A Mixed-Methods Study of the Care Needs of Individuals With Idiopathic Pulmonary Fibrosis and Their carers–CaNoPy: A Study Protocol.
A mixed-methods study of the Care Needs of individuals with idiopathic Pulmonary fibrosis and their carers–CaNoPy: a study protocol.
BMJ Open. 2013; 3(8):
Byrne A, Sampson C, Baillie J, Harrison K, Hope-Gill B, Hubbard R, Griffiths G, Nelson A
Idiopathic pulmonary fibrosis (IPF) is a progressive, life-threatening illness of unknown aetiology, with no proven pharmacological treatments. There is a limited evidence base indicating that the disease negatively affects quality of life, leading to increased dependence, restrictions on daily activities and fatigue. However, there is a paucity of in-depth information on disease impact across its trajectory, particularly in relation to unmet needs, outcomes of importance to patients and the experiences of carers. Furthermore, little is known about the support and information needs of individuals and their carers, or at what point individual need should trigger a referral to palliative care services.A mixed-methods study is proposed recruiting individuals with IPF at different stages of the disease and their carers from three respiratory centres in England and Wales. In-depth interviews will be undertaken with participants, adopting an Interpretative Phenomenological Analysis approach. The study will also use validated questionnaires to explore quality of life (EQ-5D), depression (Hospital Anxiety and Depression Scale), breathlessness (Borg dyspnoea scale) and cough (Leicester Cough Questionnaire, Cough Symptom Score).Ethical approvals were gained in April 2012. Palliative care research is a developing field, but there has been limited focus on IPF. We anticipate that the results of the study will enable healthcare professionals to provide appropriate palliative care across the trajectory for individuals with the disease, and their carers, and we therefore aim to disseminate via relevant respiratory and palliative care journals and conferences. We will also support the lay representative involved in the project to disseminate the findings to patient groups. HubMed – depression
Predictors of Short-Term Outcome to Exercise and Manual Therapy for People With Hip Osteoarthritis.
Phys Ther. 2013 Aug 8;
French HP, Galvin R, Cusack T, McCarthy GM
Physical therapy for hip osteoarthritis (OA) has shown short-term effects but limited long-term benefit. There has been limited research, with inconsistent results, in identifying prognostic factors associated with a positive response to physical therapy.To identify potential predictors of response to physical therapy (exercise therapy (ET) with or without adjunctive manual therapy (MT)) for hip OA based on baseline patient-specific and clinical characteristics.Prognostic study.Secondary analysis of data from a multicentre RCT (n=131) which evaluated the effectiveness of ET and ET+MT for hip OA was undertaken. Treatment response was defined using OMERACT/OARSI responder criteria. Ten baseline measures were used as predictor variables. Regression analyses were undertaken to identify predictors of outcome. Discriminative ability (sensitivity, specificity and likelihood ratios) of significant variables was calculated.The RCT results showed no significant difference in most outcomes between ET and ET+MT post-treatment (9 weeks) and 18 weeks. Forty-six patients were classified as responders at 9 weeks and 36 at 18 weeks. Four baseline variables were predictive of positive outcome at 9 weeks: male gender, pain with activity (<6/10), Western Ontario and McMaster University physical function (<34/68) and psychological health (Hospital Anxiety and Depression Scale <9/42). No predictor variables were identified for 18- week follow-up. Prognostic accuracy was fair for all four variables (sensitivity: 0.5-0.58; specificity: 0.57-0.72, likelihood ratios 1.25-1.77), indicating fair discriminative ability at predicting treatment response.We were unable to identify baseline variables in patients with hip OA that indicate those most likely to respond to treatment due to low discriminative ability. Further validation studies are required to definitively define the best predictors of response to physical therapy in hip OA. HubMed – depression
Impulsive frotteurism: A case report.
Med Sci Law. 2013 Aug 8;
Patra AP, Bharadwaj B, Shaha KK, Das S, Rayamane AP, Tripathi CS
Frotteurism is a perverted sexual behaviour wherein the person tends to rub or bring about physical contact between his genitals and an unrelated female or male to derive sexual pleasure. Moreover, frotteurism is a common phenomenon among the general population which usually goes unnoticed or overlooked. Nevertheless, public frottage has legal implications in almost all countries over the world. But, when frotteurism manifests on the backdrop of psychiatric illness or as a developmental abnormality then it is worth discussing what the legal liability would be. The present case report is based on hypersexual frotteuristic behaviour manifested on the background of a concealed psychiatric illness, featuring depression and obsessive compulsive disease. The hypersexual behaviour manifested in the form of masturbation with features of frotteurism and subsequent development of depression. Nevertheless, compulsive manifestation of frotteuristic behaviour and subsequent development of morbid depression is rare. This paper describes a 12-year-old boy having unrestrained impulsive frotteurism with his peers, school mates and with his younger brother. He was conscious of the fact and feeling guilty of what he was doing but unable to restrain himself. It was followed by the development of symptoms of depression which was treated with Sertraline. Concurrent psychiatric counseling and rehabilitation measures were taken too. There was complete remission of the symptoms 6 months after the onset of treatment and without relapse thereafter. The paper discusses the differential diagnosis and management of hypersexual behaviour. HubMed – depression
Acceptance of Home-Based Telehealth Problem-Solving Therapy for Depressed, Low-Income Homebound Older Adults: Qualitative Interviews With the Participants and Aging-Service Case Managers.
Gerontologist. 2013 Aug 8;
Choi NG, Wilson NL, Sirrianni L, Marinucci ML, Hegel MT
To report low-income homebound older adults’ experience of telehealth problem-solving therapy (tele-PST) and aging-service case managers’ (CMs’) experience/perception of client-level personal barriers to accessing psychotherapy in general and PST specifically.The study sample consisted of 42 homebound older adults who participated in the feasibility and efficacy trial of tele-PST and completed 36-week follow-up assessments and 12 CMs of a large home-delivered meals program who referred their clients to the tele-PST trial. In-depth interviews with the older adults and written feedback and focus group discussions with the CMs provided the data.Older adults reported a high rate of approval of PST procedures and acknowledged its positive treatment effect. Tele-PST participants were satisfied with videoconferenced sessions because they were convenient and allowed them to see their therapist. However, CMs reported that only about 10%-20% of potentially eligible older adults gave oral consent for PST. Significant treatment engagement barriers were the older adults’ lack of motivation, denial of depression, perceived stigma, and other personal attitudinal factors.The real-world implementation of tele-PST or other psychotherapies needs to include educating and motivating depressed homebound elders to recognize their depression and accept treatment. HubMed – depression