Valentina Elisabetta Di Mattei

The burden of distress in caregivers of elderly demented patients and its relationship with coping strategies

ObjectivePrevious studies have shown that taking care of elderly, demented patients carries a high cost to caregivers’ health, and is associated with negative consequences for physical and mental health. The aim of this study is to investigate which socio-demographic and clinical variables are significantly associated with higher levels of distress in caregivers, and the relationship between caregivers’ levels of distress and the coping strategies they adopt.Patients and participantsThe study samples 112 caregivers of demented patients, consecutively admitted to the Department of Neurology of San Raffaele-Turro Hospital (Milan, Italy).Measurements and resultsCaregivers were asked to complete the CBI and the COPE. Caregivers with the highest levels of distress are characterised by an impaired physical health status. Avoidance coping may represent a risk factor associated with higher levels of distress; conversely, an active and problem-focused approach to stressful situations may act as a protective factor.

Disordered eating behaviors among Italian men: Objectifying media and sexual orientation differences

Objectification theory was tested as a suitable framework for explaining sexual orientation differences in disordered eating behaviors in college-aged Italian men. The theorys applicability to 125 homosexual and 130 heterosexual men was investigated using self-report questionnaires. Gay men scored significantly higher on exposure to sexually objectifying media, body surveillance, body shame, disordered eating behaviors, and depression than heterosexual men. Although path analyses support the theorys applicability to both groups, for gay men the path model demonstrated a better fit to the objectification theory for disordered eating and depression. Practical implications are discussed.

The objectified body: media, psychophysical well-being and gender differences

PSICOLOGIA SOCIALE n. 2, maggio-agosto 2012 In accordo con la teoria dell’oggettivazione (Fredrickson e Roberts, 1997) sono stati esaminati gli effetti dell’esposizione a immagini mediatiche sessualmente oggettivanti sul processo dell’autooggettivazione e sul benessere psicofisico di giovani adulti. Per le donne l’esposizione a immagini oggettivanti conduce all’auto-oggettivazione/sorveglianza del corpo, aumentando così la vergogna per l’aspetto, che a sua volta è collegata all’insorgenza di disordini alimentari. Gli stessi risultati (seppur più deboli) sono emersi tra gli uomini. Le donne hanno ottenuto punteggi medi significativamente superiori in tutte le variabili precedentemente denominate. Differenze di genere sono emerse anche nel ruolo della sorveglianza e della vergogna come variabili mediatrici. Le implicazioni pratiche vengono discusse. Il corpo oggettivato: media, benessere psicofisico e differenze di genere

An investigative study into psychological and fertility sequelae of gestational trophoblastic disease: the impact on patients' perceived fertility, anxiety and depression.

Objectives Gestational Trophoblastic Disease (GTD) comprises a group of disorders that derive from the placenta. Even if full recovery is generally expected, women diagnosed with GTD have to confront: the loss of a pregnancy, a potentially life-threatening diagnosis and delays in future pregnancies. The aim of the study is to evaluate the psychological impact of GTD, focusing on perceived fertility, depression and anxiety. Methods 37 patients treated for GTD at San Raffaele Hospital, Milan, took part in the study. The STAI-Y (State-Trait Anxiety Inventory), the BDI-SF (Beck Depression Scale-Short Form) and the FPI (Fertility Problem Inventory) were used. Patients were grouped on the basis of presence of children (with or without), age (< or ≥35) and type of diagnosis (Hydatidiform Mole, HM, or Gestational Trophoblastic Neoplasia, GTN). Differences in the values between variables were assessed by a t-type test statistic. Three-way ANOVAs were also carried out considering the same block factors. Results The study highlights that women suffering from GTN had higher depression scores compared to women suffering from HM. A significant correlation was found between anxiety (state and trait) and depression. Younger women presented higher Global Stress scores on the FPI, especially tied to Need for Parenthood and Relationship Concern subscales. Need for Parenthood mean scores significantly varied between women with and without children too. Conclusions We can conclude that fertility perception seems to be negatively affected by GTD diagnosis, particularly in younger women and in those without children. Patients should be followed by a multidisciplinary team so as to be supported in the disease’s psychological aspects too.

