Indian Journal of Health and Wellbeing

K. Jayashankar Reddy ¹

Affiliations
1 CMR CMMS, Bangalore, Karnataka, IN

Abstract

To investigate the improvement in quality of life (QOL) of alcohol-dependent patients during a 2-week inpatient withdrawal programme, and to identify the socio-demographic, clinical and alcohol-related factors associated with baseline QOL on admission and with improvement of QOL during residential treatment.This prospective, observational study included 414 alcohol-dependent patients, hospitalised for a period of 2 weeks. QOL was measured on admission and at discharge using the English version of the Medical Outcome Study SF-36. The mean scores for each dimension and for the Physical and Mental Component Summary scores were calculated. The mean scores per dimension and the mean Physical and Mental Component Summary scores were significantly lower on admission than at discharge; the lowest scores being observed for social functioning and role limitations due to emotional problems. At discharge, the mean scores per dimension were similar to those observed in the English general population. Female gender, age >45 years, living alone, working as a labourer or employee, somatic comorbidity, and the existence of at least five criteria for alcohol dependence according to the DSM-IV classification were associated with a low Physical Component Summary score on admission; psychiatric comorbidity, the presence of at least five DSM-IV dependence criteria, smoking and suicidality were associated with a low Mental Component Summary score on admission. The increase in Physical and Mental Component Summary scores during hospitalization was more marked when the initial scores were low. Apart from the initial score, the greatest improvement in Physical Component Summary score was seen in patients with a high alcohol intake and in those without a somatic comorbidity; the increase in Mental Component Summary score was greatest in patients without psychotic symptoms and in those who abused or were dependent on illegal drugs. QOL improvement after a residential treatment was related to l

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K. Jayashankar Reddy ¹

Affiliations
1 CMR, CMMS, Bangalore, Karnataka, IN

Abstract

To study the psychosocial and socio-demographic correlates in patients with conversion disorder presenting with non-epileptic seizures and discuss its interventional implication. This cross-sectional descriptive study was carried out in Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India from September 2008 to February 2009. 151 consecutive patients with conversion disorder satisfying the inclusion and exclusion criteria were selected. They were interviewed using semi-structured socio-demographic profile proforma, Holmes and Rahe stress scale for the exploration of psycho-social stressors. The data were entered on MS excel, analyzed by SPSS-version 16.0. The psychosocial stressors were clearly identified in all patients. Almost ninety five (94.70%, n=143) out of the total 151 subjects had a history of stressors, while in the rest 4.95% no stressors could be established. The commonest stressors were Troubles with in-laws (26.49%), Death of close family member (11.92%) and Increase in argument with significant others (10.59 %). Significantly higher number of the patients presented with the stressor of troubles with in-laws, when assessed on the Holmes and Rahe Social Readjustment Rating Scale. Detection of exact nature of correlates has immense potential for therapeutic as well as preventive field.

Keywords

Psychosocial Correlates,conversion Disorder,non Epileptic Events

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D. S. Anitha ¹, K. Jayashankar Reddy ²

Affiliations
1 Department of Psychology, Jain University, Bangalore, IN
2 Department of Psychology, CMRIMS, Bangalore, IN

Abstract

The variations and consequences of care giving are distributed through the population equally, that is, adult-child, spousal, child-parent and so forth with far reaching implications. The caregiver of a member of the family with a chronic or terminal illness is in a perpetually stressful situation. The patients illness, combined with the disabilities or increased dependency caused by illness, in many cases constitute a major stressor for the entire family generally and for the caregiver in particular. The stress is intensified by such patients attributes as behavior problems and psychological distress. In case of cancer the stressor is more likely to be the patient's physical dependency arising from the side effects of medical treatment. The caregiver like the patient is in a stressful situation because of the threat to the life of the loved one, loss of the previous relationship, decrease of independence, the prospect of a decline in income and alterations in family roles. The primary caregiver plays an important in the well-being of the care receiver by providing social, emotional and physical support. The psychological distress created by stress begins at the time that the patient has difficulty in functioning and on the discharge of the patient from the hospital. Increased stress is experienced when the patient health condition moves from curative to palliative care. The patient is completely dependent on the caregiver for physical and psychological support. The caregiver is the companion throughout the illness period and provides emotional support. During palliative care the caregiver experience greater physical and psychological stress, greater burden and poor quality of life which in turn affect their role as caregiver. The need of the caregiver goes unnoticed by family members and their health suffers leading to psychological distress. The need for intervention to caregivers is a necessity which is ignored or not given importance in rural and semi urban areas. It is time the government provide hospice care to patients so that the burden of caring has less impact on the health of the caregiver thus reducing their psychological distress.

Keywords

Cancer, Caregiver, Burden, Stress, Quality of Life.

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