More than Just a Brain Disorder: A Five-Point Manifesto for Psychological Care for People with Huntington’s Disease

Huntington’s disease (HD) is a rare and complex condition where affected individuals, family members, caregivers, and clinicians face a number of both long-term and fluctuating challenges. The predominant biomedical framework adopted in HD to date has traditionally viewed it as a brain disorder first and foremost. As a consequence, one of the most challenging aspects of the condition—psychological difficulties and their care—is often not given the emphasis it deserves in everyday clinical practice. Here, we propose a manifesto outlining five points to address the quality, effectiveness, availability, and accessibility of psychological care in HD. These include (1) Listening to People with HD, (2) Reformulating Difficulties Psychologically, (3) Exploring New Interventions, (4) Increasing Psychological Provision, and (5) Learning from Other Conditions. As the search for a cure continues, we hope that this manifesto will create a new impetus towards refining the current approach to psychological difficulties in HD and ultimately improve the quality of life of the tens of thousands of families affected by HD worldwide.

Psychological demands of health professionals in the initial phase of the COVID-19 pandemic

Recent literature emphasizes how the specific stressors of the COVID-19 outbreak affect the general population and frontline professionals, including those conducting support or backup activities in health units, which can lead to vicarious traumatization. Vicarious traumatization has been used to describe negative emotional reactions in mental health professionals who assist or treat victims of traumatic events. Thus, the aim of this article is to report the actions used in the face of the psychological demands of professionals in a hospital, who were not on the frontline of COVID-19. We collected their sociodemographic information and checked the psychological impact using the depression, anxiety, and stress scale (DASS-21), which was followed by a psychoeducational program (topics related to COVID-19 control and prevention), and individual psychological care for the most severe cases. A total of 118 professionals participated in this study; they were between 20 and 67 years old. Mild to moderate anxiety was observed in 36.5% of the medical teams, 83.3% of the administrative staff, and 65.7% of general service workers, while stress symptoms were observed in 80.2%, 83.3%, and 59.9%, respectively. Depressive symptoms (35.3%) were more frequent in general service workers. The medical teams reported the benefits of primary psychological care, while the other professionals demanded more institutional support services related to the prevention and use of personal protective equipment. This study highlights relevant psychological demands that have repercussions on the daily lives of professionals. The psychoeducational program was considered positive regarding clarification actions. However, it was not perceived as effective in reducing fear, which may result from vicarious traumatization and requires other intervention modalities.

Gender roles and women’s mental health: their influence on the demand for psychological care

The prevalence of certain diagnoses, such as eating disorders, depression, anxiety, and borderline personality disorder, is higher among women than among men. When it comes to women’s mental health, focusing on social aspects influencing the way women fall ill becomes crucial. Using a sample of 368 women, we studied the classification ability of a number of clinical variables and sociocultural factors (conformity to gender norms) in order to ascertain whether or not women were receiving psychological care and determine the importance of each of the variables when predicting which women were receiving therapy. Our results showed that women were more likely to be receiving psychological treatment when scoring high on certain clinical variables (such as Suicidal Ideation and Borderline Features) and on a number of variables related to conforming to gender norms (Care for Children, Nice in Relationships, and Sexual Fidelity). Therefore, we believe that integrating the gender perspective into educational, health-related, and psychological care programmes is essential so that gender roles can become more diverse and less constricting of people’s potential, resulting in improved health. La prevalencia de determinados diagnósticos –trastorno de la conducta alimentaria, depresión, ansiedad y trastorno límite– es superior en mujeres que en hombres. Considerando la salud mental en mujeres, resulta imprescindible poner el foco en los aspectos sociales que influyen en la forma de enfermar. Se estudia en una muestra de 368 mujeres la capacidad de clasificación de algunas variables clínicas y factores socioculturales (conformidad con las normas de género) para determinar si una mujer está recibiendo asistencia psicológica o no, así como la importancia de cada una de esas variables a la hora de pronosticar qué mujeres estarían recibiendo terapia. Los resultados mostraron que cuando las mujeres puntúan alto en algunas variables clínicas (como Ideaciones Suicidas y Rasgos Límites) y en algunas relacionadas con conformidad con las normas de género (Cuidadora de Niños/as, Agradable en las relaciones y la Fidelidad Sexual) era más probable que estén recibiendo tratamiento psicológico. Por lo tanto, se considera que la inclusión de la perspectiva de género en programas de educativos, de salud y atención psicológica es fundamental para que los roles de género puedan ser más diversos y constriñan menos las potencialidades de las personas, lo que influirá en que tengan una mejor salud.

