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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Adaptation Nursing Model provided the theoretical framework for the comparative analysis of psychological and physiologic adaptation of 211 adults representing three diagnostic groups (rheumatoid arthritis, hypertension, and multiple sclerosis). Data were collected through interviews and completion of the Mental Health Index, Health-Related Hardiness Scale, and Margin in Life. Psychological adaptation was found to be independent of diagnosis. Four predictor variables (health promotion activities, psychological distress, physiologic adaptation, and dependence on medications) significantly discriminated among the three groups and correctly classified 73.08% of the total sample. Presence of the hardiness characteristic was significantly related to psychological and physiologic adaptation, involvement in health promotion activities, and participation in patient education programs. It can be concluded that a diagnosis-specific view of psychological status is not tenable or clinically meaningful.
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PMID:Responses to chronic illness: analysis of psychological and physiological adaptation. 239 37

This study examined the relationship between symptoms of psychiatric morbidity and health problems among a nationally representative, cross-sectional sample of 2107 black adults from the National Survey of Black Americans. Subjects experiencing a high level of psychiatric symptomatology had a significantly higher number of health problems and reported a lower level of satisfaction with their overall health than blacks with low levels of psychiatric symptoms or those who never experienced emotional problems. Individuals with the highest level of psychiatric symptomatology were more likely to have been physician-diagnosed as having ulcers, hypertension, diabetes, kidney problems, nervous-emotional problems, and circulatory system difficulties. These relationships persisted after controlling for age, gender, socioeconomic factors, and traditional risk factors for health problems, such as smoking and alcohol use. Although generally consistent with previous research on predominantly white samples, these specific findings underscore the complexities involved in drawing inferences from associations between psychiatric symptomatology and health problems observed in cross-sectional surveys. Prospective psychiatric epidemiologic studies, utilizing better measures of psychological distress and objective health outcome measures, are needed to clarify the relationship between psychiatric difficulties and health problems among black Americans.
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PMID:Psychiatric morbidity and health problems among black Americans: a national survey. 269 55

The aim of this study was to evaluate the presence of "type A" behaviour and possible psychological distress in 373 hypertensive patients. One-hundred and ninety-five males, 56.2 +/- 6.2 years old and one-hundred and seventy-eight females, 57.1 +/- 6.2 years old, coming from the IPPPSH and still under double-blind treatment with or without a beta-blocker (oxprenolol 160 mg SR), were studied by means of the Jenkins Activity Survey form C and several tests from the Cognitive Behavioural Assessment Battery (CBA-2.0). Seventy-four point eight percent of the patients showed a "type A" pattern, and 25.5% were in the extreme predictive interval for coronary heart disease according to WCGS. "Type A" pattern was not influenced by variables such as age, sex, education, job or previous pharmacological treatment. The patients studied did not show any particular psychological distress at the psychometric evaluation. However, special social and cultural characteristics and different therapies influenced some symptoms, such as anxiety, depression and somatic lamentation. According to this study: "type A" behaviour seems to be a steady feature of the hypertensive patient; furthermore, it seems to be due to a "biological imprinting" which can be considered a cause of hypertension; psychological distress depends on a particular set of environmental stimuli. In the first case an accurate prevention is needed while, in the second case adequate pharmacological and/or psychological therapies are needed.
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PMID:[Type A behavior and psychological characteristics of hypertensive patients undergoing antihypertensive treatment]. 275 94

This paper provides a cross-sectional analysis of the physical and emotional well-being of employed and unemployed workers. The data used consists of a sub-sample (N = 14,313) drawn from the Canada Health Survey's national probability sample (N = 31,688). The analysis indicates substantial health differences between employed and unemployed individuals. The unemployed showed significantly higher levels of distress, greater short-term and long-term disability, reported a large number of health problems, had been patients more often, and used proportionately more health services. Consistent with these measures, derived from self-reported data, physician-diagnosed measures also indicate a greater vulnerability of unemployed individuals to serious physical ailments such as heart trouble, pain in heart and chest, high blood pressure, spells of faint-dizziness, bone-joint problems and hypertension. While these health differences between the employed and unemployed persisted across socio-economic and demographic conditions, further analysis indicated strong interaction effects of SES and demographic variables on the association of employment status with physical and emotional health. Females and older unemployed individuals reported more health problems and physician visits whereas the younger unemployed (under 40) reported more psychological distress. The blue-collar unemployed were found to be considerably more vulnerable to physical illness whereas the unemployed with professional background reported more psychological distress. The low-income unemployed who were also the principal family earners, were the most psychologically distressed. A regional look at the data showed that the low-income unemployed suffered the most in terms of depressed mood in each region of the country. It is apparent that unemployment and its health impact reflect the wider class-based inequalities of advanced industrial societies. The need for social policies that effectively reduce unemployment and the detrimental impact of unemployment is clear.
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PMID:Unemployment and health: an analysis of "Canada Health Survey" data. 387 39

