater perceived burden and lower self-fulfillment and pleasure, and control and autonomy, scores, which are factors of the Perceived Quality of Life Scale. Elderly caregivers who scored low in self-fulfillment factor and pleasure (OR=101.29; CI=28.68 - 357.73) and who scored high in perceived burden (OR=5.89, CI=2.13 to 16.24) had a greater chance of having low life satisfaction scores. Conclusions: The assessment of caregivers of their satisfaction with life is more influenced by subjective than objective variables, and low satisfaction seems to be strongly associated with poor quality of life, high burden, and caregiver frailty.
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Antoszewska, Beata, and Małgorzata Moszyńska. "Doświadczenia nauczycieli szkół przyszpitalnych w paradygmacie inkluzji ucznia ze specjalnymi potrzebami edukacyjnymi." Kwartalnik Pedagogiczny 64, no. 3 (253) (2019): 194–206. http://dx.doi.org/10.5604/01.3001.0013.5542.
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The inclusion of students with special needs into the education process offered by public schools invites research concerning the transitional space created by hospital schools dedicated for chronically ill or disabled children. The interpretive paradigm was employed for the framework of the study, this choice being motivated by a wish to achieve a more comprehensive understanding of the phenomenon of inclusion. The study aimed at getting acquainted with and describing the work of teachers in hospital schools from the perspective of the inclusion of students with special needs. Hence, the study focused on the work carried out by teachers in hospital schools. The collected information related to the interviewed teachers’ experiences facilitated the identification of common areas that are described in detail in this paper, along with the teachers’ narrations. Conclusions based on the conducted study demonstrate how hospital school teachers implement the notion of inclusion of students with special needs and what their experiences are as far as the inclusion process is concerned.
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Peck, Sue. "Aftermath of the Unexpected, Unexplained, and Abrupt Termination of Healing Touch and Extrapolation of Related Costs." Complementary health practice review 12, no. 2 (2007): 144–60. http://dx.doi.org/10.1177/1533210107302934.
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This qualitative study reports 12 patients' experiences following the unplanned and unexpected termination of their healing touch treatments. Physically disabled, chronically ill patients requiring nursing home levels of care, who were being assisted in staying at home with agency support, had been treated one to two times weekly to monthly over a period of 3 to 4 months by a healing touch practitioner, under a pilot study. Patients had been interviewed twice during their treatments and had described positive experiences with healing touch. Midway through the study, there was an abrupt stopping of treatments without warning or explanation to either patients or researchers. Naturalistic inquiry methodology was used to explore patients' subsequent reactions and experiences. Six patients had negative experiences, including increased pain and impaired functional ability, sleep, and emotional status. Six patients continued to have positive experiences after treatments were terminated. Estimates of potential cost savings with healing touch treatment, as well as ethical implications of discontinuing beneficial treatment without warning or replacement, are discussed.
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Halli-Tierney, Anne, Hyunjin Noh, and Lewis Lee. "Perception of Life-Control Is Associated With Medical Care Satisfaction in Chronically Ill Rural Older Adults." Innovation in Aging 4, Supplement_1 (2020): 449. http://dx.doi.org/10.1093/geroni/igaa057.1452.
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Abstract Prior studies show patient populations have varied experiences with healthcare systems, and this may influence satisfaction with medical care. Patients feeling control over life circumstances may have resilience and ability to adapt to adverse situations. Given socioeconomic and medical differences in older adults we examined factors influencing satisfaction with medical care in the setting of chronic conditions and pain. 100 older adults in rural West Alabama with chronic illnesses and pain were recruited from community senior centers and interviewed with a structured questionnaire. Participants were queried about medical interventions for chronic conditions and satisfaction with medical care. Overall assessment of life-control was measured by the West Haven Yale Multidimensional Pain Index (WHYMPI). Bivariate correlation and multivariate analysis were conducted. Correlations between satisfaction with medical intervention and life-control scores were significantly positive (r=.21, p&lt;.05). Satisfaction with medical intervention and other covariates explained approximately 14.1% variance in life-control scores, R2=.141. Multivariate regression results confirmed those highly satisfied with medical intervention were marginally significantly likely to have increased life-control scores, b=.20, SE=.12, p=.088. Married persons were more likely to have higher life-control scores than those with other marital statuses, b=.84, SE=.34, p&lt;.05. Income was positively associated with life-control scores, b=.18, SE=.08, p&lt;.05. Older adults may perceive greater satisfaction from medical care if they feel greater control over life circumstances. Socioeconomic factors (marital status, income) are associated with life control. These findings can help predict satisfaction with healthcare and find ways to make healthcare more accessible to all.
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Hodiamont, Paul, Nelly Peer, and No Syben. "Epidemiological aspects of psychiatric disorder in a Dutch health area." Psychological Medicine 17, no. 2 (1987): 495–505. http://dx.doi.org/10.1017/s0033291700025058.
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SynopsisA two-phase study of psychiatric prevalence has been carried out among the inhabitants (aged 18–64) of a Dutch health area (Nijmegen). In phase 1, a random sample of 3232 persons answered the GHQ–30 (response rate:75%). In phase 2,486 of the respondents were interviewed withthe full PSE within two weeks. The relationship of PSE-‘caseness’ (ID ≥ 5) and GHQ score was expressed in a logistic regression model, the parameters of which showed strong agreement with the Canberra results, for all socio-demographic variables examined, except for urbanization. means of the logistic model the point-prevalence of PSE cases was calculated at 7·3% (range5·5%-9·2%).Prevalence did not differ significantly in men and women. Higher case rates were found in age category of 55–59 years, among divorced and widowed persons, the lower educational and occupational levels, the unemployed, chronically ill and unable to work, and with city people. This study adds further evidence to a growing body of epidemiological data suggesting similar rates and patterns of psychiatric disorder in populations in industrialized countries.
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Lim, Su-Lin, Claudia Canavarro, Min-Htet Zaw, et al. "Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis." ISRN Nutrition 2013 (December 30, 2013): 1–7. http://dx.doi.org/10.5402/2013/714970.
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Helicobacter pylori (HP) is associated with chronic gastritis and gastric cancer, and more than half of the world’s population is chronically infected. The aim of this retrospective study was to investigate whether an irregular meal pattern is associated with increased risk of gastritis and HP infection. The study involved 323 subjects, divided into three groups as follows: subjects with HP infection and gastritis, subjects with gastritis, and a control group. Subjects were interviewed on eating habits and meal timing. Multivariate logistic regression was used to compare groups. Adjusted odds ratios (OR) were derived controlling for gender, age, stress, and probiotic consumption. Subjects who deviated from their regular meals by 2 hours or more had a significantly higher incidence of HP infection with gastritis (adjusted OR = 13.3; 95% CI 5.3–33.3; P<0.001) and gastritis (adjusted OR = 6.1; 95% CI 2.5–15.0; P<0.001). Subjects who deviated their meals by 2 hours or more, twice or more per week, had an adjusted OR of 6.3 and 3.5 of acquiring HP infection with gastritis (95% CI 2.6–15.2; P<0.001) and gastritis (95% CI 1.5–8.5; P<0.001), respectively. Frequent deviation in meal timing over a prolonged period appears associated with increased risk of developing HP infection and gastritis.
