British Journal of Health Psychology, 13(2), May 2008, pp.223-230.
Publisher:
Wiley
Head and neck cancer and its treatment have profound effects on function, self-image, and mental health. Fears of recurrence are one of the major concerns of cancer survivors that endure and can influence the patients' ability to adjust and plan for the future. This paper describes the design and development of the adjustment to the fear, threat or expectation of recurrence (AFTER) intervention which targets recurrence fears, inappropriate checking behaviour, and beliefs about cancer, adopting recognized cognitive behavioural and health psychology principles, particularly Leventhal's self-regulation model. The intervention includes structured sessions, manualized delivery by a specialist nurse, invitation to caregiver, expression of fears, examination and change of beliefs, and checking behaviour. Initial testing showed acceptability (nurse satisfaction ratings by patient) of the intervention which may have applicability for patients who have been treated with cancer at other sites.
Head and neck cancer and its treatment have profound effects on function, self-image, and mental health. Fears of recurrence are one of the major concerns of cancer survivors that endure and can influence the patients' ability to adjust and plan for the future. This paper describes the design and development of the adjustment to the fear, threat or expectation of recurrence (AFTER) intervention which targets recurrence fears, inappropriate checking behaviour, and beliefs about cancer, adopting recognized cognitive behavioural and health psychology principles, particularly Leventhal's self-regulation model. The intervention includes structured sessions, manualized delivery by a specialist nurse, invitation to caregiver, expression of fears, examination and change of beliefs, and checking behaviour. Initial testing showed acceptability (nurse satisfaction ratings by patient) of the intervention which may have applicability for patients who have been treated with cancer at other sites.
This article examines the ways in which nurses can help patients with disfigurement to deal with anxiety and the challenges they face. It examines these in relation to four factors influencing outcome: social support; information and involvement; perception of the disfigurement's severity; and social interaction skills.
This article examines the ways in which nurses can help patients with disfigurement to deal with anxiety and the challenges they face. It examines these in relation to four factors influencing outcome: social support; information and involvement; perception of the disfigurement's severity; and social interaction skills.
Subject terms:
nursing, patients, social skills, user participation, anxiety;
British Journal of Health Psychology, 11(4), November 2006, pp.551-559.
Publisher:
Wiley
The aim was to examine Lazarus and Folkman's (1984) stress theory regarding the effects of the stress mediators information and perceived social support on anxiety (as the stress response) regarding gastrointestinal (GI) endoscopy (as the stressor) in male and female patients of various age groups. Structured interviews were conducted with 113 hospital out-patients about to undergo GI endoscopy. Participants indicated their perceptions of how much support and how much clear and useful information they had received from both their general practitioner (GP) and a patient information leaflet developed in collaboration with health psychologists as well as their perceptions of how much social support they had obtained from other patients, family and friends. Anxiety was measured with a population-specific trait and state adaptation of the Hospital anxiety and depression scale (HADS-A). Psychometric exploration of the HADS-A revealed a single general anxiety factor. The reliability of this factor was high. The majority of the sample experienced high anxiety levels. Gender, but not age, differences emerged, showing females to be more anxious than males. A regression model built on stress theory was tested, with anxiety as the dependent variable and 11 predictor variables. The model was significant. The clarity, but not the amount, of information and social support from important others, but not GPs, were both mediating the stress experience of the patients by reducing their perceived anxiety.
The aim was to examine Lazarus and Folkman's (1984) stress theory regarding the effects of the stress mediators information and perceived social support on anxiety (as the stress response) regarding gastrointestinal (GI) endoscopy (as the stressor) in male and female patients of various age groups. Structured interviews were conducted with 113 hospital out-patients about to undergo GI endoscopy. Participants indicated their perceptions of how much support and how much clear and useful information they had received from both their general practitioner (GP) and a patient information leaflet developed in collaboration with health psychologists as well as their perceptions of how much social support they had obtained from other patients, family and friends. Anxiety was measured with a population-specific trait and state adaptation of the Hospital anxiety and depression scale (HADS-A). Psychometric exploration of the HADS-A revealed a single general anxiety factor. The reliability of this factor was high. The majority of the sample experienced high anxiety levels. Gender, but not age, differences emerged, showing females to be more anxious than males. A regression model built on stress theory was tested, with anxiety as the dependent variable and 11 predictor variables. The model was significant. The clarity, but not the amount, of information and social support from important others, but not GPs, were both mediating the stress experience of the patients by reducing their perceived anxiety.
Subject terms:
hospitals, medical treatment, patients, access to information, anxiety;
British Journal of Clinical Psychology, 53(2), 2014, pp.228-244.
Publisher:
Wiley
... of fears of happiness, compassion from others and for self, in addition to measures of alexithymia, attachment, social safeness, and depression, anxiety, and stress.
