scholarly journals The Fami-life study: protocol of a prospective observational multicenter mixed study of psychological consequences of grieving relatives in French palliative care units on behalf of the family research in palliative care (F.R.I.P.C research network)

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Maité Garrouste-Orgeas ◽  
Cécile Flahault ◽  
Edith Poulain ◽  
Adrien Evin ◽  
Frédéric Guirimand ◽  
...  
Keyword(s):  
Palliative Care ◽  
Anxiety And Depression ◽  
Psychological Consequences ◽  
Post Traumatic Stress ◽  
Patient Death ◽  
Prolonged Grief ◽  
Life Issues ◽  
Palliative Care Units ◽  
Post Traumatic ◽  
End Of Life Issues

Abstract Background Grieving relatives can suffer from numerous consequences like anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and prolonged grief. This study aims to assess the psychological consequences of grieving relatives after patients’ death in French palliative care units and their needs for support. Methods This is a prospective observational multicenter mixed study. Relatives of adult patients with a neoplasia expected to be hospitalized more than 72 h in a palliative care unit for end-of-life issues will be included within 48 h after patient admission. End-of-life issues are defined by the physician at patient admission. Relatives who are not able to have a phone call at 6-months are excluded. The primary outcome is the incidence of prolonged grief reaction defined by an ICG (Inventory Complicate Grief) > 25 (0 best-76 worst) at 6 months after patient’ death. Prespecified secondary outcomes are the risk factors of prolonged grief, anxiety and depression symptoms between day 3 and day 5 and at 6 months after patients’ death based on an Hospital Anxiety and Depression score (range 0–42) > 8 for each subscale (minimal clinically important difference: 2.5), post-traumatic stress disorder symptoms 6 months after patient’ death based on the Impact of Events Scale questionnaire (0 best-88 worst) score > 22, experience of relatives during palliative care based on the Fami-Life questionnaire, specifically built for the study. Between 6 and 12 months after the patient’s death, a phone interview with relatives with prolonged grief reactions will be planned by a psychologist to understand the complex system of grief. It will be analyzed with the Interpretative Phenomenological Analysis. We planned to enroll 500 patients and their close relatives assuming a 25% prolonged grief rate and a 6-month follow-up available in 60% of relatives. Discussion This study will be the first to report the psychological consequences of French relatives after a loss of a loved one in palliative care units. Evaluating relatives’ experiences can provide instrumental insights for means of improving support for relatives and evaluation of bereavement programs. Trial registration NCT03748225 registered on 11/19/2018. Recruiting patients.

Psychological treatments for post-traumatic stress disorder, anxiety and depression following major physical civilian trauma: A systematic review and meta-analysis

Trauma ◽  
2021 ◽  
pp. 146040862110261
Author(s):  
Arham Qureshi ◽  
Edward Dickenson ◽  
Peter Wall
Keyword(s):  
Usual Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Anxiety And Depression ◽  
Wait List ◽  
Post Traumatic Stress ◽  
Psychological Treatments ◽  
Civilian Trauma ◽  
Post Traumatic ◽  
Better Than

Introduction Approximately 16% of the world’s burden of disease is attributable to traumatic injury. Psychological symptoms, including post-traumatic stress disorder (PTSD), are prevalent in this population and impact recovery from physical injury. Nevertheless, mental health has not been considered to the same degree as physical health. Psychological interventions are used widely as treatments for PTSD. Methods Systematic searches of computerised databases were conducted. Randomised controlled trials of psychological treatments for PTSD following major physical civilian trauma were included. The main outcome measure was clinician-assessed symptoms of PTSD (CAPS), with findings for anxiety and depression also reported. Included studies data were extracted and entered using RevMan 5.3 software. Quality assessments were performed, and data were analysed for summary effects. Results 10 studies were included. With regard to CAPS <6 months, individual CBT did significantly better than usual care/wait list (SMD (95% CI) = −1.24 [−1.82, −0.67]) and non-CBT treatments (SMD (95% CI) = −1.32 [−2.64, −0.04]). Non-CBT treatments were not significantly better than usual care/wait list (SMD (95% CI) −1.40 [−2.91, 0.11]). CBT was superior to usual care/wait list for reducing depressive (SMD (95% CI) −0.67 [−0.98, −0.37]) and anxiety (SMD (95% CI) −0.70 [−1.22, −0.18]) symptoms both in the shorter and longer term. Conclusion Individual CBT was superior to wait list/usual care, and there was limited evidence for non-CBT treatments in reducing clinician and self-rated PTSD, depressive and anxiety symptoms in the shorter term; however, the latter comparison was based on few studies with small sample sizes. Longer-term effects of treatments remain uncertain. There is a need for adequately powered RCTs investigating PTSD treatments following major physical civilian trauma in the longer term. There was considerable heterogeneity in the studies, so care must be taken in interpreting the results of this review.

