The relationship between post-trauma problem reporting and carer quality of life after severe head injury

Abstract

Head injury is a significant cause of death and disability. This study examined the quality of life of carers of individuals following severe head injury from the acute neurosurgical care period to one year post discharge from hospital. The contribution of patterns of problem reporting by patients and their carers to quality of life was examined. Carer psychosocial adjustment and individual quality of life evaluations were significantly poorer than general population levels and did not change over a one year period. However, significant increases in the number of problems reported were noted over time. No significant differences were found between patients and carers in the numbers of problems identified at each of three assessments, although the level of agreement about problems identified was quite low. Female patients reported significantly more problems than male patients. Carer problem reporting was found to significantly predict carer quality of life and psychosocial functioning to a greater extent than patient problem reporting, a pattern which emerged after the patient had been discharged from hospital. The study demonstrates increasing problem profiles and differing perceptions of patients and carers over time. Combined with a lack of improvement in carer quality of life over a one year recovery period, this highlights the need for longer-term professional support and advice services aimed at both patients and carers.     

Unique Ethical Concerns in Clinical Trials Comparing Psychosocial and Psychopharmalogical Interventions

In recent years, there has been a particular emphasis placed on conducting randomized controlled trials (RCTs) that compare the relative efficacy of psychosocial and pharmacological interventions. This article addresses relevant ethical considerations in the conduct of these treatment trials, with a focus on RCTs with children. Ethical concerns, including therapeutic misconception, treatment preference, therapeutic equipoise, structure of treatments, and balancing risks versus benefits, are introduced through a clinical scenario and discussed as they relate to psychotherapy versus medication RCTs. In each case, suggestions are made for researchers seeking to minimize the impact of these ethical concerns on research participants.     

Psychosocial Influences on Substance Abuse in a Sample of South African Youth: A Qualitative Analysis

This study investigated the lived experience of substance abusers in the South African context. Participants were 10 individuals attending a drug treatment centre in Durban, South Africa. Data were collected using open-ended interviews with data being analysed using thematic analysis. Findings suggest that normative social influences and levels of social support play an important role in shaping, maintaining, and determining the trajectory of drug usage.     

The Skin Picking Impact Scale: Factor structure,validity and development of a short version

In the present study, we examined the psychometric properties of the Skin Picking Impact Scale (SPIS; Keuthen, Deckersbach, Wilhelm et al., 2001), a 10 item self‐report questionnaire designed to assess the psychosocial impact of skin picking disorder (SPD). Participants were 650 individuals who met criteria for SPD in an online survey. Exploratory and confirmatory factor analyses demonstrated a unitary factor structure with high internal consistency (α = 0.94). Consequently, we constructed an abbreviated 4‐item version that retained good internal consistency (α = 0.87) and a robust factor structure. Both the short and the full versions demonstrated discriminant and convergent/concurrent validity. In conclusion, the findings indicate that both versions are psychometrically sound measures of SPD related psychosocial impact; however, some potential limitations of the full scale are discussed.     

A Qualitative Study of Community–University Partnerships That Support Psychosocial Occupational Therapy

Community partner voices are important to understand because they provide the contexts in which occupational therapy (OT) students research community-identified needs and together, create evidence-based occupation-focused programs while developing clinical reasoning skills in a natural context. The purpose of this study is to understand how community partners experienced partnerships that support community-based research in psychosocial settings. This retrospective study explores the perspectives of community partners that hosted OT students for two-semester service-learning project over 3 years. Findings revealed partners value effective communication with faculty and students, spending time observing, listening, and developing meaningful relationships with clients and staff.     

Cancer survivors’ and partners’ key concerns and quality of life

Objective: Understanding the concerns of cancer survivors is essential for effective interventions. This study was designed to identify the primary concerns of dyads coping with cancer, how concerns differed by role and sex, and whether concerns expressed during counselling were associated with survivors’ psychosocial well-being and adjustment.

Design: Forty-three dyads with breast and prostate cancer (N = 86 participants) were enrolled in an interpersonal telephone counselling intervention. Audio recordings of 228 counselling sessions were transcribed and content analysed qualitatively to identify major themes and key concerns. A total of three 30-min sessions were coded for each study participant. Quantitative data and statistical analyses were used to predict changes in survivors’ quality of life.

