Diagnosis concealment is associated with psychosocial outcomes in persons with multiple sclerosis

Persons with multiple sclerosis (pwMS) frequently conceal their diagnosis, fearing professional and personal repercussions of disclosing. Associations of concealment behavior and expected consequences of disclosure with psychosocial outcomes were examined in 90 pwMS who completed validated self-report measures of diagnosis concealment, loneliness, social support, and self-efficacy. More frequent concealment was related to worse loneliness ( rp = 0.213, p = 0.045) and lower social support ( rp = −0.211, p = 0.047), controlling for depression. Higher anticipated negative consequences of disclosure were associated with worse loneliness ( rp = 0.263, p = 0.013), lower social support ( rp = −0.338, p < 0.001), and lower self-efficacy ( rp = −0.350, p < 0.001). Findings hold implications for the development of psychological support strategies addressing concealment/disclosure issues and their psychosocial consequences.

The Promise and Neglect of Follow-up Care in Obstetric Fistula Treatment in Uganda

Considered the most severe of maternal morbidities, obstetric fistula is a debilitating childbirth injury that results in complete incontinence with severe physical and psychosocial consequences.The primary intervention for women with obstetric fistula is surgical repair, and success rates for repair are reported between 80% and 97%. However, successful treatment is commonly defined solely by the closure of the fistula defect and often fails to capture women who continue to experience urinary incontinence after repair. Residual incontinence post-fistula repair is both underreported and under-examined in the literature. Through a novel mixed-method study that examined clinical, quantitative, and qualitative aspects of residual incontinence post-repair, this chapter draws on in-depth interviews with women suffering with residual incontinence and fistula surgeons, participant observation, and a desk review of fistula policies and guidelines to argue that an inadequate model of fistula treatment that neglects follow-up care exists. We found that obstetric fistula policy has been determined in large part over the years by international development agencies and funding organizations, such as international nongovernmental organizations (INGOs). We argue that the neglect in follow-up care is evident in fistula policy and can be traced to a donor-funded treatment model that fails to prioritize and fund follow-up care as an essential component of fistula treatment, instead focusing on a “narrative of success” in fistula treatment. As a result, poor outcomes are underreported and women who experience poor outcomes are largely erased from the fistula narrative. This erasure has limited the attention, resources, research, and dedicated to residual incontinence, leaving out women suffering from residual incontinence largely without alternative treatment options.

Investigating Non-pharmacological Treatments for Psychological Problems Associated with Epilepsy: A Narrative Review

Epilepsy is one of the problems and diseases that accompanies a person for the rest of his/her life after diagnosis. This disease can severely affect a person’s physical condition and lead to psychological problems. Many patients with epilepsy suffer from psychological problems and are under the supervision of a psychiatrist, and they take medications to control the mental state. However, many patients are reluctant to take other medications, including psychiatric medications, due to long-term use of the drug. Therefore, in this study, we examined nonpharmacological treatments for psychological problems caused by epilepsy. In addition to developing epilepsy and receiving medications for the disease, these patients develop mental illnesses such as stress, depression, anxiety, and cognitive processes that require treatment. After searching for texts published in various English language databases, the required items were obtained. First, some of the psychosocial consequences of epilepsy, including negative attitude towards epilepsy, social stigma, family factors, quality of life, and sexual activity, were evaluated. Furthermore, the concurrency of psychological disorders (stress, depression, anxiety, cognitive processes, and theory of mind) along with non-pharmacological treatments were investigated.

Impact of Restricted Contact between Grandparents and Grandchildren during the COVID-19 Pandemic

To combat the COVID-19 pandemic strict contact restrictions have been imposed on institutions for both older and younger people, social structures have been locked down, families have been urged to reduce contact with older relatives, and people over 65 have been temporarily banned from their workplaces and from attending events, both in public and private spaces. These measures are assumed to have a number of psychosocial consequences. For this questionnaire study, 268 pupils (7-to-10 years-old) of nine different schools in Hamburg, Germany, with different social index were asked about how they experienced, perceived, and behaved during the COVID-19 pandemic. 75% of the children reported on restricted contact to their grandparents: While 41% did not meet their grandparents at least for a certain time at the beginning of the pandemic, 34% did not meet their grandparents during the whole first year of the pandemic. Of those who met their grandparents, 25% kept physical distance to them. These contact restrictions were significantly higher in schools with a lower social index, chi2(8)=15.49, p=.05. Those children who never met their grandparents also reported on higher perceived stress, t(220)=-2.37, p=.019, d=-.33, tended to have lower subjective well-being, t(223)=-1.73, p=.09, d=-.24, and had higher risk perceptions concerning COVID-19 infections, t(223)=-2.18, p=.03, d=-.31. Hence social isolation and loneliness is not only an issue for older people themselves, but contact restrictions also potentially increase the stress load and impair the well-being of children who have to do without support and care of their grandparents in sensitive developmental phases.

