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المؤلفون: Sarah A. Mossman, Jeffrey R. Strawn, Marissa J. Luft, Emily Harris, Anne K. Tulisiak, Jillian A. Klein, Heidi K. Schroeder, Brooks R. Keeshin, Sara T. Varney, Sian Cotton
المصدر: Current Problems in Pediatric and Adolescent Health Care. 47:15-24
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Psychopharmacology, Attitude of Health Personnel, Clinical Decision-Making, Pilot Projects, Drug Prescriptions, Article, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Humans, Pediatricians, Practice Patterns, Physicians', Child, Psychiatry, Aged, Depressive Disorder, Primary Health Care, business.industry, Mental Disorders, Health services research, General Medicine, Middle Aged, Anxiety Disorders, Mental health, Antidepressive Agents, Drug Utilization, United States, 030227 psychiatry, Tolerability, Pediatrics, Perinatology and Child Health, Antidepressant, Anxiety, Female, Clinical Competence, Health Services Research, medicine.symptom, Thematic analysis, business, Psychosocial, Psychopathology, Clinical psychology
الوصف: Among pediatricians, perceived knowledge of efficacy, tolerability, dosing, and side effects of antidepressants represent significant sources of variability in the use of these medications in youth with depressive and anxiety disorders. Importantly, the qualitative factors that relate to varying levels of comfort with antidepressants and willingness to prescribe are poorly understood. Using a mixed-methods approach, in-depth interviews were conducted with community-based and academic medical center-based pediatricians (N = 14). Interviews were audio recorded and iteratively coded; themes were then generated using inductive thematic analysis. The relationship between demographic factors, knowledge of antidepressants, dosing, and side effects, as well as prescribing likelihood scores for depressive disorders, anxiety disorders or co-morbid anxiety and depressive disorders, were evaluated using mixed models. Pediatricians reported antidepressants to be effective and well-tolerated. However, the likelihood of individual physicians initiating an antidepressant was significantly lower for anxiety disorders relative to depressive disorders with similar functional impairment. Pediatricians considered symptom severity/functional impairment, age and the availability of psychotherapy as they considered prescribing antidepressants to individual patients. Antidepressant choice was related to the physician׳s perceived knowledge and comfort with a particular antidepressant, financial factors, and the disorder-specific evidence base for that particular medication and consultation with mental health practitioners. Pediatricians noted similar efficacy and tolerability profiles for antidepressants in youth with depressive disorders and anxiety disorders, but tended to utilize "therapy first" approaches for anxiety disorders relative to depressive disorders. Parental and family factors that influenced prescribing of antidepressants by pediatricians included parental ambivalence, family-related dysfunction and impairment secondary to the child׳s psychopathology as well as the child׳s psychosocial milieu. Pediatricians consider patient- and family-specific challenges when choosing prescribing antidepressant medications and are, in general, less likely to prescribe antidepressants for youth with anxiety disorders compared to youth with depressive disorders. The lower likelihood of prescribing antidepressants for anxious youth is not related to perception of the efficacy or tolerability, but rather to a perception that anxiety disorders are less impairing and more appropriately managed with psychotherapy.
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المؤلفون: Gary L. McPhail, Daniel H. Grossoehme, Sian Cotton
المصدر: Journal of Health Care Chaplaincy. 19:22-32
مصطلحات موضوعية: Adult, Complementary Therapies, Male, Parents, medicine.medical_specialty, Health (social science), Adolescent, Cystic Fibrosis, media_common.quotation_subject, Faith healing, Alternative medicine, Pastoral Care, Article, Young Adult, Nursing, Professional-Family Relations, Pastoral care, Humans, Medicine, Child, Qualitative Research, media_common, Modalities, business.industry, Religious studies, Cognitive reframing, Middle Aged, Prayer, Clinical Psychology, Child, Preschool, Family medicine, Female, business, Faith Healing, Aromatherapy, Qualitative research
الوصف: Complementary and alternative medicine (CAM) use, including spiritual modalities, is common in pediatric chronic diseases. However, few users discuss CAM treatments with their child's physician. Semi-structured interviews of 25 parents of children who have cystic fibrosis (CF) were completed. Primary themes were identified by thematic analyses. Most parents (19/25) used at least one CAM modality with their child. Only two reported discussing CAM use with their child's pulmonologist. Most reported prayer as helpful (81%) and multi-faceted, including individual and group prayer; using aromatherapy or scented candles as an adjunct for relaxation; and the child's sleeping with a blessed prayer. Parents ascribed sacred significance to natural oral supplements. CAM use is relevant to the majority of participating parents of children under age 13 with CF. Chaplains can play a significant role by reframing prayer's integration into chronic disease care, co-creating rituals with pediatric patients, and mediating conversations between parents and providers.
