A review of policy and provision of emotional support for people living with early-stage dementia in the Republic of Ireland and call for specialist counselling and psychotherapy services

Dementia ◽  
2020 ◽  
pp. 147130122097771
Author(s):  
Ashley Morgan
Keyword(s):  
Public Policy ◽  
Emotional Support ◽  
Early Stage ◽  
Emotional Health ◽  
Healthcare Delivery ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Anxiety And Depression ◽  
National Guidelines ◽  
Diagnosis Of Dementia

Public policy in Ireland recognises that people living with early-stage dementia are likely to require considerable emotional support following diagnosis; anxiety and depression are very common within this population. Yet psychosocial interventions to support emotional health of people who receive a diagnosis of dementia are sparse; there is no mention of counselling and psychotherapy for people living with early dementia in national guidelines, despite a promising evidence base that has amassed internationally in recent decades. This article explores the psychological impact of receiving a diagnosis and the scant offering of emotional and psychological post-diagnostic support that is available for people living with early-stage dementia in Ireland. The author draws attention to the curious tension between the widely recognised psychological benefits of early diagnosis of dementia and the jarring delay in disclosure that continues to prevail across Irish healthcare delivery. The evidence base for counselling and psychotherapy for people living with mild to moderate dementia in regard to anxiety and depression is discussed. Recommendations are made for further research into specialist counselling and psychotherapy interventions with a strong involvement from people living with dementia embedded in both research and design. The author also calls for public policy to reflect the preference of people living with dementia for earlier diagnosis and to highlight the appetite and ability of people living with dementia to engage in psychotherapeutic interventions.

scholarly journals Management of Distress in Patients with Cancer—Are We Doing the Right Thing?

2020 ◽  
Vol 54 (12) ◽  
pp. 978-984
Author(s):  
Joost Dekker ◽  
Kristi D Graves ◽  
Terry A Badger ◽  
Michael A Diefenbach
Keyword(s):  
Emotional Support ◽  
Hybrid Approach ◽  
Psychosocial Care ◽  
Evidence Base ◽  
Case Finding ◽  
Lessons Learned ◽  
Distress Screening ◽  
Underlying Assumption ◽  
Patients With Cancer ◽  
The Right

Abstract Background Screening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding. Purpose In the context of finding innovative solutions to tomorrow’s health challenges, we explore ways to optimize distress management in patients with cancer. Methods and Results We discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology. Conclusions We suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.

scholarly journals Experts’ opinion on the detection and management of prediabetes in Lebanon

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110294
Author(s):  
Emile Andari ◽  
Paola Atallah ◽  
Sami Azar ◽  
Akram Echtay ◽  
Selim Jambart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preliminary Report ◽  
Early Stage ◽  
National Guidelines ◽  
Lifestyle Modifications ◽  
Multiple Tests ◽  
Lebanese Population ◽  
To Come ◽  
Near Future

Given that the complications of type 2 diabetes can start at an early stage, early detection and appropriate management of prediabetes are essential. We aimed to develop an expert opinion on prediabetes in Lebanon to pave the way for national guidelines tailored for the Lebanese population in the near future. A panel of seven diabetes experts conducted a thorough literature review and discussed their opinions and experiences before coming up with a set of preliminary recommendations for the detection and management of prediabetes in Lebanon. Lebanese physicians employ multiple tests for the diagnosis of prediabetes and no national cut-off values exist. The panel agreed that prediabetes screening should be focused on patients exceeding 45 years of age with otherwise no risk factors and on adults with risk factors. The panel reached that fasting plasma glucose (FPG) and HbA1c should be used for prediabetes diagnosis in Lebanon. FPG values of 100–125 mg/dL or HbA1c values of 5.7%–6.4% were agreed upon as indicative of prediabetes. For the management of prediabetes, a three-step approach constituting lifestyle modifications, pharmacological treatment and bariatric surgery is recommended. There should be more focus on research on prediabetes in Lebanon. This preliminary report will be further discussed with the Lebanese Society of Endocrinology, Diabetes and Lipids in 2021 in order to come up with the first Lebanese national guidelines for the detection and management of prediabetes in Lebanon.

scholarly journals Primary Care Networks and Starfield’s 4Cs: A Case for Enhanced Chronic Disease Management

2021 ◽  
Vol 18 (6) ◽  
pp. 2926
Author(s):  
Chuan De Foo ◽  
Shilpa Surendran ◽  
Geronimo Jimenez ◽  
John Pastor Ansah ◽  
David Bruce Matchar ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Early Stage ◽  
Healthcare Delivery ◽  
Stage Of Development ◽  
Facilitators And Barriers ◽  
Design Options ◽  
First Contact

