Alyson Norman

Psychosocial interventions for patients with head and neck cancer.

A diagnosis of head and neck cancer, like any cancer diagnosis, is often accompanied by much fear and uncertainty. In addition, patients with head and neck cancer face difficulties in eating, chewing, drinking, breathing, speaking, as well as changes in appearance. Simultaneously, the burden of head and neck cancer is often manifested in psychosocial dysfunction, which can have a negative impact on quality of life. Although a phenomenon well recognized, little is known about many factors that influence or impact psychosocial dysfunction in individuals with head and neck cancer. Even less is known about the effective management of psychosocial dysfunction. To date, there is evidence to suggest that psychosocial interventions generally provide an overall positive effect. Moreover, some intervention studies, such as education alone, have failed to achieve the desired results. In addition, some studies suggest an advantage of cognitive- behavioral therapy over other forms of psychological treatment. With the growing impetus to investigate factors associated with psychosocial dysfunction, and considerable advancement in the development and validation of many global and disease-specific measures, there is an opportunity for further research to develop an appropriate clinical intervention program for such patients.

Adverse childhood experience and asthma onset: a systematic review

Adverse childhood experiences such as abuse and neglect are associated with subsequent immune dysregulation. Some studies show an association between adverse childhood experiences and asthma onset, although significant disparity in results exists in the published literature. We aimed to review available studies employing a prospective design that investigates associations between adverse childhood experience and asthma. A search protocol was developed and studies were drawn from four electronic journal databases. Studies were selected in accordance with pre-set inclusion criteria and relevant data were extracted. 12 studies, assessing data from a total of 31 524 individuals, were identified that investigate the impact of a range of adverse childhood experiences on the likelihood of developing asthma. Evidence suggests that chronic stress exposure and maternal distress in pregnancy operate synergistically with known triggers such as traffic-related air pollution to increase asthma risk. Chronic stress in early life is associated with an increased risk of asthma onset. There is evidence that adverse childhood experience increases the impact of traffic-related air pollution and inconsistent evidence that adverse childhood experience has an independent effect on asthma onset. Chronic stress in early life is associated with an increased risk of asthma onset http://ow.ly/KiDUK

The Effectiveness of Psychosocial Intervention for Individuals with Cleft Lip and/or Palate:

Objective The aim of this review was to assess the effectiveness of different psychological interventions for children and adults with cleft lip and/or palate and their parents. Design We searched six databases including MEDLINE and EMBASE to June 2013 and checked bibliographies. We included research that evaluated any psychological intervention in studies in which at least 90% of the participants had cleft lip and/or palate or were parents of those with cleft lip and/or palate. Studies containing less than 90% were excluded unless they reported results separately for those with cleft lip and/or palate, or raw data were available upon request from the authors. Inclusion assessment, data extraction, and risk of bias assessment were carried out independently by two reviewers. Results Seven studies were identified as inclusions, with only two studies being included in the full data analysis (one of which failed to meet the full inclusion criteria). The five remaining studies were included only in a narrative synthesis because data were available for people or parents of those with cleft lip and/or palate only. This highlights a distinct dearth of research into psychological intervention within the field of cleft lip and/or palate. Conclusions The review found no evidence to support any specific intervention. Key uncertainties need to be identified and addressed. Adequately powered, methodologically rigorous randomized controlled trials are needed to provide a secure evidence base for psychological intervention techniques in participants with cleft lip and/or palate and their parents.

A preventable death? A family’s perspective on an adult safeguarding review regarding an adult with traumatic brain injury

Purpose The purpose of this paper is to review the care management of a man with a traumatic brain injury (TBI) from a family member’s perspective. Design/methodology/approach The paper provides a case history of “Tom” both prior to his TBI and after. Findings Tom was the subject of a safeguarding adults case review in Somerset following his death in 2014. Ultimately the paper highlights the shortcomings and failures in the care Tom received by various organisations which ultimately contributed to his suicide. Practical implications The paper highlights the need for more effective communication between professionals managing the care of those with TBI. Furthermore, professionals need training in the need for mental capacity assessments and improved safeguarding and risk assessments with adults with TBI. Originality/value This paper provides insight into the needs of an adult with TBI from the perspective of a family member who is also a trained psychologist.

The Secondary Impact of Traumatic Brain Injury: An Interpretative Phenomenological Analysis of the Experiences of Family and Friends

This study seeks to contribute to our understanding of the lived experiences of family members and friends of individuals with traumatic brain injury (TBI). The study employed an interpretative phenomenological approach, enabling family members and friends to identify and reflect upon the factors they themselves considered most significant about the impact of TBI on someone close to them, and how this experience has affected their own lives and their relationship with the TBI survivor. Eleven participants, two males and nine females aged 22–79, were from the United Kingdom. Several strong and interconnected themes emerged from the interviews, clustering into four superordinate themes: “continuity and discontinuity”; “damage, loss, and grief”; “roles and responsibility”; and “coping and not coping.” The study findings identify the importance of support and information provision for family members and friends of those with TBI to help them manage the long-term impact of TBI.

Understanding the psychosocial needs of pituitary patients: a survey of Pituitary Foundation members

1. Osbourne, M., Jackson, S., Morris , M., & Ashley, K. (2006). Cinderella’s story: the psychosocial impact of pituitary conditions. Endocrine Abstracts, 12, 84. 2. Jackson, S., Murray, J., Morris, M., Woods, T. (2008). Patient Satisfaction Survey final report for Pituitary Foundation. Pituitary Foundation. 3. Cancerbackup (2006). Big cancer information survey. www.cancerbackup.org.uk. Accessed 03.09.2015. Management of Pituitary conditions is notoriously difficult and patients often experience high levels of distress which are often not addressed by health professionals1. As a result, pituitary conditions have been found to have a large negative impact on quality of life1.

Developing a pituitary distress thermometer (PDT) - a means to improve patient quality of life

Conclusions 1.Sollner W, DeVries A, Steixner E, Lukas P, Sprinzl G, Rumpold G & Maislinger S (2001) How successful are oncologists in identifying patient distress, perceived social support, and the need for psychosocial counselling? British Journal of Cancer, 84(2): 179-185 2.Sonino N, Ruini C, Navarrini C et al. Psychological Impairment in patients treated for pituitary disease: a controlled study. Clinical Endocrinology. 2007; 67(5): 719-26. 3.Webb S, Prieto L, Badia X et al. Acromegaly quality of life questionnaire (AcroQoL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clinical Endocrinology. 2002; 57(2): 251-8. 4.Webb S, Badia X & Surinach N. Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. European Journal of Endocrinology. 2006; 155(2): 269-77. 5.Webb S, Badia X, Barahona M et al. Evaluation of health-related quality of life in patients with Cushings syndrome with a new questionnaire. European Journal of Endocrinology. 2008; 158(5): 623-30. 6.Lovas K, Curran S, Oksnes M et al. Development of a disease-specific quality of life questionnaire in Addison’s disease. Journal of Clinical Endocrinology and Metabolism. 2009; 95(2): 545-51. Pituitary tumours, though almost always benign, are now included with other central nervous system tumours in cancer services. It therefore seems appropriate to adapt this oncology tool for use with pituitary patients. • Research has shown that high levels of patient distress may not be identified during consultations with healthcare professionals (HCPs), resulting in significant patient dissatisfaction with care and additional use of primary and secondary care services[1].