Psychosocial Impact of COVID-19 on Elderly/Senior Population

Senior population is one of major social work and healthcare issues in highly developed countries. The aim of this study was assessing the late psychosocial consequences in seniors in Vienna and Bratislava after the first and second waves of the COVID-19 pandemics. The results suggest that elderly patients in contrast to children and adolescents suffer significantly more late psychosocial consequences after having coronavirus acute or chronic di- sease.

(Tele)Work and Care during Lockdown: Labour and Socio-Familial Restructuring in Times of COVID-19

COVID-19, and the lockdown requirement, altered our daily lives, including the restructuring of work and socio-familial organisation of millions of people. Through two studies, we explored how workers experienced this period. The first, qualitative study (N = 30) aimed to understand how workers lived through lockdown by identifying the key elements that shaped their experiences. Thematic content analysis revealed four emerging themes: (1) work and socio-health situation in which lockdown was experienced; (2) consequences on work organisation and resources available for change; (3) work–life balance management; and (4) psychosocial consequences and coping with the situation. The second, quantitative study (N = 332) explored the socio-health situation, new work organisation, work–life balance, and psychosocial consequences and coping strategies developed during this period, analysing participants’ differences in terms of gender, working modality (on-site or teleworking) and care responsibilities through ANOVA analysis. Results revealed the non-democratic nature of the pandemic, with differences and similarities according to gender, working modality and having or not having dependents. Results are discussed identifying areas that need to be addressed to ensure the well-being of workers.

Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here

Background Strategies to control coronavirus 2019 disease (COVID-19) have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Yet knowledge about COVID-19 has grown exponentially, and the expanding rollout of vaccines presents further opportunity to reassess the response to the pandemic more broadly. Main text We review the latest evidence concerning 10 key COVID-19 policy and strategic areas, specifically addressing: 1) the expansion of equitable vaccine distribution, 2) the need to ease restrictions as hospitalization and mortality rates eventually fall, 3) the advantages of emphasizing educational and harm reduction approaches over coercive and punitive measures, 4) the need to encourage outdoor activities, 5) the imperative to reopen schools, 6) the far-reaching and long-term economic and psychosocial consequences of sustained lockdowns, 7) the excessive focus on surface disinfection and other ineffective measures, 8) the importance of reassessing testing policies and practices, 9) the need for increasing access to outpatient therapies and prophylactics, and 10) the necessity to better prepare for future pandemics. Conclusions While remarkably effective vaccines have engendered great hope, some widely held assumptions underlying current policy approaches call for an evidence-based reassessment. COVID-19 will require ongoing mitigation for the foreseeable future as it transforms from a pandemic into an endemic infection, but maintaining a constant state of emergency is not viable. A more realistic public health approach is to adjust current mitigation goals to be more data-driven and to minimize unintended harms associated with unfocused or ineffective control efforts. Based on the latest evidence, we therefore present recommendations for refining 10 key policy areas, and for applying lessons learned from COVID-19 to prevent and prepare for future pandemics.

Counseling in psoriasis: overcoming the concerns and challenges

<p>Psoriasis is a systemic, immune-mediated disorder, characterized by systemic inflammation predominantly in skin and joints with significant physical and psychosocial consequences. It is a chronic disease with an unpredictable journey consisting of flares and remissions. Psoriasis has also been linked to loss of self-esteem in patients, depression and suicidal tendencies. In addition, it also contributes to financial burden due to the long-term management. This results in negative impact on the caregivers and family of the patient. Due to these multiple factors, there has been low compliance to therapy and higher likelihood of discontinuation of treatment. Considering the emotional aspect involved in this disease, counseling of the patients becomes one of the integral pillars for the management of the disease. Hence, the clinician’s role becomes significant, due to limited access to counselors, therapists and social groups, in our country. The present reviewdescribes the impact of psoriasis on the patient’s life and the practical approaches that may be taken to counsel the patient of psoriasis.</p>