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المؤلفون: Judith R. Ragsdale, John P. Clancy, Michael Seid, Sian Cotton, Daniel H. Grossoehme, Melenie A. Meyers, Patricia M. Joseph
المصدر: Journal of Health Care Chaplaincy. 18:110-120
مصطلحات موضوعية: Adult, Male, Religion and Psychology, Coping (psychology), Health (social science), Cystic Fibrosis, Treatment adherence, Health outcomes, Article, Grounded theory, Adaptation, Psychological, Spirituality, Humans, Qualitative Research, Motivation, Stressor, Religious studies, Cognitive reframing, Middle Aged, Clinical Psychology, Patient Compliance, Female, Psychological Theory, Psychology, Qualitative research, Clinical psychology
الوصف: Chronic illness is a significant stressor; the majority of Americans cope utilizing spirituality. Numerous studies demonstrate links between spiritual coping and health outcomes. The purpose of this study was to determine whether persons diagnosed with cystic fibrosis (CF) as adults use spirituality to cope and influence disease management. Semi-structured interviews were completed and analyzed using grounded theory. Data saturation was reached following twelve interviews (83% female); representing 100% participation of those approached and 48% of eligible adults. Persons with late-life CF diagnoses used spirituality to make meaning, understanding themselves in a collaborative partnership with their pulmonologist and God. Supporting themes were: (a) God's intervention depended on treatment adherence and (b) spiritual meaning was constructed through positively reframing their experience. The constructed meaning differed from that of adult parents of children with CF. Late-life diagnosed adults focused on personal responsibility for health. Clinical and research implications for chaplains are presented.
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المؤلفون: Joel Tsevat, Ian Kudel, William C. Holmes, Sian Cotton, Magda Szaflarski
المصدر: Annals of Behavioral Medicine. 41:92-103
مصطلحات موضوعية: Adult, Male, Coping (psychology), HIV Infections, Models, Psychological, Structural equation modeling, Religiosity, Young Adult, Social support, Adaptation, Psychological, Humans, Spirituality, Young adult, General Psychology, Aged, Causal model, Depression, Social Support, Middle Aged, Mental health, Religion, Psychiatry and Mental health, Health psychology, Mental Health, Female, Self Report, Psychology, Clinical psychology
الوصف: A causal model developed by Koenig suggests that higher levels of spirituality and religiosity effect intermediary variables and eventually result in better mental health, which then positively affects physical function. Using structural equation modeling, we tested the model and expanded versions that use self-report data of patients with HIV (n = 345). All models demonstrated good overall fit with significant parameters. The final model found that increased spirituality/religiosity predicted increased religious coping, which influenced social support. Social support, in turn, positively influenced depressed mood (as a measure of mental health); depressed mood affected fatigue; and both variables predicted self-reported physical function. These three variables predicted health rating/utility for one’s health state. Additional analyses found that two covariates, religiosity and race, differentially predicted spirituality/religiosity and religious coping. In patients with HIV, an expanded version of Koenig’s model found that increased spirituality/religiosity is positively associated with self-reported outcomes.