Fertility preservation in female cancer patients: a single center experience

Advances in cancer treatment allow women to be cured and live longer. However, the necessary chemotherapy and radiotherapy regimens have a negative impact on future fertility. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer treatment and to facilitate fertility preservation, including oocyte and ovarian tissue cryopreservation. These fertility issues are often inadequately addressed, and referral rates to oncofertility centers are low. The aim of this study was to report the 3-year experience of the San Raffaele Oncofertility Unit. A total of 96 patients were referred to the Oncofertility Unit for evaluation after the diagnosis of cancer and before gonadotoxic treatment between April 2011 and June 2014. Of the 96 patients, 30 (31.2%) were affected by breast cancers, 20 (20.8%) by sarcomas, 28 (29.2%) by hematologic malignancies, 13 (13.5%) by central nervous system cancers, 3 (3.1%) by bowel tumors, 1 (1.0%) by Wilms’ tumor, and 1 (1.0%) by a thyroid tumor; 47 (49.0%) were referred for oocyte cryopreservation before starting chemotherapy, 20 (20.8%) were referred for ovarian tissue cryopreservation, and 29 (30.2%) were not recruited. The mean time between the patients’ counseling and oocyte retrieval was 15 days (range, 2–37 days). The mean time between the laparoscopic surgery and the beginning of treatment was 4 days (range, 2–10 days). The number of patients who were referred increased over time, whereas the rate of patients who were not recruited decreased, showing an improvement in referrals to the Oncofertility Unit and in the patients’ counseling and understanding. Our results indicate that an effective multidisciplinary oncofertility team is necessary for prompt referrals and treatment.

Mental representations of illness in patients with gestational trophoblastic disease: How do patients perceive their condition?

Background Gestational Trophoblastic Disease comprises a group of benign and malignant disorders that derive from the placenta. Using Leventhal’s Common-Sense Model as a theoretical framework, this paper examines illness perception in women who have been diagnosed with this disease. Methods Thirty-one women diagnosed with Gestational Trophoblastic Disease in a hospital in Italy were asked to complete the Illness Perception Questionnaire-Revised to measure the following: illness Identity, illness opinions and causes of Gestational Trophoblastic Disease. Results High mean scores were observed in the Emotional representations and Treatment control subscales. A significant difference emerged between hydatidiform mole patients and those with gestational trophoblastic neoplasia on the Identity subscale. A significant correlation emerged between “time since diagnosis” and the Treatment control subscale. Discussion This study is the first to investigate illness perception in Gestational Trophoblastic Disease. From a clinical perspective the results highlight the need for multidisciplinary support programs to promote a more realistic illness perception.

Chemotherapy-Induced Nausea and Vomiting in Women With Gynecological Cancer: A Preliminary Single-Center Study Investigating Medical and Psychosocial Risk Factors.

Background: Chemotherapy is the treatment of choice for many gynecological tumors, but cytotoxic drugs lead to a wide range of stressful side effects; nausea and vomiting are 2 of the most common and distressing consequences of many chemotherapy regimens. Objective: The aim of this study is to investigate various risk factors that could influence the experience of nausea and vomiting after the first chemotherapeutic infusion. Methods: Women treated for various gynecological cancers (n = 94) took part in the study. Pharmacological and personal risk factors in the development of chemotherapy-induced nausea and vomiting (CINV) were assessed with the use of the State-Trait Anxiety Inventory and a self-report questionnaire. Regression analyses (both univariate and multiple) were performed to establish risk factors associated with CINV. Results: The study highlights the importance of working status (being involved in a working activity during treatment) as a protective factor for developing chemotherapy-induced nausea. Furthermore, younger age, levels of state anxiety, chemotherapy-induced nausea in previous treatments, and alcohol intake were found to have an effect on CINV, increasing its risk. Emetogenic potential was associated only with the presence of delayed vomiting. Conclusions: Although this is a preliminary study into the risk factors of CINV in gynecological tumors, these findings offer support that personal risk factors contribute to individual differences in the frequency and severity of CINV. Implications for Practice: Personal factors should be taken into consideration by the multidisciplinary treating team in gynecology.