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Mhaidat, Nizar M., Suleiman A. Ai-Sweedan, Karem H. Alzoubi, et al. "Prevalence of depression among relatives of cancer patients in Jordan: A cross-sectional survey." Palliative and Supportive Care 9, no. 1 (2011): 25–29. http://dx.doi.org/10.1017/s1478951510000519.
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AbstractObjective:Depression is common among chronically ill patients and their relatives. In this article, we investigated the prevalence of depression among relatives of cancer patients in Jordan, and studied the relation between several socio-demographic, disease- and treatment-related factors, together with the occurrence of depression among those relatives.Method:A cross-sectional survey study was conducted at a major university hospital in Jordan. Relatives of cancer patients were interviewed for socio-demographic information, and medical records were checked for information about disease and treatment of patient. Psychological status of the relative was assessed using the Hospital Anxiety & Depression Scale (HADS).Results:The prevalence of depression in our sample was 81.9%. Age and degree of relatedness were significantly correlated with the occurrence of depression among relatives of cancer patients. Significant correlations were also detected between depression among patient's relatives and the stage of the disease. Positive predictive factors for depression included relatives being middle aged, close relatedness, patients being in advanced disease stage, and on chemotherapy or undergoing surgery for cancer treatment.Significance of results:Depression is prevalent among relatives of cancer patients. Therefore, more attention is needed to detect changes in the psychological state of vulnerable relatives of cancer patients, in an effort to reduce the occurrence of depression.
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Carameli, Kelley A., David P. Eisenman, Joy Blevins, Brian d'Angona, and Deborah C. Glik. "Planning for Chronic Disease Medications in Disaster: Perspectives From Patients, Physicians, Pharmacists, and Insurers." Disaster Medicine and Public Health Preparedness 7, no. 3 (2013): 257–65. http://dx.doi.org/10.1001/dmp.2010.46.
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AbstractBackgroundRecent US disasters highlight the current imbalance between the high proportion of chronically ill Americans who depend on prescription medications and their lack of medication reserves for disaster preparedness. We examined barriers that Los Angeles County residents with chronic illness experience within the prescription drug procurement system to achieve recommended medication reserves.MethodsA mixed methods design included evaluation of insurance pharmacy benefits, focus group interviews with patients, and key informant interviews with physicians, pharmacists, and insurers.Results and DiscussionMost prescriptions are dispensed as 30-day units through retail pharmacies with refills available after 75% of use, leaving a monthly medication reserve of 7 days. For patients to acquire 14- to 30-day disaster medication reserves, health professionals interviewed supported 60- to 100-day dispensing units. Barriers included restrictive insurance benefits, patients’ resistance to mail order, and higher copay-ments. Physicians, pharmacists, and insurers also varied widely in their preparedness planning and collective mutual-aid plans, and most believed pharmacists had the primary responsibility for patients’ medication continuity during a disaster.ConclusionsTo strengthen prescription drug continuity in disasters, recommendations include the following: (1) creating flexible drug-dispensing policies to help patients build reserves, (2) training professionals to inform patients about disaster planning, and (3) building collaborative partnerships among system stakeholders. (Disaster Med Public Health Preparedness. 2013;7:257-265)
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Stipa, Giuseppe, Antonio Ancidoni, Monica Mazzola, et al. "Is Chronic Exposure to Raw Water a Possible Risk Factor for Amyotrophic Lateral Sclerosis? A Pilot Case-Control Study." Brain Sciences 11, no. 2 (2021): 193. http://dx.doi.org/10.3390/brainsci11020193.
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Background: The etiopathogenesis of amyotrophic lateral sclerosis (ALS) is still largely unknown. Methods: We performed a case-control study (33 cases and 35 controls) in Umbria, Italy. We investigated associations between common lifestyle, clinical factors, as well as environmental exposures potentially implicated with ALS onset. Face-to-face interviews were carried out. All cases were recruited and diagnosed according to El Escorial criteria. Case-control comparisons were made for educational and residential status, occupational exposures, and clinical and lifestyle factors prior to cases’ dates of diagnosis. Results: Our results showed an increased risk of ALS for subjects chronically exposed to raw water use (odds ratio (OR) = 6.55, 95% confidence interval (CI): 2.24–19.12). Garden activities showed a tight association with ALS as well, very likely as a consequence of chronic raw water exposure. Indeed, we could exclude an impact for pesticides, as no significant differences were observed in pesticide exposure in the two groups interviewed. However, cases were more often exposed to fertilizers. After adjustment for age, sex, and heavy physical activities, exposure to raw water was still associated with increased ALS risk (OR = 4.74, 95% CI: 1.33–16.85). Discussion: These findings suggest an association between ALS and exposure to raw water, which should be further investigated for the presence of chemicals interfering with nervous system functionality.
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Lemke, S., HH Vorster, NS Jansen van Rensburg, and J. Ziche. "Empowered women, social networks and the contribution of qualitative research: broadening our understanding of underlying causes for food and nutrition insecurity." Public Health Nutrition 6, no. 8 (2003): 759–64. http://dx.doi.org/10.1079/phn2003491.
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AbstractObjective:To investigate underlying causes for food and nutrition insecurity in black South African households and to gain understanding of the factors contributing to better nutrition security, with emphasis on household organisation, gender and intra-household dynamics and social networks.Design, setting and subjects:Within a larger cross-sectional survey that investigated the impact of urbanisation on the health of black South Africans, 166 people, mostly women, were interviewed on household food security. Methods used were structured face-to-face interviews, in-depth interviews, observation, interviews with key informants and a sociodemographic questionnaire. Information was collected from 1998 to 2000 in 15 rural and urban areas of the North West Province, South Africa.Results:Three-quarters of households in this sample are chronically food-insecure. Families are disrupted, due to migrant work, poverty and increasing societal violence, and half of households are female-headed. Certain categories of female-headed households and households based on partnership relationships, despite more limited resources, achieve a better or an equal economic status and better nutrition security than those households led by men, with the latter often being considered an economic liability. The reliance on and fostering of social ties and networks appear to be of central significance.Conclusion:Gender and intra-household relations, as well as social networks and income from informal sector activities, are often not uncovered by conventional statistical methods. Qualitative research can reveal the unexpected and furthermore empowers people, as their voices are heard.
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Jeuring, H. W., M. Huisman, H. C. Comijs, M. L. Stek, and A. T. F. Beekman. "The long-term outcome of subthreshold depression in later life." Psychological Medicine 46, no. 13 (2016): 2855–65. http://dx.doi.org/10.1017/s0033291716001549.