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المؤلفون: Michael S. Yi, Sian Cotton, Richard W. Hornung, Joseph M. Mrus, Christina M. Puchalski, Terrance J. Wade, Amy H. Peterman, Mona L. Ho, Joel Tsevat
المصدر: Journal of General Internal Medicine. 21:S21-S27
مصطلحات موضوعية: Adult, Male, Religion and Psychology, medicine.medical_specialty, Health Status, HIV Infections, Comorbidity, Cohort Studies, Quality of life, Acquired immunodeficiency syndrome (AIDS), Immunopathology, Adaptation, Psychological, Prevalence, Internal Medicine, Humans, Medicine, Psychiatry, Depression (differential diagnoses), Marital Status, Depression, business.industry, Original Articles, medicine.disease, Mental health, United States, Causality, Mood disorders, Multivariate Analysis, Female, business, Cohort study
الوصف: Depression has been linked to immune function and mortality in patients with chronic illnesses. Factors such as poorer spiritual well-being has been linked to increased risk for depression and other mood disorders in patients with HIV.We sought to determine how specific dimensions of religion, spirituality, and other factors relate to depressive symptoms in a contemporary, multi-center cohort of patients with HIV/AIDS.Patients were recruited from 4 medical centers in 3 cities in 2002 to 2003, and trained interviewers administered the questionnaires. The level of depressive symptoms was measured with the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale. Independent variables included socio-demographics, clinical information, 8 dimensions of health status and concerns, symptoms, social support, risk attitudes, self-esteem, spirituality, religious affiliation, religiosity, and religious coping. We examined the bivariate and multivariable associations of religiosity, spirituality, and depressive symptoms.We collected data from 450 subjects. Their mean (SD) age was 43.8 (8.4) years; 387 (86.0%) were male; 204 (45.3%) were white; and their mean CD4 count was 420.5 (301.0). Two hundred forty-one (53.6%) fit the criteria for significant depressive symptoms (CESD-10 scoreor = 10). In multivariable analyses, having greater health worries, less comfort with how one contracted HIV, more HIV-related symptoms, less social support, and lower spiritual well-being was associated with significant depressive symptoms (P.05).A majority of patients with HIV reported having significant depressive symptoms. Poorer health status and perceptions, less social support, and lower spiritual well-being were related to significant depressive symptoms, while personal religiosity and having a religious affiliation was not associated when controlling for other factors. Helping to address the spiritual needs of patients in the medical or community setting may be one way to decrease depressive symptoms in patients with HIV/AIDS.
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المؤلفون: John M. Salsman, Cassie R. Campbell, Amy H. Peterman, Eboni C. Winford, Joel Tsevat, Sian Cotton, Richard P. McQuellon, Charlie L. Reeve
المصدر: Psychological assessment. 26(1)
مصطلحات موضوعية: Adult, Male, Psychometrics, Sense of Coherence, Test validity, Article, Developmental psychology, Surveys and Questionnaires, Outcome Assessment, Health Care, Humans, Spirituality, Meaning (existential), Aged, Discriminant validity, Construct validity, Middle Aged, Mental health, Psychiatry and Mental health, Clinical Psychology, Scale (social sciences), Well-being, Chronic Disease, Female, Psychology, Factor Analysis, Statistical, Social psychology
الوصف: The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp; Peterman, Fitchett, Brady, Hernandez, & Cella, 2002) has become a widely used measure of spirituality; however, there remain questions about its specific factor structure and the validity of scores from its separate scales. Specifically, it remains unclear whether the Meaning and Peace scales denote distinct factors. The present study addresses previous limitations by examining the extent to which the Meaning and Peace scales relate differentially to a variety of physical and mental health variables across 4 sets of data from adults with a number of chronic health conditions. Although a model with separate but correlated factors fit the data better, discriminant validity analyses indicated limited differences in the pattern of associations each scale showed with a wide array of commonly used health and quality-of-life measures. In total, the results suggest that people may distinguish between the concepts of Meaning and Peace, but the observed relations with health outcomes are primarily due to variance shared between the 2 factors. Additional research is needed to better understand the separate and joint role of Meaning and Peace in the quality of life of people with chronic illness.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8fa5c3d2481b9fada9cd17a33ed73582
