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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: Christina M. Luberto, Monzer Haj-Hamed, Whitney Janee Raglin Bignall, Sian Cotton, Adrianne Falkenberg Cornette
المصدر: Journal of Asthma. 52:889-896
مصطلحات موضوعية: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Universities, Urban Population, Pilot Projects, Anxiety, law.invention, Patient Education as Topic, Quality of life, Randomized controlled trial, law, Intervention (counseling), Asthma control, Humans, Immunology and Allergy, Medicine, Breathing retraining, Asthma, business.industry, Respiration, medicine.disease, Community-Institutional Relations, United States, Respiratory Function Tests, respiratory tract diseases, Test (assessment), Black or African American, Self Care, Pediatrics, Perinatology and Child Health, Quality of Life, Physical therapy, Female, medicine.symptom, business
الوصف: Asthma affects approximately seven million children/adolescents in the USA, with African-American children disproportionately affected. Breathing retraining techniques have been shown to improve asthma outcomes in adults, though research in youth is limited. The purpose of this pilot study was to test the feasibility and preliminary efficacy of a school-based randomized controlled trial of breathing retraining for asthma outcomes and anxiety symptoms in a sample of urban, African-American adolescents.Adolescents were randomized into either the intervention group (20-min breathing retraining plus education) or control group (20-min standard education). Participants completed two study visits, one month apart. Asthma control, asthma quality of life and lung functioning (FEV1 and peak flow) were the primary outcomes, and state anxiety (pre-post the intervention) and trait anxiety (over the one-month period) were the secondary outcomes.Thirty-three African-American adolescents participated in the study, with a 90% retention rate between visit 1 and visit 2. Asthma control and asthma quality of life, significantly improved over time (p ≤ 0.01) with no differences between intervention and control groups. State anxiety significantly decreased (p ≤ 0.01) immediately post intervention at both time points with no differences between groups. There were no significant differences found in lung functioning or trait anxiety over the one-month time period.These preliminary results suggest that breathing retraining is a feasible, acceptable and potentially efficacious intervention (although no significant differences between groups were found) for improving asthma symptoms in urban adolescents with asthma in a school-based setting.
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المؤلفون: Jerren C. Weekes, Michael S. Yi, Meghan E. McGrady, Kenneth I. Pargament, Susan L. Rosenthal, Joel Tsevat, Sian Cotton, Yvonne Humenay Roberts, Paul A. Succop
المصدر: Journal of Religion and Health. 51:118-131
مصطلحات موضوعية: Male, Religion and Psychology, medicine.medical_specialty, Adolescent, Urban Population, media_common.quotation_subject, Ethnic group, Article, Interviews as Topic, Religiosity, Surveys and Questionnaires, Spirituality, medicine, Humans, General Nursing, Asthma, media_common, Medical setting, Public health, Religious studies, Mean age, General Medicine, medicine.disease, United States, Prayer, Female, Psychology, Attitude to Health, Clinical psychology
الوصف: Predictors of multiple dimensions of spirituality/religiosity (S/R) and adolescents' preferences for having S/R (e.g., prayer) addressed in hypothetical medical settings were assessed in a sample of urban adolescents with asthma. Of the 151 adolescents (mean age = 15.8, 60% female, 85% African-American), 81% said that they were religious and spiritual, 58% attended religious services in the past month, and 49% prayed daily. In multivariable models, African-American race/ethnicity and having a religious preference were associated with higher levels of S/R (R (2) = 0.07-0.25, P .05). Adolescents' preferences for including S/R in the medical setting increased with the severity of the clinical situation (P .05).
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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: Joel Tsevat, P. Neal Ritchey, Sian Cotton, Anthony C. Leonard, Ian Kudel, Magdalena Szaflarski
المصدر: Journal of religion and health. 51(4)
مصطلحات موضوعية: Coping (psychology), medicine.medical_specialty, Concept Formation, Human immunodeficiency virus (HIV), Multidimensional assessment, HIV Infections, Empirical Research, medicine.disease_cause, Article, Empirical research, Surveys and Questionnaires, Spirituality, medicine, Humans, In patient, General Nursing, Public health, Religious studies, General Medicine, Models, Theoretical, United States, Religion, Conceptual framework, Quality of Life, Psychology, Factor Analysis, Statistical, Social psychology
الوصف: A decade ago, an expert panel developed a framework for measuring spirituality/religion in health research (Brief Multidimensional Measure of Religiousness/Spirituality), but empirical testing of this framework has been limited. The purpose of this study was to determine whether responses to items across multiple measures assessing spirituality/religion by 450 patients with HIV replicate this model. We hypothesized a six-factor model underlying a collective of 56 items, but results of confirmatory factor analyses suggested eight dimensions: Meaning/Peace, Tangible Connection to the Divine, Positive Religious Coping, Love/Appreciation, Negative Religious Coping, Positive Congregational Support, Negative Congregational Support, and Cultural Practices. This study corroborates parts of the factor structure underlying the Brief Multidimensional Measure of Religiousness/Spirituality and some recent refinements of the original framework.