scholarly journals Traumatized Syrian Refugees with Ambiguous Loss: Predictors of Mental Distress

2021 ◽  
Vol 18 (8) ◽  
pp. 3865
Author(s):  
Anna Renner ◽  
David Jäckle ◽  
Michaela Nagl ◽  
Anna Plexnies ◽  
Susanne Röhr ◽  
...  
Keyword(s):  
Mental Health ◽  
Traumatic Stress ◽  
Ambiguous Loss ◽  
Treatment Seeking ◽  
Syrian Refugees ◽  
Post Traumatic Stress ◽  
Prolonged Grief ◽  
Boundary Ambiguity ◽  
Stress Symptoms ◽  
Post Traumatic

Refugees from war zones often have missing significant others. A loss without confirmation is described as an ambiguous loss. This physical absence with simultaneous mental persistence can be accompanied by economic, social or legal problems, boundary ambiguity (i.e., uncertainty about who belongs to the family system), and can have a negative impact on mental health. The aim of this study was to identify sociodemographic and loss-related predictors for prolonged grief, anxiety, depression, post-traumatic stress disorder (PTSD) and somatization in treatment-seeking Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. For the present study, data were based on the treatment-seeking baseline sample of the “Sanadak” randomized-controlled trial, analyzing a subsample of 47 Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. Sociodemographic and loss-related questions were applied, along with standardized instruments for symptoms of prolonged grief (ICG), anxiety (GAD-7), depression (PHQ-9), PTSD (PDS-5) and somatization (PHQ-15). Linear regression models were used to predict mental health outcomes. Having lost a close family member and higher boundary ambiguity showed a statistically significant association with higher severity in prolonged grief. The overall model for somatization reached statistical significance, while no predictor independently did. Boundary ambiguity showed a statistically significant positive association with depression, while the overall model showed no statistically significant associations. Boundary ambiguity and missing family members seemed to be important predictors for prolonged grief. These findings support the importance of reunification programs and suggest an inclusion of the topic into psychosocial support structures, e.g., including psychoeducational elements on boundary ambiguity in support groups for traumatized individuals and families experiencing ambiguous loss. Further research is needed for a more detailed understanding of the impact of ambiguous loss on refugee populations.

Palliative Care and End-of-Life Issues

2017 ◽  
pp. 621-633
Author(s):  
Rashmi Khadilkar ◽  
Hilary Yehling ◽  
Quill Timothy E.
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Life Issues ◽  
End Of Life Issues

scholarly journals Public awareness of palliative care in Sweden

2018 ◽  
Vol 46 (4) ◽  
pp. 478-487 ◽  
Author(s):  
Caroline Westerlund ◽  
Carol Tishelman ◽  
Inger Benkel ◽  
Carl Johan Fürst ◽  
Ulla Molander ◽  
...  
Keyword(s):  
Palliative Care ◽  
Public Awareness ◽  
Population Sample ◽  
Healthcare Setting ◽  
Swedish Population ◽  
Lack Of Information ◽  
Open Questions ◽  
Life Issues ◽  
The Media ◽  
End Of Life Issues

Objective: The aim of this study was to investigate the awareness of palliative care (PC) in a general Swedish population. Design: We developed an e-survey based on a similar study conducted in Northern Ireland, consisting of 10 questions. Closed questions were primarily analyzed using descriptive statistics. Open questions were subject to inductive qualitative analysis. Subjects: The study utilized a population sample of 7684 persons aged 18–66, of which 2020 responded, stratified by gender, age and region. Results: Most participants reported ‘no’ ( n = 827, 41%) or ‘some’ ( n = 863, 43%) awareness of PC. Being female or older were associated with higher levels of awareness, as was a university-level education, working in a healthcare setting and having a friend or family member receiving PC. Most common sources of knowledge were the media, close friends and relatives receiving PC, as well as working in a healthcare setting. Aims of PC were most frequently identified as ‘care before death’, ‘pain relief’, ‘dignity’ and a ‘peaceful death’. The preferred place of care and death was one’s own home. The main barriers to raising awareness about PC were fear, shame and taboo, along with perceived lack of information and/or personal relevance. The term ‘palliative care’ was said to be unfamiliar by many. A number of strategies to enhance awareness and access to PC were suggested, largely reflecting the previously identified barriers. Conclusions: This survey found limited awareness of palliative care in an adult sample of the Swedish general public ≤ 66 years, and points to a more widespread disempowerment surrounding end-of-life issues.