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BackgroundSubthreshold depression (SUBD) in later life is common and important as prodromal state and prominent risk factor in the development of major depressive disorder (MDD). Indicated prevention can reduce the incidence of MDD among people with SUBD substantially, but needs to be targeted to those that are truly at risk of developing MDD.MethodN = 341 eligible participants with SUBD were included from the first (1992/1993), second (1995/1996) and third (1998/1999) cycle from the Longitudinal Aging Study Amsterdam (LASA) by using a two-stage screening design. LASA is an ongoing prospective cohort study in The Netherlands among the older population (55–85 years). At baseline (1992/1993) N = 3107 participants were interviewed and follow-up cycles were conducted every 3 years until 2008/2009, resulting in maximal 17 years of observational period. The proportion of people that developed MDD, remained SUBD, or recovered from SUBD was measured and Cox proportional regression analyses were performed to investigate 29 putative predictors of MDD and recovery from SUBD.ResultsN = 153 (44.9%) recovered from SUBD, N = 138 (40.5%) remained chronically SUBD, and N = 50 (14.7%) developed MDD (incidence rate 15.1/1000 person-years). Women, high neuroticism, more chronic diseases, high body mass index, smoking and less social support predicted conversion to MDD. Men, low neuroticism and absence of pain predicted recovery from SUBD.ConclusionsAlthough older people with SUBD are clearly at risk of developing MDD, the majority did not, even after a long and thorough follow-up. Given the risk factors that were uncovered, targeting and prevention of MDD in those at very high risk is feasible.
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Acharya, Samita, and Katrina Butterworth. "Patient perspectives on health in chronic illness." Journal of Patan Academy of Health Sciences 5, no. 2 (2018): 35–40. http://dx.doi.org/10.3126/jpahs.v5i2.23989.
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Introductions: Medical students need to understand patients’ perspectives about illness and its impact on their lives and family, to evolve as truly socially accountable physicians. 
 Methods: Medical students were assigned in pairs to regularly visit a chronically sick patient over 6 months. They completed a portfolio exploring patient attitudes towards their illness, medication, concerns and beliefs. Themes were coded and portfolios were reviewed independently by two tutors and four students extracting data that matched the themes. New themes were added during the review. Data was later compiled and discussed by the team to refine key themes and portfolios were again reviewed to check for frequency.
 Results: Fifty-eight students interviewed twenty-nine patients with a variety of chronic conditions. Areas identified included the important role of family and community. A major concern of 18/29 (62%) patients was the impact on the family emotionally, socially and financially of their illness. Other concerns were loneliness (5/29), uncertainty about the illness and deteriorating function. Spiritual issues were important, together with prayer. Some patients (7/29) viewed their illness as a punishment or curse and wanted to die. Other patients believed their illness was due to diet, physical or emotional stress, contagion or exposure to environmental factors. Two believed the oxygen for their COPD was addictive, so restricted its use.
 Conclusions: As part of providing patient-centered care in the context of Nepal it is important to explore the level of family and community support available to the patient as well as the current impact on the family.
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Sun, Amy Y., Emily Finkelstein, and Karin Ouchida. "SOCIAL ISOLATION, LONELINESS, AND CAREGIVER BURDEN AMONG PAID AND UNPAID CAREGIVERS OF HOMEBOUND OLDER ADULTS." Innovation in Aging 3, Supplement_1 (2019): S967. http://dx.doi.org/10.1093/geroni/igz038.3505.
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Abstract Caregivers of homebound older adults may have high levels of burden and more vulnerability to social isolation and loneliness, given that their care recipients are more physically frail and isolated. Existing literature has not fully investigated differences between paid and unpaid caregiver burden or their experiences of social isolation. We interviewed paid (n=21) and unpaid family caregivers (n=22) of homebound older adults in a hospital-affiliated geriatric house call program. We used validated survey instruments to measure social isolation, loneliness, and caregiver burden, and semi-structured interviews to solicit qualitative data. In our sample, 42% of caregivers helped with 5+ ADLs and 58% with 5+ iADLs. Using the Caregiver Burden Inventory, burden types between caregivers were compared with chi-squared tests. Compared to paid caregivers, unpaid family caregivers experienced more “developmental” burden such as “missing out on life” (p&lt;0.01). Paid caregivers exhibited more “time” burden, such as “not having a minute’s break from caregiving responsibilities” (p&lt;0.01). 44% of caregivers were considered socially isolated according to the Berkman-Syme Social Index. However, using the UCLA 3-item Loneliness Scale, few caregivers felt lonely (14%). Thematic analysis revealed that family caregivers desired support groups but time pressures limited their participation (23%). Interestingly, smart phones were regularly cited as a tool for alleviating loneliness for paid caregivers when alone on the job (19%), a novel finding. Findings suggest that caregivers of the chronically ill and physically isolated may be at particular risk of social isolation. Network based social support interventions may mitigate some of these vulnerabilities.
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Stewart, J. A., V. H. Ilkka, J. J. Jokinen, et al. "Long-Term Survival and Quality of Life After Hypothermic Circulatory Arrest in Aortic Surgery." Scandinavian Journal of Surgery 107, no. 4 (2018): 322–28. http://dx.doi.org/10.1177/1457496918766719.
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Background and Aims: Hypothermic circulatory arrest carries a high risk of mortality and neurological complications. An important part of assessing surgical treatment is the evaluation of long-term survival and postoperative health-related quality of life. Material and Methods: In this prospective study, 30 patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta, and 31 comparison patients undergoing elective coronary artery surgery without hypothermic circulatory arrest were evaluated for long-term survival and health-related quality of life, using the RAND 36-Item Health Survey questionnaire. The results were compared to national age- and sex-matched reference populations of the chronically ill and healthy adults. Results: After 4.6–8.0 years, available study (88%) and comparison (59%) patients were interviewed. The life expectancy was similar with 4- and 8-year survival of 90%, and 87% for the study group, and 94%, and 94% for the comparison group, respectively (log rank test, p = 0.62). The RAND-36 scores for study and comparison groups were congruent in all dimensions, describing physical, mental, and social domains. The study patients’ health-related quality of life results were similar to the national reference population with chronic illnesses. Conclusion: After hypothermic circulatory arrest, patients undergoing surgery of the thoracic aorta achieve a similar long-term life expectancy and health-related quality of life as do patients undergoing coronary surgery without hypothermic circulatory arrest, and a health-related quality of life similar to the national reference population with chronic illnesses. These results justify operative treatment in this high-risk patient population.
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Gonyea, Judith, and Kelly Melekis. "What Does It Mean to Age in Place as an Older Homeless Woman? Facing an Altered Sense of Place, Belonging, and Identity." Innovation in Aging 4, Supplement_1 (2020): 52–53. http://dx.doi.org/10.1093/geroni/igaa057.171.