Psychological care for HIV-infected patientsat the St. Petersburg AIDS Center: history and the present time

The psychological state of people living with HIV is suffering from the moment when the diagnosis of HIV infection is perceived to the onset of remission during treatment. To achieve real effectiveness of HIV treatment, it is important to use not only the potential of modern pharmacotherapy, it is equally important that all people living with HIV receive psychological support in overcoming the difficulties arising from daily regular intake of drugs throughout their lives. Psychologists who are working at the AIDS Center are ready and conduct crisis counseling, extended counseling on adherence to treatment, psychological diagnostics to identify disorders which prevent the initiation and continuation of drug therapy, psychological correction in case of treatment interruptions. The use of traditional psychological methods should be based on knowledge of the characteristics of the disease and the specific treatment of HIV-infected people, which is currently being acquired in real clinical conditions. The article summarizes the many years of experience of the team of psychologists at the St. Petersburg AIDS Center and presents a model of modern psychological care for HIV-infected people based on knowledge of the characteristics of the disease, its prevention and specific treatment.

Application of Multifunctional Intelligent Suspension Treatment Beds in Nursing Care of Patients with Extensive Burns

The nursing care of patients with extensive burns by using multifunctional intelligent suspension treatment beds was studied. 40 patients, including 30 males and 10 females, with extensive burns were nursed using multifunctional intelligent suspension treatment beds. First of all, the patients were given psychological care, which was patiently explained, so that they can overcome their fears and be treated with peace of mind. Second, the room temperature and bed temperature were closely monitored. Finally, special attention was paid to the adjustment of rehydration volume, regular detection of plasma electrolytes, prevention of electrolyte disorder, and dehydration. Besides, disinfection and isolation should be performed when using. The results showed that 4 cases (20%) were positive in group A and 8 cases (40%) were positive in group B on the 10th day after injury X 2 = 4.005 , and the incidence of wound infection in group A was significantly lower than that in group B. The use of suspension beds in patients with extensive burns makes them safe and comfortable, and the whole body wound scabs healed faster, as well as the infection was minimized. A suspended bed is especially suitable for the clinical treatment of patients with extensive burns. The advantages of suspended bed can be fully realized by summarizing clinical experience.

A Qualitative Study Exploring Barriers and Facilitators to Establishing Nurse-led, Multidisciplinary Psychological Care for Trauma Patients: Experiences From Doctors and Nurses

BackgroundTrauma patients are often in a state of psychological stress, experiencing helplessness, sadness, frustration, irritation, avoidance, irritability and other adverse emotions. Doctors and nurses are at the forefront of caring trauma patients and they play a crucial role in psychological supports and mental health care. However, few qualitative studies had based on the framework of the Theory of Planned Behavior (TPB) to explore the experiences in providing psychological care for trauma patients. We examined attitudinal, normative, and control beliefs underpinning medical staffs’ decisions to perform psychological care.MethodA qualitative study of in-depth semi-structured interviews was conducted among 14 doctors and nurses engaging in trauma care. The participants came from six tertiary hospitals in Chongqing, China. Data analysis was performed using the approach of Colaizzi. According to the framework of TPB, the researchers identified and summarized the themes.ResultsImportant advantages (mutual trust, patients' adherence and recovery), disadvantages (workload, short-term ineffective, practice unconfidently), referents (supportive: managers, patients, kinsfolk, nursing culture; unsupportive: some colleagues and patients), barriers (insufficient time or energy, resources situations), and facilitators (access to psychologist, training/education, reminders) were identified. Some demands, such as training diversity, multidisciplinary cooperation and families' support, reflected by doctors and nurses were important for them to carry out psychological care.ConclusionAccording to the TPB, this article explored the internal and external promotion and hindrance factors that affecting the intentions and behaviors of doctors and nurses in implementing psychological care for trauma patients. We also focused on the experience and demands of health professionals in conducting psychological care, which could provide references for managers to formulate corresponding psychological care procedures and norms.

Measuring and Predicting Maturity to Parenthood: What Has Personality Got to Do with It?

Maturity to parenthood is essential for taking on parental roles but remains an understudied issue. Still, close relations between maturity and personality dimensions are commonly emphasized. Thus, conducting research on maturity in context of personality seems a valuable research direction. The present research consists of two studies, focusing on the development and validation of Maturity to Parenthood Scale (MPS), in relation to personality, emotional regulation, coping with challenges, and intimate relationship satisfaction. In both studies, childless adults aged 20–35 years took part: (1) 718 participants (Mage = 25.49; SD = 2.89; 479 women), (2) 150 participants (Mage = 23.69; SD = 3.15; 104 women). All the participants had been in an intimate relationship for at least six months at the time of the study, the majority declared their willingness to have children in the future, had higher education, and were professionally active. The results showed that MPS is a reliable, valid measure comprising the following three subscales: valence, behavioral, and cognitive–emotional maturity to parenthood. The findings also confirmed the importance of broad- and narrow-band individual differences and contextual factors for maturity. MPS may be used in psychoeducation, supporting the transition to biological or adoptive/foster parenthood, as well as in medical and psychological care.