The primary care network (PCN) was implemented as a healthcare delivery model which organises private general practitioners (GPs) into groups and furnished with a certain level of resources for chronic disease management. A secondary qualitative analysis was conducted with data from an earlier study exploring facilitators and barriers GPs enrolled in PCN’s face in chronic disease management. The objective of this study is to map features of PCN to Starfield’s “4Cs” framework. The “4Cs” of primary care—comprehensiveness, first contact access, coordination and continuity—offer high-quality design options for chronic disease management. Interview transcripts of GPs (n = 30) from the original study were purposefully selected. Provision of ancillary services, manpower, a chronic disease registry and extended operating hours of GP practices demonstrated PCN’s empowering features that fulfil the “4Cs”. On the contrary, operational challenges such as the lack of an integrated electronic medical record and disproportionate GP payment structures limit PCNs from maximising the “4Cs”. However, the enabling features mentioned above outweighs the shortfalls in all important aspects of delivering optimal chronic disease care. Therefore, even though PCN is in its early stage of development, it has shown to be well poised to steer GPs towards enhanced chronic disease management.

scholarly journals IQ and Internalising Symptoms in Adolescents with ASD

2020 ◽  
Author(s):  
Monisha Edirisooriya ◽  
Dominika Dykiert ◽  
Bonnie Auyeung
Keyword(s):  
Autism Spectrum Disorder ◽  
Intellectual Disabilities ◽  
Emotional Support ◽  
Intelligence Quotient ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Anxiety And Depression ◽  
Social And Emotional ◽  
The Relationship ◽  
Adolescents With Asd

AbstractIntelligence quotient (IQ), has been found to relate to the presence of internalising symptoms in autism spectrum disorder (ASD). This meta-analysis sought to clarify the direction of the relationship between IQ and two prevalent internalising symptoms, anxiety and depression, in adolescents with ASD. Secondly, this study aimed to highlight methodological factors contributing to inconsistent findings in existing research. Self-reported anxiety was found to be significantly higher in youth with a lower IQ, while depression was positively associated with IQ. Consequently, parents, schools and clinicians should be cautious of underestimating anxiety in youth with a lower IQ. However, care should also be taken to ensure adolescents with ASD without intellectual disabilities are not overlooked with regards to social and emotional support.

scholarly journals Support, Health, Activities, Resources, & Education (SHARE): New Program Innovations for Early-Stage Families

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 625-626
Author(s):  
Carol Whitlatch ◽  
Steven Zarit ◽  
Steven Zarit
Keyword(s):  
Early Stage ◽  
Home Monitoring ◽  
Family Care ◽  
Positive Outcomes ◽  
Program Support ◽  
Care Partners ◽  
Diagnosis Of Dementia ◽  
Recent Diagnosis ◽  
Group Version

Abstract Persons living with a recent diagnosis of dementia experience great uncertainty and stress as they and their families try to adjust to the new reality of their lives and futures. One fruitful strategy for intervening with these families is to include both the person living with dementia and their family care partner in the program. Although dyadic approaches are rare among early-stage programs, promising examples exist. The SHARE Program (Support, Health, Activities, Resources, and Education) is one exception where dyadic materials address: 1) current and long- term needs of care partners, and 2) how the family can develop a realistic plan of care based on their care values and preferences. This symposium describes the development and positive outcomes of the original SHARE intervention and the promising adaptations that expand how and to whom the intervention is delivered. Presentations explore: 1) the original SHARE for Dementia program and strategies for expanding its reach into chronic conditions populations (Orsulic-Jeras & Whitlatch), 2) a group version translated into Spanish (“EPIC: Early-stage Partners in Care,” Dr. Coon), and 3) the development of a remote needs assessment and unobtrusive in-home monitoring technology platform that guides care planning and helps to maintain independence (“SHARE-sense,” Dr. Miller). Discussion will focus on the challenges, unique solutions, and positive outcomes when adapting SHARE to different settings and populations (Dr. Zarit).

scholarly journals Automated Classification of Normal Control and Early-Stage Dementia Based on Activities of Daily Living (ADL) Data Acquired from Smart Home Environment

2021 ◽  
Vol 18 (24) ◽  
pp. 13235
Author(s):  
Lee-Nam Kwon ◽  
Dong-Hun Yang ◽  
Myung-Gwon Hwang ◽  
Soo-Jin Lim ◽  
Young-Kuk Kim ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Normal Control ◽  
Daily Living ◽  
Smart Home ◽  
Early Stage ◽  
Machine Learning Techniques ◽  
Evaluation Tool ◽  
Dementia Patients ◽  
Diagnosis Of Dementia

With the global trend toward an aging population, the increasing number of dementia patients and elderly living alone has emerged as a serious social issue in South Korea. The assessment of activities of daily living (ADL) is essential for diagnosing dementia. However, since the assessment is based on the ADL questionnaire, it relies on subjective judgment and lacks objectivity. Seven healthy seniors and six with early-stage dementia participated in the study to obtain ADL data. The derived ADL features were generated by smart home sensors. Statistical methods and machine learning techniques were employed to develop a model for auto-classifying the normal controls and early-stage dementia patients. The proposed approach verified the developed model as an objective ADL evaluation tool for the diagnosis of dementia. A random forest algorithm was used to compare a personalized model and a non-personalized model. The comparison result verified that the accuracy (91.20%) of the personalized model was higher than that (84.54%) of the non-personalized model. This indicates that the cognitive ability-based personalization showed encouraging performance in the classification of normal control and early-stage dementia and it is expected that the findings of this study will serve as important basic data for the objective diagnosis of dementia.