Results: Fears of compassion and happiness were highly correlated with alexithymia, adult attachment, and depression, anxiety, and stress. Fear of happiness was found to be the best predictor of depression, anxiety, and stress, whereas fear of compassion from others was the best predictor of adult attachment. A path analysis showed that fears of positive emotion fully mediate the link between alexithymia and depression. This clinical sample had higher mean scores in fears of positive emotions, alexithymia, and depression, anxiety, and stress than a previously studied student sample.
Conclusions: This study adds to the evidence that fears
(Publisher abstract)
Objectives: In a non-clinical population, fears of compassion and fear of happiness have both been found to be highly correlated with alexithymia and depression. This study sought to explore these processes and their links with adult attachment and social safeness and pleasure in a depressed group.
Method: A total of 52 participants suffering from moderate to severe depression completed measures of fears of happiness, compassion from others and for self, in addition to measures of alexithymia, attachment, social safeness, and depression, anxiety, and stress.
Results: Fears of compassion and happiness were highly correlated with alexithymia, adult attachment, and depression, anxiety, and stress. Fear of happiness was found to be the best predictor of depression, anxiety, and stress, whereas fear of compassion from others was the best predictor of adult attachment. A path analysis showed that fears of positive emotion fully mediate the link between alexithymia and depression. This clinical sample had higher mean scores in fears of positive emotions, alexithymia, and depression, anxiety, and stress than a previously studied student sample.
Conclusions: This study adds to the evidence that fears of positive emotions are important features of mental health difficulties. Unaddressed, these fears can block positive emotions and may lead to emotional avoidance of positive affect thus contributing as blocks to successful therapy. Therapies for depression may therefore profitably assess and desensitize the fear of positive emotions.
(Publisher abstract)
The National Audit of Psychological Therapies for Anxiety and Depression (NAPT) has provided a unique opportunity to begin to understand the range and quality of services and the experience of those who receive therapy. This report is of the audit findings. It incorporates data from across Wales and England, derived from a spectrum of services, including those in primary and secondary care, small and large services, IAPT and non‐ IAPT services. The report into the care received by patients with anxiety and depression across NHS-funded psychological therapy services in England and Wales has revealed good overall standards of care, but substantial variation in quality. The audit collected data from 357 services and over 10,000 people in therapy for anxiety and depression and measured ten standards,
The National Audit of Psychological Therapies for Anxiety and Depression (NAPT) has provided a unique opportunity to begin to understand the range and quality of services and the experience of those who receive therapy. This report is of the audit findings. It incorporates data from across Wales and England, derived from a spectrum of services, including those in primary and secondary care, small and large services, IAPT and non‐ IAPT services. The report into the care received by patients with anxiety and depression across NHS-funded psychological therapy services in England and Wales has revealed good overall standards of care, but substantial variation in quality. The audit collected data from 357 services and over 10,000 people in therapy for anxiety and depression and measured ten standards, including patient satisfaction, effectiveness of therapy, waiting times and number of treatment sessions offered.
Subject terms:
patients, performance management, psychotherapy, social care provision, anxiety, depression;
British Journal of Health Psychology, 13(4), November 2008, pp.683-699.
Publisher:
Wiley
... to take part in the study. 103 questionnaire packs were included in the analysis. Multiple regression equations determined whether hope was able to predict significant variance in adjustment over and above that accounted for by other factors (demographic and illness-related factors, perceived control, and social support). Measures of anxiety, depression, and quality of life constituted a multidimensional measure of adjustment to ESRF. Each of the regression models was significant. Hope emerged as an independent significant predictor in five of the multiple regressions: anxiety; depression; effects and symptoms of kidney disease; and mental health quality of life. Age also emerged as an important predictor of outcome. It appears that hope is a significant predictor of adjustment to ESRF. Clinical
Hope is important in determining positive outcomes in a range of chronic illnesses. This study examined the role of hope in adjustment to end-stage renal failure (ESRF) and consequent dialysis. A cross-sectional design examined the ability of hope to predict adjustment to ESRF over and above other relevant variables. Individuals receiving dialysis at 4 units in the North-West UK were invited to take part in the study. 103 questionnaire packs were included in the analysis. Multiple regression equations determined whether hope was able to predict significant variance in adjustment over and above that accounted for by other factors (demographic and illness-related factors, perceived control, and social support). Measures of anxiety, depression, and quality of life constituted a multidimensional measure of adjustment to ESRF. Each of the regression models was significant. Hope emerged as an independent significant predictor in five of the multiple regressions: anxiety; depression; effects and symptoms of kidney disease; and mental health quality of life. Age also emerged as an important predictor of outcome. It appears that hope is a significant predictor of adjustment to ESRF. Clinical implications of this research are discussed, along with suggestions for future research.
Subject terms:
kidney diseases, long term conditions, patients, quality of life, attitudes, anxiety, dialysis;
British Journal of Clinical Psychology, 47(3), September 2008, pp.281-293.
