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Understanding health anxiety among community dwelling seniors with varying degrees of frailty
- Authors:
- BOURGAULT-FAGNOU Michelle D., HADJISTAVROPOULOS Heather D.
- Journal article citation:
- Aging and Mental Health, 13(2), March 2009, pp.226-237.
- Publisher:
- Taylor and Francis
The levels of health anxiety among younger adults and older people, with either low or high levels of frailty were compared. Predictors of health anxiety in older people were explored. Forty-nine seniors with high levels of frailty were compared with 63 seniors with low levels of frailty and 130 younger adults. Comparisons were made on the Illness Attitudes Scale (IAS) and on a Medically Adjusted Illness Attitudes Scale, an adapted version ensuring scores reflect health anxiety, and not greater illness. Seniors also completed measures of frailty, pain, depression, trait anxiety and coping. Results varied depending on the health anxiety measure. Using the traditional IAS, seniors with high frailty experienced greater levels of health anxiety than seniors with low-frailty and younger adults. Using the medically adjusted version, seniors with high frailty experienced similar levels of heath anxiety compared with younger adults; seniors with low frailty had the lowest levels of health anxiety. Using multiple regression analysis, emotional preoccupation and trait anxiety uniquely predicted health anxiety among seniors. Researchers and clinicians should ensure that health anxiety measures actually assess health anxiety and not physical illness. Using an appropriate health anxiety measure, the results suggest seniors with relatively fewer health problems may experience reduced health anxiety compared with other older adults and younger adults. The results are considered in the context of research on aging and anxiety. Implications for clinical practice and future research are discussed.
Impairments in life quality among clients in geriatric home care: associations with depressive and anxiety symptoms
- Authors:
- DIEFENBACH Gretchen J., TOLIN David F., GILLIAM Christina M.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(8), August 2012, pp.828-835.
- Publisher:
- Wiley
This study examined the independent contributions of depressive and anxiety symptoms to quality of life among older adults who were in receipt of a home care program. Participants were 66 community-dwelling older adults (ages 65 years and older), living in the northwestern United States who were experiencing chronic medical illness and concomitant functional disability. They completed self-report measures of depression, anxiety, and health-related quality of life. Additional data on cognitive, health, and functional status were collected for use as covariates. The associations of depressive symptoms with quality of life impairments in home care were substantial and pervasive. Depressive symptoms were significantly associated with quality of life impairments in nearly all domains. After controlling for depressive symptoms, anxiety symptoms accounted for additional and statistically significant variance in impaired life quality in the domains of mental health, role emotional functioning, and bodily pain. The results show that depressive and anxiety symptoms have negative associations with life quality among older adults receiving home care. The authors highlight the importance of developing community-based programs to assess and treat depressive and anxiety symptoms among home care clients.
Meeting the psychological needs of the physically ill
- Author:
- CURRID Thomas
- Journal article citation:
- Nursing Times, 13.11.12, 2012, pp.24-27.
- Publisher:
- Nursing Times
Many patients with physical health conditions have high rates of psychological distress resulting in poorer quality of life, greater use of health care services and poor adherence to treatment. This article explores the issues relating to the psychological needs of patients presenting with physical health problems in acute and primary care settings, with a specific emphasis on depression and anxiety. It argues that nurses have an important role in addressing these issues and offers models of delivery that may be helpful in developing a strategy. It also stresses that all health professionals would benefit from training in the detection of and interventions in mental health conditions.
Mind over matter
- Author:
- JOHNSTON Suzy
- Journal article citation:
- Mental Health Today, June 2012, pp.14-15.
- Publisher:
- Pavilion
- Place of publication:
- Hove
When a person goes into a general medical ward they tend to be waiting for an operation, suffering from an illness or are in some way injured. These effects can all lead to a feeling of fear, worry, anxiety or depression. When there is already an underlying psychiatric disorder, these emotions can overwhelm a patient. This article presents a personal account on how it feels to be a patient in a medical ward while suffering mental and physical distress. It discusses the problems in opening up to staff at a hospital, and explores some coping strategies that can be utilised in such a situation.
Health status and suicide in the second half of life
- Authors:
- CONWELL Yeates, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(4), April 2010, pp.371-379.
- Publisher:
- Wiley
This paper examines the associations of suicide in older people with medical and psychiatric illness and functional limitations. A retrospective case-control design was used to compare 86 people over 50 who committed suicide with a comparison group of 86 participants that were individually matched on age, gender, race, and locality. Findings showed that suicide victims had mood and anxiety disorders, worse physical health status, and greater impairment in functional capacity. They were more likely to have required psychiatric treatment, hospitalisation in the last year, and a visiting home care service. In a multivariate model, the presence of any active disorder and any impairment in instrumental activities of daily living made independent contributions to suicide risk. The authors concluded that mental and physical illness along with functional impairments increased risk of suicide in this age group. In addition to individuals with psychiatric illness, those with severe or comorbid physical illness and functional disability who require inpatient and home care services should be targeted for screening and preventive interventions.
Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis
- Authors:
- MEAD Nicola, et al
- Journal article citation:
- British Journal of Psychiatry, 196(2), February 2010, pp.96-101.
- Publisher:
- Cambridge University Press
A systematic review was carried out to examine the clinical and cost-effectiveness of befriending for individuals in the community focusing on the impact on depressive symptoms and emotional distress. Although there is increasing consensus about the management of major depression there is less clarity regarding the optimal management of those with sub threshold symptoms, a proportion which may be the result of physical, social and economic problems and could benefit from social interventions that do not medicalise the problem. After evaluation, 24 randomised trials of interventions met the inclusion criteria. Compared with usual care or no treatment, befriending had a modest but significant effect on depressive symptoms in the short term (standardised mean difference SMD = –0.27, nine studies) and long term (SMD = –0.18, five studies). However it did not have an effect on perceived support. Cost effectiveness data was limited and inconclusive. The authors conclude that befriending has a modest effect on depressive symptoms and emotional distress in varied patient groups. However they point to some limitations of the study and note that befriending is a complex intervention and difficult to define consistently. It is suggested that further exploration of what constitutes befriending, appropriate target populations and optimal methods of delivery is required.
Cognitive function and common mental disorders in older people with vascular and non-vascular disorders: a national survey
- Authors:
- BEGUM Aysha, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(7), July 2009, pp.701-708.
- Publisher:
- Wiley
Vascular disorders are important potential causes of cognitive impairment and common mental disorders but their specificity as risk factors has yet to be clarified. The objectives of this analysis were to compare vascular and non-vascular health problems with respect to their associations with cognitive function and common mental disorder. An analysis was carried out of cross-sectional data from the 2000 UK National Survey of Psychiatric Morbidity. The two dependent variables analysed were common mental disorder (revised Clinical Interview Schedule) and cognitive function (TICSm and animal naming) in survey participants who were aged 60-74 years (n = 2007). Associations with self-reported vascular and common non-vascular (musculoskeletal, respiratory or gastrointestinal) disorders were compared. Disability (SF-12 physical scale) was considered as a potential confounding/mediating factor). Results showed that vascular disorders were associated with impaired global cognitive function and lower memory but not verbal fluency scores after adjustment for age, gender, education and social class. No such associations were found for non-vascular disorders. Vascular and non-vascular disorders were associated with common mental disorder to a similar extent, and associations were substantially explained by disability. Lower cognitive function was specifically associated with vascular disorders. Findings for common mental disorder were more consistent with an effect of disability rather than the actual consequences of specific health complaints.
Returning to work: the role of depression
- Authors:
- MUNIR Fehmidah, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2009
- Pagination:
- 95p.
- Place of publication:
- London
The study conducted focus groups with employers and questionnaires and interviews with employees in order to examine the interaction between depression and the psycho-social work environment. Poor adjustment to work and continuing exposure to work-related stress may lead to a ‘relapse’ in sickness absence, early retirement or unemployment. The report shows that almost half (45%) of those with a physical condition experienced mild to moderate depression, but were more worried about telling their employer about their mental health issues than their cancer or heart disease. Despite the fact that depression impacted on their well-being and ability to function at work, most felt unable to tell their line managers about the difficulties they were facing. The study also found that while most line managers were initially supportive when a person returned to work, they were not aware of the long-term effects of a serious physical illness or condition upon an employee’s ability to work and mental health.
An exploration of the explanatory models of illness amongst Pushtuun families living in the UK who are high attenders in general practice
- Authors:
- FAZIL Qulsom, WALLACE Louise M., HUSSAIN Abid
- Journal article citation:
- Diversity in Health and Social Care, 3(3), 2006, pp.171-181.
- Publisher:
- Radcliffe Publishing
People from the North West Frontier of Pakistan are known as Pushtuuns. This study explored the health beliefs and explanatory models of health illness in a Pakistani sub-population known as the Pushtuuns, who were high attenders at a UK general practitioner's clinic. The study interviewed five families who were amongst the top 10 highest attenders at the practice. The interview involved an in-depth exploratory of health beliefs using the Self Explanatory Model Inventory (SEMI); families were also screened for anxiety and depression symptoms. The study found that these families were living in poor adverse social conditions and all the high attenders, plus five other family members, were found to have high scores above the screening threshold for clinical depression. As well as attributing illness to biological and psychosocial causes, a strong theme emerged in reporting by first-generation Pushtuuns who attributed illness causation to supernatural powers. Families also reported going abroad for treatment, and the main barrier in accessing services was reported as communication in the Pushtuun's own language. It is concluded that a more patient-centred approach to primary health-care is required, as well as culturally appropriate language and service provision to access main-stream secondary care services.
Supporting anxious parents in search of internet information
- Author:
- BLAKE Jody
- Journal article citation:
- Nursing Times, 9.05.06, 2006, pp.24-26.
- Publisher:
- Nursing Times
Parental uncertainty and anxiety is easily transmitted to sick children and can impede their recovery. Providing information to parents can help them manage their anxiety. This article explores how nurses can use the internet to support anxious parents.