Lesley Glover

Returning home after intensive care: A comparison of symptoms of anxiety and depression in ICU and elective cardiac surgery patients and their relatives

ObjectiveThis study gathered data on symptoms of anxiety and depression in patients and relatives after discharge from intensive care and examined whether the intensive care population differ from an elective cardiac surgery group with regards to their anxiety and depression symptom reporting.Design and settingA single measurement point matched group comparison study in an ICU follow-up programme.Patients and participantsTwenty ICU patients and their relatives and a matched comparison group of 15 elective cardiac surgery patients and their relatives.Measurements and resultsPatients and relatives completed the Hospital Anxiety and Depression Scale. Relatives answered an open question to explore the perceived impact of Intensive care/cardiac surgery on their lives. ICU patients’ relatives reported significantly higher number of symptoms of anxiety than did ICU patients, higher number of symptoms of depression than cardiac surgery patients’ relatives, and more troubling and life-altering experiences than the relatives of cardiac surgery patients.ConclusionsRelatives of ICU patients also suffer anxiety and depression, and services should address this need. Group differences suggest that ICU patients’ relatives have ‘unique’ characteristics of depression symptom reporting.

Development of the fertility adjustment scale

OBJECTIVE To develop a standardized measure of psychological adjustment to infertility. DESIGN A cross-sectional two-group comparison study. SETTING Two specialized fertility clinics in large teaching hospitals. PATIENT(S) Fifty men and 50 women undergoing evaluation and/or treatment of fertility problems. INTERVENTION(S) The Fertility Adjustment Scale was administered with the Hospital Anxiety and Depression Scale as a measure of concurrent validity. MAIN OUTCOME MEASURE(S) Scores on the Fertility Adjustment Scale and the Hospital Anxiety and Depression Scale. RESULT(S) Scores on the Fertility Adjustment Scale were distributed normally. Split-half and internal consistency were high. A significant correlation with measures of mood, anxiety, and distress provided evidence of concurrent validity. CONCLUSION(S) Preliminary results suggest that this measure will be a useful tool in assessing psychological reactions to fertility problems and outcomes of treatment.

Distress in sub-fertile men: A longitudinal study

Abstract This study aims to describe the experiences of sub-fertile men and to document change over time. Patients attending a specialist male sub-fertility clinic completed questionnaires at clinic attendance and at 6 weeks and 18 months following consultation. Data were collected on mood, blame, life satisfaction, sexuality and expectations of pregnancy. Results suggest that these men are highly anxious. They blame themselves for their fertility problems and often feel less of a man because of them. Their satisfaction with life is much less than they perceive it would be if they had a baby. Expectations of life satisfaction and blame are both implicated in contributing to distress. Measures of mood, life satisfaction and self-blame are unchanged at 6 weeks and 18 months.

Men and chronic illness: a qualitative study of LUTS.

In order to determine how men react to and manage chronic conditions 16 men with Lower Urinary Tract Symptoms (LUTS) were interviewed to examine the relationship between detecting symptoms and seeking medical help, perceptions of symptoms and the impact of symptoms on daily life. Transcripts were analysed employing IPA and four major themes identified: Uncertainty/Trying to understand, Implications, Ways of coping and Self-concept/Identity. Uncertainty about the nature and origins of their condition and its gradual onset contributed to the delay in seeking medical advice. Men adopted a range of coping strategies to manage their symptoms. Implications for primary health care consultations are considered.

Men's experiences of having lower urinary tract symptoms: factors relating to bother

To gain an understanding of mens experiences of having lower urinary tract symptoms (LUTS) and of bother, a principle determinant of whether a patient has an intervention for LUTS.

Donor insemination: Exploring the experience of treatment and intention to tell

This study explored the concerns and experience of men and women undergoing donor insemination (DI) treatment: levels of distress, mood, adjustment to infertility (Fertility Adjustment Scale: FAS), and intention to tell any potential child were examined. Two samples were included, a DI clinic in a London teaching hospital and the DI support group, the DC Network (the Donor Conception Network). Clinically significant levels of anxiety (HADS), high levels of distress and high scores on the FAS were reported by both men and women in the samples, suggesting that fertility problems and DI treatment are experienced as challenging. Achieving a pregnancy was the main concern expressed, but concerns about the donor and telling the child were also reported. Those who did not plan to tell their child reported higher levels of concern about telling, and higher levels of distress than those who planned to tell. Interest was expressed in accessing further counselling throughout treatment, and the difficulties in terms of the secrecy surrounding DI are discussed.

Assessing women’s perinatal psychological health: exploring the experiences of health visitors

Objective: This study aimed to explore health visitors’ (HVs) experiences of the assessment of women with psychological distress and mental health problems across the perinatal period in clinical practice. Background: In international contexts, there is now a firm policy remit for the assessment of psychological and mental health disorder across the perinatal period. Women are in regular contact with health professionals across this time and consultations intuitively create an ideal and appropriate context in which to assess women’s psychological health. National reports and academic literature highlight that to prevent the escalation of perinatal mental illness, significant change is needed to support health professionals in detecting, discussing and dealing with mental illnesses. Methods: In a qualitative aspect of a larger mixed-method study, data were collected from two Focus Group Discussions with HVs pre and post a training session related to assessing and managing perinatal mental health problems in practice. For the purposes of this paper, the data were explicitly examined for references to recognition and assessment. Results: Four themes emerged from the data: recognising the problem; questioning and identification; so what do I do now; the importance of support to promote effective identification and assessment. Conclusion: Findings elucidate the complexities that practitioners face in assessing women’s psychological health in real world settings. HVs’ experiences highlight that the implementation of measures into practice needs to be workable and accompanied by contemporary and appropriately contextualised knowledge, adequate service provision and clear referral pathways to ensure effective assessment of women’s psychological health.

Lower urinary tract symptoms in men : self-perceptions and the concept of bother

An interesting study from the UK explores the meaning men attach to their experiences of having LUTS and to understand the meaning of the word bother in this context. Their findings are very helpful to clinicians, and perhaps to people constructing clinical trials in the future. A second report assesses the bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. The author concluded from their study that when determining the most appropriate management strategy doctors should consider the experience of being incontinent as being unique to each individual.

The psychological impact of overactive bladder: A systematic review

This review aimed to provide an overview of the current research on the psychological impact of overactive bladder. A systematic search yielded 32 papers. It was found that people with overactive bladder tended to have greater levels of depression, anxiety and embarrassment/shame; difficulties with social life; impact on sleep and sexual relationships; and a lower quality of life than people without overactive bladder. A psychological impact on family members was also found. Psychological health should be considered an important aspect of managing overactive bladder and further research is required to determine how best to provide psychological care and support in this area.

Low Urinary Tract

An interesting study from the UK explores the meaning men attach to their experiences of having LUTS and to understand the meaning of the word bother in this context. Their findings are very helpful to clinicians, and perhaps to people constructing clinical trials in the future. A second report assesses the bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. The author concluded from their study that when determining the most appropriate management strategy doctors should consider the experience of being incontinent as being unique to each individual.