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Abstract The emergence of “aging in place” as social policy in the U.S and globally reflects a deepening understanding that a home is more than a physical domicile, it also represents a source of personal and social identity and offers one a sense of place and belonging. In this qualitative study we explore the question, What does “aging in place” mean to older homeless women navigating the shelter system and streets? Using a phenomenological approach, we conducted semi-structured interviews with fifteen chronically homeless women in their fifties using the shelter system. Our analysis process was inductive and iterative with the culminating phases being the generation and interpretation of themes. Our analysis revealed the links between place, sense of belonging, and identity. To be displaced from a physical home can present challenges to defining one’s very existence. Specific themes emerging from the women’s narratives included the ways in which shelter and street life impacted their sense of personal control, privacy, security, health, and comfort as well as underscored that shelters are dehumanizing places that further diminish one’s sense of self and self-worth. The interviewed women sought to construct a positive sense of self through speaking about their past, present, and future roles as well as identities gained through social relations and place identity connections. Based on the findings, we suggest strategies by which shelters might better respond to unique needs of older women, including adopting ways that do not further disempower or stigmatize them but rather promote pathways out of homelessness.
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NasrEldin, Eman, Safaa A. A. Khaled, Nada O. Abdelhameed, et al. "Genotyping versus phenotyping of non-ABO erythrocyte antigens in patients with the Mediterranean hemopathic syndromes: Effect of transfusion therapy." PLOS ONE 16, no. 7 (2021): e0251576. http://dx.doi.org/10.1371/journal.pone.0251576.
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The Mediterranean hemopathic syndromes (MHS) are the most prevalent hemoglobinopathies in the Mediterranean basin. Transfusion therapy is the main therapy for these disorders, particularly for severe forms of the disease. Currently, pre-transfusion serological typing of erythrocyte antigens is the standard tool for reducing complications of transfusion in those patients. This study compared genotyping with phenotyping of non-ABO erythrocyte antigens in patients with MHS and assessed the effect of transfusion therapy on their results. One-hundred ninety-eight MHS patients were recruited, screened, and proven negative for allo-antibodies. They were grouped into two groups: (1) 20 newly diagnosed patients with no transfusion history and (2) 178 previously diagnosed patients undergoing transfusion therapy. Patients were interviewed and clinically examined. Full blood count (FBC) and high performance liquid chromatography (HPLC) were done for group 1 only. Genotyping and phenotyping of non-ABO erythrocyte antigens were performed for group 1, and 25 patients out of group 2 were propensity score-matched (PSM) with group 1. Both groups were gender and age matched; 55% and 74% of groups 1 and 2 had major disease, respectively. Insignificant differences were observed between genotyping and phenotyping of non-ABO erythrocyte antigens in group 1, while significant discrepancies and mixed field results were noted in group 2 patients. Discrepancies were obvious with JKa, JKb, and little c antigens. Conclusively, molecular typing is a powerful tool for pre-transfusion testing in chronically transfused MHS patients. This testing reduces incidence of transfusion reactions. JKa, JKb and little c antigens are the most clinically significant non-ABO erythrocyte antigens.
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BREMER, V., N. BOCTER, S. REHMET, G. KLEIN, T. BREUER, and A. AMMON. "Consumption, Knowledge, and Handling of Raw Meat: A Representative Cross-Sectional Survey in Germany, March 2001." Journal of Food Protection 68, no. 4 (2005): 785–89. http://dx.doi.org/10.4315/0362-028x-68.4.785.
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Outbreaks of gastroenteritis have been repeatedly associated with the consumption of raw meat and raw meat products. To assess the potential of this problem in Germany, frequency of consumption and knowledge about and handling of raw meat during food preparation in the German population was estimated. We conducted a population-based nationwide cross-sectional survey in private households in March 2001 by random telephone numbers. Consenting German-speaking persons were randomly chosen among household members for standardized interviews. Proportions were standardized by age, sex, and region (eastern and western Germany). A total of 510 people were interviewed (response 45.1%), including 62.3% women and 31.8% considered at high risk (children younger than 10 years old, elderly more than 65 years old, and chronically ill persons). The mean age was 45.7 years. Of those who ate raw ground meat at least once a week, 17.8% lived in eastern Germany and 5.1% in western Germany, (chi-square test, P &lt; 0.001). Teewurst was eaten by 50.8% of all respondents and 53.8% of respondents in the high-risk group. That salami or Teewurst were raw meat products was known to 58.1 and 36.3% of the respondents, respectively. Respondents reported not washing their hands (46.6%) or cleaning their cutting boards with soap (48.1%) after preparing raw meat. A total of 10.3% of the respondents had diarrhea during the last 3 months. Although knowledge is poor, consumption of raw meat products is widespread in Germany, even among high-risk persons. More information is necessary on which products contain raw meat, the potential risk of diarrhea after raw meat products are consumed, and appropriate handling of raw meat products.
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Weber, Magda Blessmann, Daniel Lorenzini, Clarissa Prieto Herman Reinehr, and Bárbara Lovato. "Assessment of the quality of life of pediatric patients at a center of excellence in dermatology in southern Brazil." Anais Brasileiros de Dermatologia 87, no. 5 (2012): 697–702. http://dx.doi.org/10.1590/s0365-05962012000500004.
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BACKGROUND: Skin diseases cause negative impact on the emotional state, social relationships and daily activities, due to the stigma caused by the appearance of the lesions. OBJECTIVE: This study aimed to assess the quality of life of pediatric patients with skin diseases attending a dermatology service, compare the scores obtained among the dermatoses found in the sample and associate them to the variables, in addition to observing how the skin disease specifically affects quality of life. METHODS: Cross-sectional study, with patients between 5 and 16 years attending the Dermatology Service of the University of Health Sciences of Porto Alegre, Brazil, between July 2010 and February 2011. The data collection instruments were the Children's Dermatology Life Quality Index questionnaire and the AUEQI questionnaire. RESULTS: A total of 161 patients were interviewed, with mean age of 9,66 years. The main dermatoses were atopic dermatitis (29.8%), warts (13%) and molluscum contagiosum (7.5%). Chronic diseases (73.9%) were the most prevalent. The overall mean Children's Dermatology Life Quality Index score was 5.01 for chronic dermatoses and 2.07 for acute illnesses, indicating a compromised quality of life among chronically ill patients. The comparison between the scores obtained with the AUEQI scale and the Children's Dermatology Life Quality Index scores indicates that the overall quality of life is less affected than the specific quality of life related to the dermatosis. CONCLUSIONS: The data presented reinforce how important it is that the patients, their families and caregivers understand the symptoms, triggers and treatment of the skin disease in question. This information facilitates adherence to the treatment and justifies the conduct adopted by the dermatologist.
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Weaver, Raven H., and Cory Bolkan. "IMPLEMENTATION CHALLENGES AND OPPORTUNITIES IN A COMMUNITY-BASED TRANSITIONAL CARE SERVICES PROGRAM." Innovation in Aging 3, Supplement_1 (2019): S501. http://dx.doi.org/10.1093/geroni/igz038.1855.