scholarly journals Comparisons of emotional health by diagnosis among women with early stage gynecological cancers

2020 ◽  
Author(s):  
Audrey Messelt ◽  
Lauren Thomaier ◽  
Patricia I. Jewett ◽  
Heewon Lee ◽  
Deanna Teoh ◽  
...  
Keyword(s):  
Early Stage ◽  
Emotional Health ◽  
Gynecological Cancers

scholarly journals PARENTING EFFICACY OF PARENTS FOR CHILDREN WITH VISUAL IMPAIRMENT: A LITERATURE REVIEW

2020 ◽  
Vol 5 (1) ◽  
pp. 85
Author(s):  
Raiza Aulia
Keyword(s):  
Visual Impairment ◽  
Special Needs ◽  
Emotional Support ◽  
Anxiety And Depression ◽  
Normal Children ◽  
Parenting Efficacy ◽  
Self Confidence ◽  
Important Concern ◽  
The Gift ◽  
Children With Visual Impairments

The gift of God in establishing a household is the presence of a child. Caring for children is an important concern for parents, especially children who have special needs. Parents who have children with special needs with visual impairment become a big challenge and generally parents will experience stress, anxiety and depression in caring for children with visual impairment. The success of parenting in children with visual impairment must be in accordance with its limitations so that children can reach the aspects given in accordance with learning blindness. Parents also have confidence in success in caring for children with visual impairments so that their children have the same abilities as normal children. This research is interesting because in the literature used there are results that parenting efficacy in parents with children with visual impairment varies, namely building self-confidence, developing social mobility and skills and emotional support, appreciation, and informative.

scholarly journals Substantiation of connection between affective disorders and development of malignant neoplasms of pancreas: experience of the center

2021 ◽  
Vol 38 (2) ◽  
pp. 14-22
Author(s):  
V. E. Moiseenko ◽  
Izeta G. Kardanova ◽  
A. V. Pavlovsky ◽  
D. A. Granov ◽  
G. V. Rukavishnikov ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Affective Disorders ◽  
Early Stage ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Malignant Neoplasms ◽  
European Organization ◽  
Screening Programs ◽  
Russian Version ◽  
The Relationship

Objective. To analyze the relationship between the affective disorders in the form of anxiety and depression and the development of pancreatic cancer and stomach cancer. Today, there is an interest to the relationship between changes in the emotional sphere of patients with malignant neoplasms (MNO) of the pancreas at the early stages of the disease, when there are no other clinically significant symptoms, which allow suspecting the disease at an early stage. Materials and methods. A questionnaire survey was carried out in 63 patients with histologically verified cancer of the pancreas and stomach, who were treated at the FGBU RNTSRKhT named after Acad. A.M. Granov in the period from 2018 to 2020. The survey was conducted using the questionnaire of the European Organization for Research and Treatment of Cancer (EORTC-QLQ-C30 Russian version) and the Hospital Anxiety and Depression Scale (HADS), Russian version. Statistical processing of treatment results was carried out using regression analysis and Mann-Whitney test with the SPSS statistical software package (Statistika 13.0). The probability of error p 0.05 was considered sufficient to conclude that the differences in the data obtained were statistically significant. Results. In a comparative assessment of the indicators of affective disorders in pancreatic cancer patients, there were noted more pronounced affective disorders, such as feeling of depression, feeling of irritation, anxiety and tension, the values of which, according to the results of the analysis of questionnaires, were 1.00 1, 1, 00 1.00 1 and 2.00 1, respectively. In patients with gastric cancer, the values of these affective disorders, according to the survey results, were less pronounced and amounted to 3.00 1.00 1.00, 3.00 1.00, 3.00 1, respectively (p = 0.000). Conclusions. Severe affective disorders, such as anxiety and depression, in patients with pancreatic cancer should be regarded as a factor of the early manifestation of the disease. Further study of this connection can create a theoretical basis for the development of specialized screening programs to identify patients in the risk groups for the development of pancreatic cancer.

scholarly journals A review of guidance on fish consumption in pregnancy: is it fit for purpose?

2018 ◽  
Vol 21 (11) ◽  
pp. 2149-2159 ◽  
Author(s):  
Caroline M Taylor ◽  
Pauline M Emmett ◽  
Alan M Emond ◽  
Jean Golding
Keyword(s):  
Pregnant Women ◽  
Fish Consumption ◽  
Evidence Base ◽  
Positive Contribution ◽  
National Guidelines ◽  
International Guidelines ◽  
Beneficial Effects ◽  
Use Of Technology ◽  
The Impact ◽  
In Pregnancy

AbstractObjectivePublic health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption.DesignWe searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed.ResultsWe identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all.ConclusionsGuidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.

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