Spirituality and quality of life in HIV-positive persons

With the amount of turmoil in the world today and often in our personal lives as well, spirituality has become a major focus for many people. Because of the demonstrated importance of spiritual well-being in coping with a chronic illness, the author researches the effects of spirituality and quality of life on the lives of HIV-positive persons.     

Prenatal exposure to wartime stress: long-term effect on coronary heart disease in later life

Background. Increased rates of coronary heart disease (CHD) and cerebrovascular disease in later life have been repeatedly observed in subjects with low birth-weight. One possible reason for low birth-weight is prenatal stress. Little is known about the influence of prenatal stress on lifelong health outcomes. Aims. In this study we investigate the influence of prenatal stress on CHD and cerebrovascular disease incidence in adult life. Methods. We analysed data originating from the Helsinki Birth Cohort Study including hospital data from all men and women born between 1934 and 1944 (n = 13,039) in two hospitals of Helsinki. We estimated the hazard function based on Weibull distribution. We compared those exposed and unexposed to bombings while in utero in terms of lifelong CHD and cerebrovascular disease hazard. Results. In women exposed to bombings while in utero, we observed higher survival rates of both CHD and cerebrovascular disease than in those unexposed. In men, the results were ambiguous. Conclusions. Our findings suggest that prenatal exposure to severe stress may be associated with protective effects on the development of CHD in later life.     

Colony-stimulating factors in stem cell transplantation: effect on quality of life

Health-related quality of life (QOL) is poorest during the immediate post-transplantation period, but the impact of medical interventions during this period has not been studied. Colony-stimulating factors (CSFs), which are used to minimize short-term negative outcomes, might be expected to improve QOL; however, little is published about their impact on QOL during this period. We conducted a MEDLINE search to identify studies reporting on outcomes of stem cell transplantation (SCT) affected by the CSFs, mainly sargramostim and filgrastim. End points studied were: mucositis, incidence and type of infection, duration of hospitalization, time to myeloid engraftment, and quantity and quality of harvested cells. To impute the impact of CSFs on QOL post-SCT, we also reviewed the association between QOL and CSF outcomes in other circumstances. Data suggest that both CSFs improve QOL in the early autologous or allogeneic post-bone marrow transplantation period. Poor QOL caused by infection and increased length of hospital stay is expected to be improved by sargramostim. Time to myeloid engraftment, when negatively affecting QOL, is expected to be improved with both CSFs; however, the time to myeloid engraftment is consistently shorter with filgrastim. Current prospective trials designed to study the effects of CSFs in the immediate post-SCT period should collect QOL data.     

Spirituality at the beginning of life

Aim. The aim of this paper was to explore the issues surrounding the spirit of the unborn child. Background. Pregnancy and birth have been recognised to have a spiritual nature by women and health professionals caring for them. Midwives and nurses are expected to have a holistic approach to care. I suggest that for care to be truly holistic exploration is required of the spiritual nature of the unborn fetus. Methods. Historical, philosophical and religious views of the spirit of the fetus, are explored as well as those of women. Investigation was made of views of the timing of ‘ensoulment’. Results. The review demonstrates the value women place on the sacredness of pregnancy and birth, and that the spiritual nature of the unborn should be recognised. Conclusion. This paper shows that the views and values women have of pregnancy and birth and the powerful, spiritual relationship they have with the unborn, indicates that further discussion and research needs to be carried out in this area. Relevance to clinical practice. It is recommended that all who work with women who are pregnant should recognise the spiritual nature of the unborn when carrying out care.     

Self-esteem in later life: a nursing perspective

Self-esteem provides a measure for the quality of life of the elderly in long-term care. This article defines self-esteem in relation to self-concept and identifies the antecedents that affect its development. Elements of labeling theory, activity theory, and social exchange theory are explored to account for a potential decline in self-esteem among the elderly. According to this electric theoretical framework, stigmatization, decreased social interaction, and loss of control over the environment are all negatively correlated with self-esteem. Institutionalization intensifies the effect of these forces. Nursing is in a unique position to promote self-esteem by combating ageism, promoting social interaction, and maximizing the control and participation of elderly residents.     