Publisher:
Wiley
Using a new validated instrument (Questionnaire on Control Expectancies in Psychotherapy, TBK), this study investigated whether and how perceived responsibility for change predicts favourable response to group cognitive-behavioural therapy in a sample of 49 outpatients with social anxiety disorder (SAD). Patient engagement and therapy-related self-efficacy were assessed as possible process variables. Among therapy-related control beliefs, low powerful others expectancies (towards the therapist) were found to be the strongest predictor for clinical improvement at follow-up. At a process level, analyses of mediation showed that powerful others expectancies predicted therapy engagement, which then influenced the degree of clinical improvement on social anxiety levels and global symptoms. The association between therapy-specific internality and outcome was confirmed for social anxiety at follow-up and was partially mediated by therapy-related self-efficacy. Findings confirm that therapy-related control beliefs predict psychotherapy process (patient engagement and therapy-specific self-efficacy) and outcome in cognitive-behavioural group therapy for SAD. Implications for clinicians and for future
Using a new validated instrument (Questionnaire on Control Expectancies in Psychotherapy, TBK), this study investigated whether and how perceived responsibility for change predicts favourable response to group cognitive-behavioural therapy in a sample of 49 outpatients with social anxiety disorder (SAD). Patient engagement and therapy-related self-efficacy were assessed as possible process variables. Among therapy-related control beliefs, low powerful others expectancies (towards the therapist) were found to be the strongest predictor for clinical improvement at follow-up. At a process level, analyses of mediation showed that powerful others expectancies predicted therapy engagement, which then influenced the degree of clinical improvement on social anxiety levels and global symptoms. The association between therapy-specific internality and outcome was confirmed for social anxiety at follow-up and was partially mediated by therapy-related self-efficacy. Findings confirm that therapy-related control beliefs predict psychotherapy process (patient engagement and therapy-specific self-efficacy) and outcome in cognitive-behavioural group therapy for SAD. Implications for clinicians and for future research are discussed.
Subject terms:
outcomes, patients, personality disorders, attitudes, anxiety, behaviour therapy, group therapy;
This article reports on an external evaluation of the INSUCH Project, a 20-week pilot project which offered a range of complementary therapies to patients and an inpatient acute care unit in Taunton. The results of the evaluation found that complementary therapies can make an important contribution to patient well-being and recovery.
This article reports on an external evaluation of the INSUCH Project, a 20-week pilot project which offered a range of complementary therapies to patients and an inpatient acute care unit in Taunton. The results of the evaluation found that complementary therapies can make an important contribution to patient well-being and recovery.
Subject terms:
patients, severe mental health problems, stress, acute psychiatric care, anxiety, complementary therapies, evaluation;
Therapeutic Communities: the International Journal of Therapeutic Communities, 27(2), Summer 2006, pp.265-273.
Publisher:
Emerald
... factors (from the patient's point of view) led to their leaving and how they functioned after they left the institution. Nearly half of the dropouts reported that they ended treatment in the first two weeks because of very high levels of anxiety. The remaining dropout patients reported more diffuse motives. Most patients recommended more supportive elements in the treatment to prevent dropout.
This study investigates what motivated patients to end their treatment prematurely, and to give recommendations for changes in the policy. Between May 1999 and December 2001, 24 patients were dropouts from a three-month in-patient psychotherapy programme in the Netherlands. The authors held interviews with 16 of them. The aim was to find out what they experienced during the treatment, which factors (from the patient's point of view) led to their leaving and how they functioned after they left the institution. Nearly half of the dropouts reported that they ended treatment in the first two weeks because of very high levels of anxiety. The remaining dropout patients reported more diffuse motives. Most patients recommended more supportive elements in the treatment to prevent dropout. As a result of the study, staff changed its attitude and endorsed a more supportive approach, especially in the first weeks of the treatment. In the next period from January 2002 till May 2003 the dropout rate was reduced from 16% to 8%.
Subject terms:
mental health problems, patients, psychotherapy, service uptake, short term treatment, user views, anxiety;
The effects of a minor head injury can be anything but minor to the person concerned. They can include nausea, headaches, dizziness, impaired concentration, memory problems, extreme tiredness, intolerance to light and noise, and can lead to anxiety and depression. When problems like this persist, they are often called post-concussion syndrome. A common problem is that either no scans were done
The effects of a minor head injury can be anything but minor to the person concerned. They can include nausea, headaches, dizziness, impaired concentration, memory problems, extreme tiredness, intolerance to light and noise, and can lead to anxiety and depression. When problems like this persist, they are often called post-concussion syndrome. A common problem is that either no scans were done at the time of the accident, or subsequent scans show no damage. This frequently gives rise to the impression that there is nothing medically wrong. The persistent problems can be misunderstood by GP's, sometimes being considered as almost hypochondria on the part of the patient. Although it is true that in some cases where the symptoms persist for months a psychological element such as depression can come into play. Whist this may make existing conditions even more difficult to live with, it is not on the whole true or helpful to say that 'it is all in the mind'. A second opinion should be sought from a neurologist or neuro-psychologist
Subject terms:
patients, treatment, therapy and treatment, anxiety, depression, head injuries;