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Abstract High-risk older adults (i.e., low-income, chronically ill) often have complex, costly healthcare needs and are at risk of re-hospitalization. Hospitals traditionally lead efforts to reduce readmissions, while community-based aging services organizations (e.g., Area Agency on Aging AAA) offer older adults in-home health, social support, and information/referral to community resources. Thus, creating, sustaining, and scaling up hospital-community partnerships can better meet older adults’ comprehensive needs. We evaluated efforts of a hospital-AAA project to develop and implement a local transitional care services program (TCSP) that provided in-home/phone support post-discharge for high-needs older adults. Over a four-year period, 1,921 individuals (mean= 75 years; 57% women) were referred from hospital as eligible for TCSP. After referral, however, only 22.8% were successfully connected to community-based services and men were more likely than women to complete TCSP (Χ2= 6.92; p= .009). Of those referred, only 4% were re-hospitalized, indicating potential success of TCSP. Data revealed most were unable to be contacted (27.9%), refused the program (21.6%) or utilized alternative services, including SNFs (20.3%); inconsistent data collection and procedures yielded problematic missing data and inability to assess reasons for low engagement. We also surveyed and interviewed AAA staff (n=16) and found most staff exhibited high readiness for evidence-informed practices, supported proactive data use to improve planning, advocating, and serving clients, and identified significance of multidisciplinary community partnerships. Our findings generated recommendations to enhance staff engagement in TCSP, improve data collection for transforming data utility beyond enrollment purposes, and consider programmatic modifications to reach vulnerable elders.
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Ryan, C., and I. Hynd. "511 DO ORAL NUTRITIONAL SUPPLEMENTS IMPROVE QUALITY OF LIFE IN THE FRAIL ELDERLY- A SYSTEMATIC REVIEW." Age and Ageing 50, Supplement_2 (2021): ii14—ii18. http://dx.doi.org/10.1093/ageing/afab119.12.
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Abstract Background Oral nutritional supplements (ONS) are regularly used in older frail adults to help reduced oral intake, recovery from acute illness and weight gain. As, many frailer patients have limited life expectancies the priority for treatment should be improving quality of life (QoL). We set out to find if ONS increase QoL in the frail elderly adult. Method We searched Embase, Medline and OVID databases for using terms for ONS, frail older adults and QoL. The two authors independently reviewed all papers with any dispute was resolved by discussion. Each paper was then reviewed by both authors to extract data and determine bias before collation. Results The search returned 516 papers. Each paper was briefly reviewed to check for relevance leaving 65 papers for detailed review of which 8 papers were included. Two systematic reviews were included. One was unable to draw conclusions from the 3 papers (out of 17) that included QoL as the graded evidence was too poor. The other showed no impact on QoL (in the 2 out of 12 papers that included QoL) in patients post hip fracture receiving ONS. One paper interviewed frail elderly patients about the perceived benefits of their ONS. Nursing home residents perceived that ONS improved their ability to see family which was inferred as improving QoL. Three papers assessed ONS in conjunction with physical exercise. Two showed an improvement in quality of life in the ONS group despite controls also receiving a physical exercise programme. Two papers assessed the impact of ONS on patients discharged from hospital and those chronically unwell- neither showed any difference in QoL. Discussion Quality of life has been a neglected area of study when assessing the impact of ONS on frail elderly patients. When used in conjunction with physical exercise it seems to have a positive effect.
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Anonymous. "Researchers Interview and Study Chronically Homeless Older Men." Journal of Psychosocial Nursing and Mental Health Services 32, no. 4 (1994): 45. http://dx.doi.org/10.3928/0279-3695-19940401-18.
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Lehman, Anthony F. "A quality of life interview for the chronically mentally ill." Evaluation and Program Planning 11, no. 1 (1988): 51–62. http://dx.doi.org/10.1016/0149-7189(88)90033-x.
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Treadwell, Marsha, Jennifer Sung, Eileen Murray, et al. "Barriers to Deferoxamine Adherence for Adults with Sickle Cell Disease." Blood 104, no. 11 (2004): 3760. http://dx.doi.org/10.1182/blood.v104.11.3760.3760.
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Abstract Background: The barriers to adherence with chelation therapy for chronically transfused and iron overloaded patients with sickle cell disease (SCD) have been described only anecdotally. Objectives: To describe barriers to home deferoxamine (DFO) administration adherence among adults with SCD. It was hypothesized that barriers would include limited patient education on the importance of chelation and perceived aversiveness of the regimen. Methods: Medical records were reviewed for 189 adult patients seen at a comprehensive sickle cell center. Patients with transfusion induced hemosiderosis, defined as a serum ferritin ≥ 1500 ng/ml, were administered a four item interview asking if iron overload had ever been discussed with them; if they had been informed they were iron over loaded; if chelation therapy had been offered; and if not currently home chelating, why not. Patients not interviewed were deceased (3); unavailable (10); or declined (3). A study coordinator who did not provide clinical care conducted the interviews. Results: 54 of the 189 patients (29%) had a history of intermittent or chronic transfusion, or pheresis. 45 of these patients were iron overloaded. 29 of these patients agreed to complete the interview; 22 (76%) were female. Average age was 41.5 years (range 22.4 – 58.4 years) and average serum ferritin was 4240.8 (range 1547 – 9420). 23 of the 29 patients (79%) reported that their physician or nurse had discussed iron overload and chelation with them. 16 of these (55%) reported that they were currently receiving home DFO therapy. Reasons given for not administering home DFO included: Reason Number (%) “Don’t want to stick self” 3 (23) No longer being transfused or being exchanged 3 (23) Awaiting clinical trial for oral chelator 2 (15) Home situation too complex 2 (15) Don’t want to (no further explanation) 2 (15) Too many adverse effects 1 (8) Discussion: Life threatening levels of iron overload were observed in intermittently transfused adult sickle cell patients. Contrary to expectations, iron overload and its treatment had been discussed with most patients. However, just over half were currently chelating at home. Toxicity of DFO and misunderstanding that iron overload is no longer a problem if chronic transfusion therapy stops are the most common reasons for non-compliance. Repeated patient counseling are essential in order to prevent progressive iron toxicity in sickle cell disease. Reason Number (%) “Don’t want to stick self” 3 (23) No longer being transfused or being exchanged 3 (23) Awaiting clinical trial for oral chelator 2 (15) Home situation too complex 2 (15) Don’t want to (no further explanation) 2 (15) Too many adverse effects 1 (8)
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Abd-Almahdi, Ali Hamid, and Zuhair B. Kamal. "Association between gallbladder diseases and Helicobacter pylori infection." AL-Kindy College Medical Journal 16, no. 2 (2020): 30–34. http://dx.doi.org/10.47723/kcmj.v16i2.263.