This report gives results from eight intensive, exploratory interviews with Black women who suffered infant deaths within one year after delivery. Interviews were conducted as a final step in a research project to discover the correlates of very low birthweight among disadvantaged women in a city which maintains among the highest low birthweight and infant mortality rates in the United States. Qualitative results are presented within the context of a case/control study based on an in-depth medical record review. Statistical results showed that prenatal care, alcoholism, migrant status, smoking, hypertension history and previous poor pregnancy outcome distinguished women with very low birthweight infants. The medical record review also implicated violence, weak social support systems, poor social and psychological adjustments and ineffective contraception. Interview results further explore the social and psychological context of pregnancy for the disadvantaged inner city Black woman. Three-quarters of all women are unmarried at the time of delivery, and interviewed women expressed bitterness and resentment toward the men in their livers for non-support. They received the most help from 'girlfriends', and not consistent support--as expected--from mothers and female kin. Answers to open-ended questions and responses to a specially designed interview section on attitudes and beliefs suggest that these women conceptually dissociate three important areas of cultural focus: relationships with men, pregnancy and childbirth; and, that they value the 'gestator' role as separate from the role of 'mother'. They espouse contradictory beliefs about men: they believe that men are predatory and not trustworthy, but also more mainstream beliefs that call for reliance on the opposite sex. Because of their unstable relationships with men and their long histories of poor pregnancy outcome and termination, they face frequent disappointment. Responses to items in the attitudes and beliefs section suggest that these women feel powerless, hopeless and that life is somewhat meaningless. However, items designed to test Lewis' 'culture of poverty' do not support the concept of a consistent intergenerational poverty lifestyle. The report closes with a section on program and policy development in several areas: public health recordkeeping, health style education programs, special training programs for physicians and other health personnel, and some type of program to combat the social alienation and psychological distress of inner city women during pregnancy.
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PMID:Social and cultural factors in the etiology of low birthweight among disadvantaged blacks. 401 45

Health beliefs influencing compliance and psychosocial adjustment to illness were compared in two groups of hypertensive patients. Based upon clinical judgments of physicians, 15 controlled and 15 uncontrolled hypertensives made up the study group. Subjects came from a white middle to upper class suburban community and were demographically homogeneous. There was no significant difference between groups in health beliefs affecting compliance, but significant differences were found in several domains related to psychosocial adjustment to illness. Uncontrolled hypertensives showed less illness-related adjustment. They reported significantly greater difficulties in their domestic environments, more disturbances in extended family relationships, and more psychological distress. Less adjustment to illness was significantly correlated with less compliance and with a more complex medication regimen. No relationships were found between compliance and demographic variables, medication variables, or duration of hypertension; nor between adjustment, demographic variables, or illness duration. Clinical assessment of illness-related adjustment problems may help enhance compliance of hypertensive patients.
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PMID:Health beliefs, adjustment to illness, and control of hypertension. 656 95

Previous research has yielded inconsistent results in the control of essential hypertension. One explanation for response to drug or behavioral therapy may be the patient's psychological status upon entering treatment. Thirty-five borderline hypertensive males entered into a self-management program with biofeedback and cognitive restructuring components. The SCL-90 (Symptom Checklist-90) and the Holmes' Schedule of Recent Events were used to determine if responders and nonresponders could be distinguished prior to treatment on the basis of psychological status. Patients whose hypertension was resistant to treatment (diastolic greater than or equal to 90 mm Hg) reported significantly greater levels of psychological distress and greater life changes than did controlled patients. Pretreatment differences could not be explained by compliance or expectation of success. This study suggests that a relationship exists between psychological distress, life changes and the subsequent control of hypertension; this has implications for treatment selection and design for psychologically distressed individuals.
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PMID:The impact of psychological distress on the control of hypertension. 667 69

Evidence of the interaction between psychological factors and blood pressure is reviewed with a focus on stressful events and mental health. While the hypertensive personality remains an elusive and perhaps fictional entity, and indices of psychological distress, psychopathology, or poor adjustment do not correlate highly with blood pressure or hypertension, environment stressors such as the threat of unemployment and job pressures adversely affect blood pressure and mental health across groups of individuals. Recent studies suggest that the diagnosis of hypertension may elicit clinically significant psychological distress and anxiety. Adverse reactions to antihypertensive medication may interact with and exacerbate pre-existing distress. Implications for nurses dealing with hypertensive patients are discussed.
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PMID:Blood pressure, stress, and mental health. 676 59

Two self-rating scales of psychological distress, the Symptom Rating Test (SRT) and the Symptom Questionnaire (SQ), have been validated in translations in Italy. They were administered in several studies to psychiatric patients (neurotics and depressives), matched controls, and patients suffering from various organic illnesses (dermatologic disorders, hypertension, secondary amenorrhea and patients undergoing amniocentesis). The SRT and the SQ sensitively discriminated between psychiatric patients and normals, between different levels of psychological distress in several of the somatic illnesses, and detected significant changes in the psychological status of patients participating in medical procedures such as amniocentesis. The scales were found to be useful in research in psychiatry and psychosomatic medicine. The findings suggest that the Italian translations are valid and sensitive scales of distress and can apparently be used as effectively in research as the original. They are likely to be of value in cross-cultural research in Canada. Both scales may be helpful in the psychological assessment of Italian immigrants in North America and Australia, especially in those whose English is poor.
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PMID:Italian validation of the Symptom Rating Test (SRT) and Symptom Questionnaire (SQ). 683 79

A consecutive unselected series of 20 outpatients suffering from essential hypertension is included in this study. These patients were compared to a control group of 20 patients other than hypertensives, matched for age, sex, marital status, years of schooling, social class and duration of illness. Stressful life events prior to illness onset, psychological distress as measured by SCL-90, and alexithymia were investigated. Patients with hypertension were exposed to undesirable life events before disease onset and exhibited alexithymic traits significantly more than the control group.
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PMID:Stress and distress in essential hypertension. 720 58


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