The Impact of Cosmetic Plastic Surgery on Body Image and Psychological Well-Being: A Preliminary Study

The relationship between body image and cosmetic surgery represents a new generation of research on the psychological aspects of cosmetic surgery. This preliminary study intends to investigate the role of distress relating to body image in conditioning the levels of post-operatory patient benefit both the impact of cosmetic surgery on the state of psychological well-being and body image through the analysis of the differences between the pre and post-operative stages.

Analisi della domanda e dei bisogni psicologici in un reparto di ginecologia oncologica

Negli ultimi quindici anni si e assistito, in ambito oncologico, a una crescita dell’interesse per lo studio della qualita della vita. A differenza delle donne colpite da cancro al seno per le quali esistono da anni numerose associazioni che si occupano di offrire un sostegno psico-educazionale e psicoterapeutico, le donne colpite da tumore ginecologico non possono contare su una tale ricchezza di risorse e possono quindi essere considerate piu a rischio di isolamento sociale. Il presente studio si prefigge di indagare, in un campione di 67 pazienti ricoverate presso il reparto di Ginecologia dell’Ospedale San Raffaele di Milano, la percezione del bisogno di un supporto di tipo psicologico e la presenza di sofferenza psicologica, in particolare, di manifestazioni ansiose e depressive, ponendole in associazione ad alcune variabili relative al tipo di trattamento intrapreso. I dati a nostra disposizione suggeriscono che, per quanto vissuti di ansia, depressione e angoscia siano frequentemente associati all’esperienza del ricovero, non emergono differenze significative al confronto tra pazienti ricoverate per patologia oncologica e non oncologica. E emersa prevalentemente la necessita di seguire il malato oncologico con competenze psicologiche specifiche, sensibilizzando quanto piu possibile anche il personale medico ed infermieristico. I risultati della presente ricerca, per quanto preliminari, forniscono importanti spunti di riflessione relativamente ai bisogni psicologici delle pazienti con disturbi ginecologici di natura oncologica e non oncologica.

Il burnout negli operatori della salute mentale: quali interventi?

Il costrutto del burnout e stato formulato da oltre trent’anni e strumenti con buone proprieta psicometriche per la sua valutazione e il suo assessment sono ormai di uso comune. Tuttavia, minore attenzione sembra essere stata rivolta dai ricercatori allo studio dell’efficacia degli interventi psicologici e organizzativi per la sua gestione in particolare nell’area della salute mentale. Obiettivo del presente studio e quello di offrire una panoramica degli interventi sul burnout in operatori della salute mentale prestando particolare attenzione alle prove di efficacia che li supportano. A tale scopo, la letteratura sul tema degli interventi terapeutici per la gestione della sindrome del burnout in operatori della salute mentale e stata raccolta attraverso le banche dati Medline e PsychInfo estendendo la ricerca a partire dal 1980. Il panorama degli interventi terapeutici proposti e alquanto ampio e spazia da approcci centrati sull’individuo (counseling e psicoterapia), ad interventi di gruppo, a livello organizzativo e strategie di auto-aiuto. Tuttavia, gli studi controllati sull’efficacia di tali approcci sono assai limitati pertanto le conclusioni che se ne possono trarre rappresentano esclusivamente delle considerazioni preliminari; in generale, emerge che gli interventi piu efficaci siano quelli che agiscono contemporaneamente a vari livelli. Si e ancora molto lontani dalla formulazione di strategie d’intervento manualizzate e di efficacia verificata empiricamente. Diversi contributi presentano evidenti limiti metodologici soprattutto relativamente alla scarsa ampiezza dei campioni esaminati, all’assenza di gruppi di controllo e alla valutazione dell’efficacia di piu di un intervento alla volta. Inoltre, si impone la necessita che studi successivi focalizzino maggiormente l’attenzione sugli altri profili professionali dell’area in oggetto e non soltanto sul personale infermieristico.