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Background: Helicobacter pylorus is one of the most harmful human pathogens & carcinogen. Of the world's population, more than 50% has H. pylori in their upper gastrointestinal tracts. It has been linked to a variety of extra gastric disorders. In correlation to hepatobiliary diseases; recently, the bacterium has been implicated as a risk factor for various diseases ranging from chronic cholecystitis and primary biliary sclerosing cholangitis to gall bladder cancer and primary hepatic carcinomas. However, the association between Helicobacter pylori (H. pylori) and gallbladder diseases is still vague and is controversial.
 Aim of study: To elucidate the association of H pylori and gallbladder diseases (calculus, acalculous, polyp), the feasibility of using rapid urease test in post-operative diagnosis, and many factors related bacterium.
 Subjects & methods: This case series study was conducted in Al-Kindy Teaching hospital - surgical unit during a period extended for 2 years from September 2016 to September 2018, where patients suffered from signs and symptoms of gallbladder disease were interviewed using a predesigned questionnaire including age, gender, occupation, residency and whether the drinking water was safe (purified) or not. Physical examination was done including weight status, BMI was calculated (BMI=wt. (kg)/ height (M) [2]. Provisional diagnosis of gallbladder disease was confirmed by examination, necessary laboratory investigations (Hematology, Biochemistry, and radiology).
 Cholecystectomy was done by using Laparoscopic cholecystectomy or open surgery.
 The presence of H.pylori in the mucosa of excised gallbladder was studied by using:
 1) Rapid urease kit (HNAN C., LTD)
 2) Histopathology & chemical analysis of associated gallstone
 Results: Seventy-eight patients undergoing cholecystectomy for symptomatic gallbladder disease, the gallbladder mucosa of 30 patients were tested positive for H. pylori with any one of the tests used in this study. The rapid urease test was sensitive 57.1% and specific 58.3 % of the cholecystectomies performed in our study. The mean age of studied patients was (34 ± 4 years). Females constitute 73.1% (57 out of the total 78 of patients). Of the studied cases; 26 patients (33.3%) were obese. Employee patients constitute 43 (55.1%) of patients, and 53 patients (67.9%) lived in urban areas. Purified water consumed by 61 (78.2%) of the studied population.
 Gallstones were detected in 56 (71.8%) of studied cases, acalculus chronically inflamed gallbladder was found in 20 (25.64%), and 2 cases (2.56%). were found to have gallbladder polyp. pylori infection was diagnosed in 30 (38.5%) of total cases (of the 56 calculus confirmed cases 48.2% were H.pylori positive, and of the 22 acalculus cases 13.6% H.pylori positive).
 Conclusion:
 Significant association is found between chronic calculus cholecystitis and H.pylori infection. While no significant association was found in correlation with acalculus cholecystitis and other gallbladder pathology. In regard to feasibility of using urease kit test, it is found that this test is sensitive 57.1%, and specific 58.3%, as such it is less accurate than histopathology study. Significant correlation was found between age, gender, weight status, and non-purified water source with H.pylori infection..
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Marcussen, Michael, Signe Beck Titlestad, Kim Lee, Niels Bentzen, Jens Søndergaard, and Birgitte Nørgaard. "General practitioners’ perceptions of treatment of chronically ill patients managed in general practice: An interview study." European Journal of General Practice 27, no. 1 (2021): 103–10. http://dx.doi.org/10.1080/13814788.2021.1932810.
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Wood, Frank H. "Media Review: The Adolescent Interpretive Interview, the Educational Physical Examination for the Physically Disabled/Chronically III Young Adolescent." Exceptional Children 55, no. 5 (1989): 466. http://dx.doi.org/10.1177/001440298905500514.
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Grossarth-Maticek, R., H. J. Eysenck, and G. J. Boyle. "Alcohol Consumption and Health: Synergistic Interaction with Personality." Psychological Reports 77, no. 2 (1995): 675–87. http://dx.doi.org/10.2466/pr0.1995.77.2.675.
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In this study, 6,386 males and 5,990 females, with a mean age of 55 years, constituting a random sample, were administered questionnaires by interviewers relating to amount of self-regulation and drinking status. They were then followed up over a 20-yr. period, and health status (living well, chronically ill, or deceased) was ascertained. It was hypothesized that the deleterious effect of alcohol would be worse for those low on self-regulation; that health status would be worse for those in whom drinking diminished self-regulation, as compared with those for whom drinking improved self-regulation; and that smoking would have greater effects in lowering health status in those in whom drinking diminished self-regulation than in those in whom drinking improved self-regulation. All predictions were borne out by the data at high statistical significance. The results confirmed findings from an earlier study to the effect that psychological factors like self-regulation powerfully influence the kind of effects drinking has with respect to health.
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Vennedey, Vera, Kira Isabel Hower, Hendrik Hillen, Lena Ansmann, Ludwig Kuntz, and Stephanie Stock. "Patients’ perspectives of facilitators and barriers to patient-centred care: insights from qualitative patient interviews." BMJ Open 10, no. 5 (2020): e033449. http://dx.doi.org/10.1136/bmjopen-2019-033449.
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ObjectivesPrevious studies on patient-centred care (PCC) and its facilitators and barriers usually considered specific patient groups, healthcare settings and aspects of PCC or focused on expert perspectives. The objective of this study was to analyse patients’ perspectives of facilitators and barriers towards implementing PCC.DesignWe conducted semistructured individual interviews with chronically ill patients. The interviewees were encouraged to share positive and negative experiences of care and the related facilitators and barriers in all settings including preventive, acute and chronic health issues. Interview data were analysed based on the concept of content analysis.SettingInterviews took place at the University Hospital Cologne, nursing homes, at participants’ homes or by telephone.ParticipantsAny person with at least one chronic illness living in the region of Cologne was eligible for participation. 25 persons with an average age of 60 years participated in the interviews. The participants suffered from various chronic conditions including mental health problems, oncological, metabolic, neurological diseases, but also shared experiences related to acute health issues.ResultsParticipants described facilitators and barriers of PCC on the microlevel (eg, patient–provider interaction), mesolevel (eg, health and social care organisation, HSCO) and macrolevel (eg, laws, financing). In addition to previous concepts, interviewees illustrated the importance of being an active patient by taking individual responsibility for health. Interviewees considered functioning teams and healthy staff members a facilitator of PCC as this can compensate stressful situations or lack of staff to some degree. A lack of transparency in financing and reimbursement was identified as barrier to PCC.ConclusionIndividual providers and HSCOs can address many facilitators and barriers of PCC as perceived by patients. Large-scale changes such as reduction of administrative barriers, the expansion of care networks or higher mandatory nurse to patient ratios require political action and incentives.Trial registration numberDRKS00011925
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Hafkenscheid, A. "The “appropriate” conditions for establishing interrater reliability of interview-based rating scales. A controversial issue." European Psychiatry 9, no. 3 (1994): 149–50. http://dx.doi.org/10.1017/s0924933800001140.