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المؤلفون: Sian, Cotton, Devon, Berry
المصدر: Adolescent medicine: state of the art reviews. 18(3)
مصطلحات موضوعية: Male, Adolescent, Health Behavior, Psychology, Adolescent, Coitus, Religion and Sex, United States, Adolescent Behavior, Humans, Female, Interpersonal Relations, Attitude to Health, Contraception Behavior, Life Style, Sexual Abstinence
الوصف: There are many individual, family, and cultural factors that influence the development of healthy sexuality in adolescents. One factor that is less often described but may play a role is religion/spirituality. Adolescents' religious/spiritual belief system or the cultural religious context within which they are raised may impact their attitudes or beliefs about having sex before marriage, decisions about the timing of coital debut, or contraceptive practices. In this article we will define the terms "religiosity" and "spirituality"; highlight the key scientific literature on the relationships between religiosity, spirituality, and adolescent sexual health outcomes (e.g., coital debut, contraceptive practices), including describing why religiosity/spirituality may be related to these outcomes; and briefly discuss programs/clinical implications for integrating these findings into clinical practice.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=pmid________::3fdf3146ba2393201d3503df13b2788f
https://pubmed.ncbi.nlm.nih.gov/18453228 -
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المؤلفون: Joel Tsevat, Ian Kudel, Anthony C. Leonard, William C. Holmes, Sian Cotton, Susan N. Sherman, Magdalena Szaflarski, Judith Feinberg
المصدر: Journal of general internal medicine. 21
مصطلحات موضوعية: Gerontology, Adult, Male, Religion and Psychology, Social Alienation, Coping (psychology), medicine.medical_specialty, media_common.quotation_subject, Human immunodeficiency virus (HIV), HIV Infections, Ethnic origin, medicine.disease_cause, Life Change Events, Acquired immunodeficiency syndrome (AIDS), Spirituality, Internal Medicine, Odds Ratio, Medicine, Humans, Sex Distribution, skin and connective tissue diseases, media_common, business.industry, Public health, Odds ratio, Original Articles, medicine.disease, United States, Black or African American, Social alienation, Female, sense organs, business, Clinical psychology
الوصف: Having a serious illness such as HIV/AIDS raises existential issues, which are potentially manifested as changes in religiousness and spirituality. The objective of this study was (1) to describe changes in religiousness and spirituality of people with HIV/AIDS, and (2) to determine if these changes differed by sex and race.Three-hundred and forty-seven adults with HIV/AIDS from 4 sites were asked demographic, clinical, and religious/spiritual questions. Six religious/spiritual questions assessed personal and social domains of religiousness and spirituality.Eighty-eight participants (25%) reported being "more religious" and 142 (41%) reported being "more spiritual" since being diagnosed with HIV/AIDS. Approximately 1 in 4 participants also reported that they felt more alienated by a religious group since their HIV/AIDS diagnosis and approximately 1 in 10 reported changing their place of religious worship because of HIV/AIDS. A total of 174 participants (50%) believed that their religiousness/spirituality helped them live longer. Fewer Caucasians than African Americans reported becoming more spiritual since their HIV/AIDS diagnosis (37% vs 52%, respectively; P.015), more Caucasians than African Americans felt alienated from religious communities (44% vs 21%, respectively; P.001), and fewer Caucasians than African Americans believed that their religiousness/spirituality helped them live longer (41% vs 68% respectively; P.001). There were no significantly different reported changes in religious and spiritual experiences by sex.Many participants report having become more spiritual or religious since contracting HIV/AIDS, though many have felt alienated by a religious group-some to the point of changing their place of worship. Clinicians conducting spiritual assessments should be aware that changes in religious and spiritual experiences attributed to HIV/AIDS might differ between Caucasian and African Americans.
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المؤلفون: Christina M. Puchalski, Anthony C. Leonard, Joseph M. Mrus, Amy H. Peterman, Sian Cotton, Judith Feinberg, Amy C. Justice, Susan N. Sherman, Joel Tsevat, Kenneth I. Pargament
المصدر: Journal of General Internal Medicine. 24:994-994
مصطلحات موضوعية: Adult, Male, Religion and Psychology, medicine.medical_specialty, Multivariate analysis, Alcohol Drinking, media_common.quotation_subject, education, Ethnic group, Self-concept, HIV Infections, Personal Satisfaction, Social support, Acquired immunodeficiency syndrome (AIDS), Residence Characteristics, Adaptation, Psychological, Spirituality, Ethnicity, medicine, Internal Medicine, Humans, Psychiatry, media_common, business.industry, Self-esteem, Social Support, Original Articles, social sciences, medicine.disease, Self Concept, United States, humanities, Logistic Models, Multivariate Analysis, Female, Erratum, business, Psychosocial, Follow-Up Studies
الوصف: Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months.We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy-Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms.The patients' mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God's love and care) more often than negative ones (e.g., wondered whether God has abandoned me; P.0001). In 8 multivariable models, factors associated with most facets of spirituality/religion included ethnic and racial minority status, greater optimism, less alcohol use, having a religion, greater self-esteem, greater life satisfaction, and lower overall functioning (R2=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months.Most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness. Patients with greater optimism, greater self-esteem, greater life satisfaction, minorities, and patients who drink less alcohol tend to be both more spiritual and religious. Spirituality levels remain stable over 12 to 18 months.
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