Occurence of post-traumatic stress symptoms, anxiety and depression in the acute phase of transient ischemic attack and stroke

2020 ◽  
Author(s):  
Helge HO Müller ◽  
Katharina Czwalinna ◽  
Ruihao Wang ◽  
Caroline Lücke ◽  
Alexandra P. Lam ◽  
...  
Keyword(s):  
Acute Phase ◽  
Psychiatric Symptoms ◽  
Depression Score ◽  
Anxiety And Depression ◽  
Post Traumatic Stress ◽  
Stroke Patients ◽  
Stress Symptoms ◽  
Post Traumatic ◽  
Ischemic Attack ◽  
And Coping

Abstract Background Rates of post-traumatic stress symptoms, anxiety and depression are increased in patients having experienced a transient ischemic attack (TIA) or stroke several months ago. However, data of psychiatric symptoms in the acute phase within the first days after ictus are lacking. Methods In 20 patients with stroke and 33 patients with TIA we assessed disease severity by means of the NIHSS, levels of depression and anxiety by HADS, PTSD-like symptoms by PC-PTSD, quality of life (HrQoL) by SF-12, and coping style by brief COPE Inventory within the first 5 days after ictus. Results NIHSS on admission was lower in patients with TIA (0 ± 1) than in patients with stroke (3 ± 2, p < 0.001). HADS depression score was significantly higher in patients with stroke (7.0 ± 4.5) than in patients with TIA (4.9 ± 4.0). HADS anxiety score, HrQoL and coping styles were similar between TIA and stroke patients (p > 0.05). 5 and 3 of 33 TIA patients as well as 4 and 3 of 20 stroke patients had at least 11 points in the HADS anxiety and depression score respectively (p = 0.001). 2 of 33 TIA patients and 2 of 20 stroke patients had more than 2 points in the PC-PTSD (p = 0.646). We did not find consistent correlations between the NIHSS and the psychometric parameters. Conclusions Within the first five days after patients having experienced a TIA or stroke PTSD-like, anxious and depressive symptoms are more common than in the general population. As the acute psychological status after ictus is predictive for psychiatric comorbidity years later physicians should pay attention and adequately treat psychiatric symptoms already in the acute phase of stroke.

Reproductive and Mental Health during Natural Disaster

2015 ◽  
pp. 265-291
Author(s):  
Jasim Anwar
Keyword(s):  
Mental Health ◽  
Reproductive Health ◽  
Natural Disasters ◽  
Psychological Trauma ◽  
Depression And Anxiety ◽  
Psychological Consequences ◽  
Post Traumatic Stress ◽  
Health And Wellbeing ◽  
Post Traumatic ◽  
The Impact

With the ever-increasing number of natural disasters, it is important to understand the impact on the health and wellbeing of survivors, especially women. The reproductive and mental health of women contributes significantly to their overall wellbeing. The Chapter gives an overview of natural disasters with an emphasis on consequences of earthquakes of health and wellbeing of the survivors. It includes a critical review of published studies on psychological trauma and reproductive health following earthquake disasters. Among the psychological consequences of earthquakes, this chapter describes post-traumatic stress disorder, depression and anxiety. The last section of this chapter reviewed reproductive health in relation to the mental health consequences following natural disasters.

Reactions to stressful experiences

2017 ◽  
pp. 135-160
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Childhood Abuse ◽  
Current Evidence ◽  
Stress Reactions ◽  
Psychological Consequences ◽  
Post Traumatic Stress ◽  
Response To Stress ◽  
Post Traumatic ◽  
Stressful Experiences ◽  
Refugee Experience ◽  
Coping Patterns

‘Reactions to stressful experiences’ covers emotional and physiological elements of the response to stress and the way in which maladaptive coping patterns and inappropriate defence mechanisms can lead to clinical disorders. Stress reactions are often short-lived and respond to support from friends and family. However, particularly severe stresses can lead to the condition of post-traumatic stress disorder (PTSD), an important source of morbidity and disability, whose clinical features, psychology, neurobiology, and treatment are described in detail. The chapter also covers adjustment to threatening and traumatic life events, such as childhood abuse, sexual assault in women, the refugee experience, serious physical illness, and bereavement. These events can produce various kinds of adverse psychological consequences over the lifespan, and the chapter shows how these psychiatric sequelae can be recognized, theoretically understood, and best managed according to current evidence-based practice.

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