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For many of the conditions with which psychiatry is concerned, there is still no anatomical or physiological abnormality that is reliably found in those affected with the conditions and not in other people. Some evidence exists that, for instance, severe and chronical psychopathological symptoms such as persistent auditory hallucinations, may be linked to structural brain abnormalities in certain subgroups of schizophrenic patients. However, such associations are not well-established as yet and the research in this field does not have practical implications for psychiatric assessment so far.Because objective (physical) indices for measuring (the severity of) psychopathological states have hardly been available up to now, the rating scale is an essential instrument in clinical (psychopharmacological) research.
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Fortes, Tatiana Roccato, Isabel Altenfelder Santos Bordin, and Norma Lottenberg Semer. "Toronto Alexithymia Scale: Adaptation of the Brazilian Version to Low-Educated Adults." Paidéia (Ribeirão Preto) 27, no. 67 (2017): 100–109. http://dx.doi.org/10.1590/1982-43272767201712.
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Abstract: For the purpose of studying Alexithymia in low-educated adults, we intend to adapt the Brazilian version of the Toronto Alexithymia Scale (TAS-26) and to verify its internal consistency. With that aim, we translated the original TAS-26 (English) to Portuguese, adopting a colloquial language, without content distortion. An exploratory qualitative study interviewed 50 women (38-65 years, education <9 years) and identified comprehension difficulties in 22 items, that needed adaptation. A professional translator performed the back-translation of the adapted TAS-26, that was applied to a new sample of women (90 with chronical pain and 90 without pain, 38-65 years, education <9 years) to evaluate its internal consistency. Only four items (1/2/3/16) of the pre-existing Brazilian version (appropriate to university students) did not require modification. The internal consistency (Cronbach’s alpha) was satisfactory for total score (0.65) and elevated for factor 1 (0.87). The adapted Brazilian version of TAS-26 is appropriate to low-educated adults.
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Pass, Lauren Elizabeth, Korey Kennelty, and Barry L. Carter. "Self-identified barriers to rural mental health services in Iowa by older adults with multiple comorbidities: qualitative interview study." BMJ Open 9, no. 11 (2019): e029976. http://dx.doi.org/10.1136/bmjopen-2019-029976.
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ObjectivesIndividuals in rural areas face critical health disparities, including limited access to mental healthcare services and elevated burden of chronic illnesses. While disease outcomes are often worse in individuals who have both physical and mental comorbidities, few studies have examined rural, chronically-ill older adults’ experiences accessing mental health services. The aim of the study was to determine barriers to finding, receiving and adhering to mental health treatments in this population to inform future interventions delivering services.DesignWe conducted a qualitative study of barriers and facilitators to mental healthcare access. 19 interviews were analysed deductively for barriers using a modified version of Penchansky and Thomas’s theory of access as an analytical framework.SettingThis study was conducted remotely using telephonic interviews. Patients were located in various rural Iowa towns and cities.Participants15 rural Iowan older adults with multiple physical comorbidities as well as anxiety and/or depression.ResultsWe found that while patients in this study often felt that their mental health was important to address, they experienced multiple, but overlapping, barriers to services that delayed care or broke their continuity of receiving care, including limited knowledge of extant services and how to find them, difficulties obtaining referrals and unsatisfactory relationships with mental health service providers.ConclusionsOur findings indicate that intervention across multiple domains of access is necessary for successful long-term management of mental health disorders for patients with multiple chronic comorbidities in Iowa.
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Basha, Elyas Admasu, Behailu Tariku Derseh, Yohannes Gebre Egziabher Haile, and Gedion Tafere. "Factors Affecting Psychological Distress among People Living with HIV/AIDS at Selected Hospitals of North Shewa Zone, Amhara Region, Ethiopia." AIDS Research and Treatment 2019 (July 22, 2019): 1–8. http://dx.doi.org/10.1155/2019/8329483.
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Background. The new advances for the treatment of HIV infection using Highly Active Antiretroviral Therapy (HAART) have dramatically improved disease prognosis. However, they are living longer with a chronic condition that increases the risk for psychiatric and psychosocial problems. Various studies have linked HIV/AIDS with a number of psychological problems, depression being the most common. Moreover, studies have found that chronically ill people are at increased risk of psychological problems. Thus, this study aimed at assessing the level of psychological distress and its associated factors among people living with HIV/AIDS in selected Hospitals of North Sowa Zone of Amhara region, Ethiopia, 2017. Method. Institution based cross-sectional study design with systematic random sampling method was used. Data was collected by structured interviewer-based Amharic version questionnaire. A total of 422 people living with HIV/AIDS were involved in the study from 1 to 30 May 2017. Data analysis was done with the help of a computer program (SPSS version 16.0). Binary logistic regression analysis was used for bivariate and multivariate analysis. The strength of the association was presented by odds ratio with a 95% confidence interval. Result. The prevalence of psychological distress was 7.8% (95% CI: 5.25%, 10.39%). Being female (AOR = 3.02; 95% CI: 1.16, 7.82), illiterates (AOR = 3.91; 95% CI: 1.31, 6.45), participants who currently use alcohol (AOR = 2.70; 95% CI: 1.23, 5.88), respondents whose CD4 count is less than 500 cells/μl (AOR = 2.28; 95% CI: 1.02, 5.11), and participants who are considered stigmatized (AOR = 2.41; 95% CI: 1.11, 5.22) were positively associated with psychological distress. Conclusion. The prevalence of psychological distress was low as compared to other studies conducted in Ethiopia. This may affect the quality of life of people living with HIV/AIDS and their families. Being female, illiteracy, alcohol use, and having lower CD4 count and perceived stigma increased the odds of psychological distress. Thus, concerned stakeholders should collaborate on the integration of HIV/AIDs treatment and mental health services.
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Rafferty, Katherine A., Stephanie Nemmers-Bello, Sydney Tietz, and Melissa Lipovac. "Mothers’ Support Preferences With Their Chronically Ill Child’s Health Care Team." Western Journal of Nursing Research, July 8, 2021, 019394592110303. http://dx.doi.org/10.1177/01939459211030338.
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Children living with medical complexities are a growing population in the United States. Supportive pediatric health care team members are arguably the single most important factor in helping mothers manage their child’s multifaceted condition. To better understand what constitutes helpful support from health care team members, we interviewed 17 mothers affiliated with a pediatric palliative care program at a large Midwestern U.S. hospital. Using Charmaz’s approach to grounded theory analysis, we found that mothers desired a collaborative partnership with their child’s health care team. However, the development of this partnership was contingent upon team members’ effective use of informational, emotional, and network support. We identified two specific strategies that qualified each of these three different types of helpful supportive communication. These strategies may be implemented into training and educational programs for health care professionals to improve their communication skills.
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Frahsa, A., R. Farquet, and T. Abel. "The co-design approach in the MIWOCA project." European Journal of Public Health 29, Supplement_4 (2019). http://dx.doi.org/10.1093/eurpub/ckz185.763.