The effect of diabetes on adolescents' quality of life

This pilot study assessed the impact of diabetes on overall quality of life (QOL) of 23 adolescents (12-16 years old). The impact of diabetes on daily life, satisfaction with life, and common worries and frustrations were explored through the Diabetes Quality of Life for Youth scale (DQOLY) and semistructured interviews. The four major themes that emerged from the interviews were (a) restrictions, (b) differentness, (c) negative emotion, and (d) adaptation. Adolescents reported being most bothered by dietary restrictions, including the regimentation/scheduling of eating and its social ramifications. Adolescents in this study worried the most about the future and, in particular, complications. Older adolescents worried less, had lower Diabetes Impact scores, and had better Quality of Life scores on the DQOLY. The theme of adaptation and the negative emotion theme were both expressed most often by participants who had had diabetes for a longer period of time.     

控制疼痛对晚期肿瘤患者生活质量的影响

目的：探讨控制疼痛的方法以及对提高晚期肿瘤患者生活质量的影响。方法：对106例晚期肿瘤患者采取有效的止痛和完善的护理措施,并对患者采用措施前后疼痛指标作出评价。结果：通过一系列干预措施,患者的疼痛获得了较好的控制,明显减轻了痛苦,提高了生活质量。结论：有效控制疼痛和完善的护理对提高晚期肿瘤患者的生活质量有重要意义。     

Prenatal exposure to wartime stress – long-term effect on coronary heart disease in later life

Abstract

Background. Increased rates of coronary heart disease (CHD) and cerebrovascular disease in later life have been repeatedly observed in subjects with low birth-weight. One possible reason for low birth-weight is prenatal stress. Little is known about the influence of prenatal stress on lifelong health outcomes.

Aims. In this study we investigate the influence of prenatal stress on CHD and cerebrovascular disease incidence in adult life.

Methods. We analysed data originating from the Helsinki Birth Cohort Study including hospital data from all men and women born between 1934 and 1944 (n = 13,039) in two hospitals of Helsinki. We estimated the hazard function based on Weibull distribution. We compared those exposed and unexposed to bombings while in utero in terms of lifelong CHD and cerebrovascular disease hazard.

Results. In women exposed to bombings while in utero, we observed higher survival rates of both CHD and cerebrovascular disease than in those unexposed. In men, the results were ambiguous.

Conclusions. Our findings suggest that prenatal exposure to severe stress may be associated with protective effects on the development of CHD in later life.     

Coping with anxiety in later life

The goal of this study was to determine how older adults cope with three forms of anxiety, and potential avenues for applied interventions. Although the findings shed light on some interesting findings with potential psychosocial applications, several limitations need to be noted. First, this study was based on two assumptions. The assumption, based on earlier work (Carver et al., 1989; Lazarus & Folkman, 1984; Zeidner & Saklofske, 1996), that certain coping strategies are more effective than others, and an assumption of the direction of influence in which anxiety is a precursor of coping strategies. Because this was an exploratory study, the research questions did not directly test these assumptions. Second, this study is correlational in nature. Therefore, conclusions cannot be drawn about the causality of these associations. Third, as with any self-report data and self-selected sample, one needs to interpret the findings with caution. Similarly, for the purposes of the study, a non-clinical sample of older adults was examined using three distinct conceptualizations of anxiety. Suggestions for future research include: Replication of this study using a multidimensional measure of anxiety appropriate for clinical samples. A longitudinal replication of this study identifying patterns of coping that facilitate adjustment over time. Finally, a more general purpose of this study was to focus attention on a neglected issue in gerontology--the experience of anxietY in later life (Frazier & Waid, 1999; Gatz, 1995; Rabins, 1992; Shamoian, 1991; Sheikh, 1992; Smyer, 1995; Stanley & Beck, 1998), and, most importantly, the role of gerontological nurses in early assessment and intervention for successful treatment of anxiety in older adults.     

The effect of skin conditions on patients' quality of life

Skin conditions can adversely affect many aspects of patients' lives. The quality of life for people with skin conditions such as psoriasis, atopic eczema and acne can be significantly impaired in terms of their psychological wellbeing, social functioning and everyday activities. The significant psychological and social morbidity that occurs in patients with common skin conditions may go unrecognised without appropriate assessment. The level of psychosocial morbidity associated with skin disorders may be underestimated by health professionals.     

Depression and older people: securing wellbeing in later life

This article, brought to you in association with Help the Aged, looks at the factors that can contribute to depression in older people and highlights the information available from the Charity.