Main Outcome Measures: Participants completed psychosocial well-being measures (depression, positive/negative affect, and relationship satisfaction), pre- and post-counselling.

Results: Survivors’ concerns focused on cancer- and treatment-related issues, whereas partners’ concerns centred on the well-being of their spouse/partner with cancer, and what they were doing to help their loved one cope with his/her illness. Key concerns for all consisted of relationship maintenance and communication issues. Further, discussion of these concerns was predictive of significant improvements in adjustment post-counselling for women with breast cancer.

Conclusion: Discussion of interpersonal concerns may play a more important role in the well-being of women, than men, coping with cancer.     

Relationships at work and psychosocial risk: The feeling of belonging as indicator and mediator

Introduction/objectiveThis article highlights the links between, one the one hand, the feeling of belonging to the work group and, on the other hand, the tension and burnout experienced, amongst 444 employees in a hospital centre.MethodologyThe methodology is based on the use of 4 self-administered questionnaires (Karaseck's JCQ, Maslach's MBI, Quality of relationships with parties concerned and Feeling of belonging) and is based on correlations and multiple regressions.ResultsThe results highlight the fact that relationships perceived as generally relaxed with the different people concerned (care team, doctors, management and administrative staff), predicted Karaseck's three dimensions and those assessed by the Maslach Burnout Inventory (MBI). Similarly, the feeling of belonging predicted all these variables. Most of the time it played a mediating role between the perceived quality of relationships and the different measures of well-being at work. So, the feeling of belonging seems to be a variable of interest, which can play a key role in the prevention of suffering at work.     

Utility of the Multidimensional Health Profile—Psychosocial Functioning Scales (MHP-P) for Assessing Psychosocial Adjustment in Gastric Bypass Surgery Patients

This study examined the utility of the Multidimensional Health Profile—Psychosocial Functioning (MHP-P) for the preoperative assessment of gastric bypass surgery (GBS) applicants. The MHP-P, a 58-item screening inventory that assesses 4 psychosocial areas relevant to health (mental health, life stress, social resources, and coping skills), was administered to 449 morbidly obese patients who were being considered for GBS. Data were compared with the results of a much more lengthy assessment procedure involving a 273-item comprehensive biographical and medical history interview, the MMPI-2, the Basic Personality Inventory, and the Beck Depression Inventory. The 17 measures of the MHP-P showed highly significant correlations with other measures considered to be of relevance in GBS outcome, confirming the utility of the MHP-P as a cost-effective procedure for use in this clinical medical setting.     

Evolution of the wealth gap in child development and mediating pathways: Evidence from a longitudinal study in Bogota,Colombia

Large gaps in cognition and language on the Bayley‐III between the top and bottom household wealth quartiles in 1,330 children aged 6–42 months in a representative sample of low‐ and middle‐income families in Bogota were previously shown. Maternal education and the home environment mediated these wealth effects, whereas height‐for‐age mediated a small amount of the language deficit only. At ages 6–8 years, we relocated 72% of the children and assessed their IQ on the WISC‐V, school achievement, and behavior to investigate the evolution of the wealth gaps and potential mediators. The wealth gap in IQ at 6–8 years was significantly larger than that in a factor combining Bayley‐III language and cognition at 6–42 months; whereas the gap in achievement was larger but not significantly. Moreover, in cross‐sectional analysis, the IQ gap increased from 6 to 8 years reaching over 1 SD. In contrast, the gap in behavior was not significant in either childhood stage. Parental education and early home environment remained major mediators of the wealth gap in IQ and achievement at 6–8 years; later home environment and attending private education also had an effect; and early height‐for‐age was no longer significant. The home environment partly mediated the effect of parental education on wealth. All mediators combined explained most of the variance in the wealth gap; the remaining gaps being not significant. Results highlight the importance of the early home environment and suggest that interventions focusing on that should have long‐term benefits. Also, continued intervention through to 8 years may be desirable. A video abstract of this article can be viewed at https://youtu.be/_U53iXNww3I .