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Abstract MIWOCA study group Background The project MIWOCA researches how chronically ill women of Portuguese, Turkish and German origin and women without a migration background subjectively experience, understand, interpret and use the Swiss health care system. Methods We conducted 48 qualitative semi-structured interviews with chronically ill women between the ages of 23 and 85 in Bern and Geneva (n = 36 with German, Portuguese and Turkish migrant backgrounds) and n = 12 Swiss women. In addition, n = 12 stakeholder interviews were conducted (doctors, nurses, social workers, psychologists, physiotherapists). In focus groups with interviewed women in Bern and Geneva, results are reflected back, identified topics from the interviews prioritized and representatives named for the cooperative planning. In a participatory planning approach, affected women in the canton of Bern, together with stakeholders from the Swiss healthcare system selected by a systematic stakeholder analysis (e.g. Swiss Medical Association, Red Cross Switzerland, Spitex, Federal Office of Public Health), develop recommendations for improving the quality of care and concrete dissemination strategies. Results Interviewees had multiple and chronic diseases and resulting extensive experience with the Swiss healthcare system. Relevant aspects referred to issues such as quality of specific services, complexity of the healthcare system, costs of care, role of family and social support, and multidimensional stigmatization (migration, chronic illness, alleged overuse of the care system). Findings are incorporated in evidence briefs and narrative stories for focus groups and participatory planning. Conclusions MIWOCA contributes to a targeted and differentiated improvement of structures and options for action in health care for specific groups. Results will be relevant for planning in the health system and may be incorporated into academic teaching and practical training in PH, medicine and social sciences.
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Mondal, Md Sanaul Haque. "Factors of Influence on Evacuation Behaviour: Survey Results from the Riverine Floodplain Communities in Bangladesh." Quaestiones Geographicae, September 2, 2021. http://dx.doi.org/10.2478/quageo-2021-0025.
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Abstract River floods are distinct because not all of them are destructive and typically affect the people who are living in riverine areas. Therefore, people often refuse to evacuate even when they face imminent danger. River floods are a recurrent phenomenon in Bangladesh. This research aims to analyse the flood evacuation behaviour of riverine people in Bangladesh. A total of 377 households were selected for the questionnaire survey and were interviewed from April 2019 to May 2019. Bivariate and multivariate statistics were employed to analyse riverine people's evacuation behaviour based on their socio-demographic and economic characteristics. This study found that although 82% of the households had received flood warning messages, only 40% had evacuated. Results from multivariate analysis suggested that the age of household heads, their education, whether they are disabled/chronically ill members, their income, the height of floodwater inside the house, and the type of warning messages they receive appear to be key determinants that influenced their decisions regarding evacuation. Elderly household heads had a lower likelihood to evacuate. The results showed a negative association between early warning messages and evacuation. Household with disabled/chronically ill member(s) was associated with a higher likelihood of evacuation. Similarly, higher water depth in the home was associated with evacuation. These findings will be helpful for policymakers to enhance awareness of riverine households.
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Schönenberg, Aline, Ulrike Teschner, and Tino Prell. "Expectations and behaviour of older adults with neurological disorders regarding general practitioner consultations: an observational study." BMC Geriatrics 21, no. 1 (2021). http://dx.doi.org/10.1186/s12877-021-02469-3.
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Abstract Background Patients’ relationship with their GPs is linked to adherence, patient behaviour and satisfaction with healthcare. Several factors pertaining to this relationship have already been identified, however expectations and preferences vary depending on age and diagnosis. Chronically ill elderly patients constitute a group of patients with specific needs that are not yet understood. Methods For this observational study, 100 (44 female, mean age 72.72 + − 8.28 years) patients were interviewed. Multiple linear or binary logistic regression as well as analysis of variance was used to understand the link between factors pertaining to GP relationship and patient behaviour, and principal component analysis was performed to understand the underlying structure of patients’ needs. Results Patients attribute high importance to their GP’s opinion of them. On average, what the GP thinks about the patients is almost as important as what their partners think. Patients primarily want to be perceived as engaged, friendly and respected individuals, and it is important for patients to be liked by their GP. This importance is linked to active preparation; 65% of the patients prepared actively for GP consultations. Expectations regarding GP consultations can be split into two components: a medical aspect with a subfactor concerning emotional support, and a social component. Prominent factors influencing the relationship are the possibility to talk about emotions and mental well-being, trust, and GP competency. Satisfaction and trust were mainly linked to medical competency. Being able to show emotions or talk about mental well-being enhances perceived GP competence, satisfaction, and active patient preparation. However, a focus on the social component such as frequent talking about private topics reduces both perceived GP competency as well as active patient preparation. Conclusion Older patients take GP consultations seriously, and their expectations regarding GP consultations focus on medical competence and care as well as empathetic listening and understanding. Older persons seek a deeper connection to their GPs and are willing to be active and cooperative. As the patient–GP relationship influences health outcomes, treatment of older patients should be adjusted to enable this active participation.
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Varsi, Cecilie, Aud-Eldrid Stenehjem, Elin Børøsund, and Lise Solberg Nes. "Video as an alternative to in-person consultations in outpatient renal transplant recipient follow-up: a qualitative study." BMC Nephrology 22, no. 1 (2021). http://dx.doi.org/10.1186/s12882-021-02284-3.
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Abstract Background Renal transplant recipients have to see a nephrologist for regular follow-up for the rest of their lives. To reduce the burden for the patients, video consultation can be an alternative to traditional in-person hospital consultations. The aim of the current study was, from the perspectives of patients and health care providers, to investigate the perceived benefits and challenges of using video consultations in outpatient renal transplant recipient follow-up. Methods Patients (i.e., renal transplant recipients; n = 18) alternated between regular in-person follow-up consultations and video consultations. Patients and health care providers were then invited to participate in semi-structured interviews. The interviews were analyzed using thematic analysis. Results Patients interviewed (n = 15) were median 53 years old (range 37–64) and 53% female. The video consultation solution used in the study turned out to have major technical deficiencies. Despite the technical challenges, however, the majority of the patients reported appreciating being able to alternate between video and in-person hospital consultations. Main benefits reported included not needing to travel to the hospital and thereby saving time, less focus on being chronically ill and potential economic benefits for patients and society. The health care providers (n = 3) also valued the benefits provided by the use of video consultations, but described the reoccurring technical challenges as disruptive. The fact that patients were in a stable phase of their health condition and already had an established, trusting relationship with their nephrologist, acted as facilitators for success. Possible challenges and harms described included concerns related to security, confidentiality and interruptions, as well as the potential need for physical examinations. Conclusions Benefits from using video consultations as an alternative to in-person consultations may outweigh potential technological challenges for patients as well as health care providers. A long-lasting mutually trusting relationship between patient and provider may be an important prerequisite for the experienced benefits of using video consultation. Findings also indicate that starting such care delivery changes in a small-scale, with a few selected patients in a stable phase of their condition, may be an important factor for success.