https://pubmed.ncbi.nlm.nih.gov/24188147 -
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المؤلفون: Judy Ragsdale, Alexandra L. Quittner, Gary L. McPhail, Daniel H. Grossoehme, Sian Cotton, Michael Seid
المصدر: Journal of health care chaplaincy. 19(2)
مصطلحات موضوعية: Adult, Male, Parents, Health (social science), Psychotherapist, Adolescent, Cystic Fibrosis, Treatment adherence, media_common.quotation_subject, Disease, Grounded theory, Article, Faith, Young Adult, Spirituality, Medicine, Humans, Young adult, Child, Qualitative Research, media_common, business.industry, Religion and Medicine, Religious studies, Middle Aged, Prayer, humanities, Clinical Psychology, Child, Preschool, Patient Compliance, Female, business, Psychological Theory, Qualitative research
الوصف: A limited number of studies address parental faith and its relationship to their children's health. Using cystic fibrosis as a disease exemplar in which religion/spirituality have been shown to play a role and parental health behaviors (adherence to their child's daily recommended home treatments) are important, this study explored whether parents with different levels of adherence would describe use of faith differently. Twenty-five interviews were completed and analyzed using grounded theory methodology. Some parents described no relationship between faith and treatment adherence. However, of those who did, higher-adherence parents believed God empowered them to care for their child and they used prayer to change themselves, while lower-adherence parents described trusting God to care for their child and used prayer to change God. Clinical implications for chaplains' differential engagement with parents are presented.
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المؤلفون: Joseph M. Mrus, Judith Feinberg, Joel Tsevat, Anthony C. Leonard, Sian Cotton, Magdalena Szaflarski, Susan N. Sherman
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Longitudinal study, media_common.quotation_subject, Health Status, Human immunodeficiency virus (HIV), Self-concept, HIV Infections, medicine.disease_cause, Article, Cohort Studies, Interviews as Topic, Social support, Optimism, Quality of life, Surveys and Questionnaires, Medicine, Humans, Spirituality, Longitudinal Studies, Psychiatry, media_common, business.industry, Public Health, Environmental and Occupational Health, Social Support, Middle Aged, Viral Load, Self Concept, Religion, Infectious Diseases, Family medicine, HIV-1, Quality of Life, Female, sense organs, business, Viral load, Cohort study
الوصف: The objective of this study was to assess in patients with HIV perceptions of life pre-HIV versus post-HIV diagnosis and examine whether such perceptions change over time. We conducted interviews and chart reviews of 347 outpatients with HIV from three cities in 2002-2004. In two interviews 12-18 months apart, patients compared their life now with their life before HIV was diagnosed. Independent variables included demographic and clinical characteristics; HIV-specific health status, symptoms, and concerns; spirituality/religion; social support; self-perception; and optimism. The patients' mean (standard deviation [SD]) age was 44.8 (8.3) years; half were minorities; and 269 (78%) were taking antiretroviral therapy. Comparing life at time 1 versus before diagnosis, 109 (31%) patients said their life was better at time 1, 98 (28%) said it was worse, and the rest said it was about the same or did not know. By time 2, approximately one fifth of the patients changed their answers to indicate life improvement and one sixth changed them to indicate life deterioration. In multivariable analysis, change in perception for the better between time 1 and time 2 (versus prediagnosis) was positively associated with time 1 positive religious coping scores, whereas change in perception for the worse was associated with study site, heterosexual orientation, a detectable viral load, shorter duration of HIV, lower spirituality scores, and lower positive religious coping scores. We conclude that many patients with HIV feel that their life is better than it was before their diagnosis, although results of such comparisons often change over time.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4bd9e23de39fcdd072c83fd3c09eaea3
https://europepmc.org/articles/PMC2832655/ -
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المؤلفون: Michael S. Yi, M. Susan Moyer, Maria T. Britto, Frank W. Putnam, Sian Cotton, Joel Tsevat, Uma R. Kotagal, Deborah Canfield, Susan N. Sherman, Steven Carlton-Ford
مصطلحات موضوعية: Gerontology, Adult, Male, medicine.medical_specialty, Multivariate analysis, Adolescent, Visual analogue scale, Health Status, Inflammatory bowel disease, Article, Quality of life, Internal medicine, Adaptation, Psychological, medicine, Humans, Spirituality, Child, Ohio, business.industry, Public health, Case-control study, Time tradeoff, medicine.disease, Inflammatory Bowel Diseases, Quality-adjusted life year, Case-Control Studies, Pediatrics, Perinatology and Child Health, Multivariate Analysis, Quality of Life, Female, business, Attitude to Health
الوصف: Objective To examine for differences in and predictors of health value/utility scores in adolescents with or without inflammatory bowel disease (IBD). Study design Adolescents with IBD and healthy control subjects were interviewed in an academic health center. We collected sociodemographic data and measured health status, personal, family, and social characteristics, and spiritual well-being. We assessed time tradeoff (TTO) and standard gamble (SG) utility scores for current health. We performed bivariate and multivariable analyses with utility scores used as outcomes. Results Sixty-seven patients with IBD and 88 healthy control subjects 11 to 19 years of age participated. Among subjects with IBD, mean (SD) TTO scores were 0.92 (0.17), and mean (SD) SG scores were 0.97 (0.07). Among healthy control subjects, mean (SD) TTO scores were 0.99 (0.03) and mean (SD) SG scores were 0.98 (0.03). TTO scores were significantly lower ( P = .001), and SG scores trended lower ( P = .065) in patients with IBD when compared with healthy control subjects. In multivariable analyses controlling for IBD status, poorer emotional functioning and spiritual well-being were associated with lower TTO (R 2 = 0.17) and lower SG (R 2 = 0.22) scores. Conclusion Direct utility assessment in adolescents with or without IBD is feasible and may be used to assess outcomes. Adolescents with IBD value their health state highly, although less so than healthy control subjects. Emotional functioning and spiritual well-being appear to influence utility scores most strongly.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9503d089bf31c106d39b338d9e0db117
https://europepmc.org/articles/PMC2757929/ -
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المؤلفون: Paul A. Succop, Harini Pallerla, Ian Kudel, Michael S. Yi, Yvonne Humenay Roberts, Sian Cotton, Joel Tsevat
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Ethnic group, Article, Young Adult, Quality of life (healthcare), Spirituality, Medicine, Humans, Young adult, Psychiatry, Child, Depression (differential diagnoses), Ohio, business.industry, Public Health, Environmental and Occupational Health, Case-control study, Inflammatory Bowel Diseases, Mental health, Psychiatry and Mental health, Mental Health, Case-Control Studies, Pediatrics, Perinatology and Child Health, Well-being, Female, business
الوصف: The purpose of this study was threefold: 1) to describe spiritual well-being (existential and religious well-being) in adolescents with inflammatory bowel disease (IBD) versus healthy peers; 2) to examine associations of spiritual well-being with mental health outcomes (emotional functioning and depressive symptoms); and 3) to assess the differential impact of existential versus religious well-being on mental health.A total of 155 adolescents aged 11-19 years from a children's hospital and a university hospital filled out questionnaires including the Spiritual Well-Being Scale, the Children's Depression Inventory-Short Form, and the Pediatric Quality of Life Inventory. Covariates in multivariable models included demographics, disease status, and interactions.Participants' mean (SD) age was 15.1 (2.0) years; 80 (52%) were male; and 121 (78%) were of white ethnicity. Levels of existential and religious well-being were similar between adolescents with IBD and healthy peers. In multivariable analyses, existential well-being was associated with mental health (partial R(2) change = .08-.11, p.01) above and beyond other characteristics (total R(2) = .23, p.01). Presence of disease moderated both the relationship between existential well-being and emotional functioning and that between religious well-being and depressive symptoms: that is, the relationships were stronger in adolescents with IBD as compared with healthy peers. Religious well-being was only marginally significantly associated with mental health after controlling for other factors.Although both healthy adolescents and those with IBD had high levels of spiritual well-being, having IBD moderated the relationship between spiritual well-being and mental health. Meaning/purpose was related to mental health more than was connectedness to the sacred.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::99bafaa1dac8249e1193f8e5b6895f59
https://europepmc.org/articles/PMC2704380/
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