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Article ; Online: Effectiveness of cognitive interventions for adult surgical patients after general anaesthesia to improve cognitive functioning: A systematic review.

Bowden, Tracey / Hurt, Catherine S / Sanders, Julie / Aitken, Leanne M

2022 Volume 32, Issue 13-14, Page(s) 3117–3129

Abstract: Aims and objectives: To examine the effectiveness of cognitive interventions after general anaesthesia to improve cognitive functioning.: Background: The number of surgical procedures performed worldwide is large and growing. Postoperative cognitive ... ...

Abstract	Aims and objectives: To examine the effectiveness of cognitive interventions after general anaesthesia to improve cognitive functioning. Background: The number of surgical procedures performed worldwide is large and growing. Postoperative cognitive dysfunction is a common complication associated with poor postoperative outcomes. A variety of cognitive interventions have been developed to maintain or improve cognitive function in one or more cognitive domains. Cognitive interventions have shown to be effective in healthy older populations, those with mild cognitive impairment, and those with heart failure. The impact of cognitive interventions in surgical patients after general anaesthesia is a relatively new focus of research and is therefore less well established. Methods: Seven bibliographic databases were searched in relation to 'surgery' and 'cognitive interventions'; no date or language limits were imposed. Studies including adult patients who were scheduled for, or who had undergone surgery under general anaesthesia, had a baseline cognitive assessment using a validated measurement, and had engaged with any cognition-based intervention were included. Full-text review for inclusion, quality assessment and data extraction were undertaken independently by two authors. This study is reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Results: A total of 550 papers were identified for possible inclusion, of which nine met the inclusion criteria and were included in the review. The majority were randomised controlled trials (RCTs) (n = 6 [66.7%]). Four studies used computerised cognitive interventions, while five used traditional cognitive interventions. Most of the studies used multi-domain cognitive training focusing on two or more domains (n = 7 [77.8%]) while two studies used single-domain cognitive training. Memory (n = 7 [77.8%]) and attention (n = 5 [55.6%]) were the cognitive domains most often targeted during the intervention. Conclusions: The use of cognitive interventions demonstrated some efficacy in improving cognitive function after general anaesthesia, particularly those targeting memory. Relevance for clinical practice: The findings of this review suggest that cognitive interventions show promise at improving cognitive performance in patients with POCD and could be usefully implemented in clinical practice to improve patient outcomes.
MeSH term(s)	Adult ; Humans ; Cognition ; Cognitive Dysfunction ; Anesthesia, General/adverse effects
Language	English
Publishing date	2022-06-22
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1159483-4
ISSN	1365-2702 ; 0962-1067 ; 1752-9816
ISSN (online)	1365-2702
ISSN	0962-1067 ; 1752-9816
DOI	10.1111/jocn.16423
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Zs.A 3764: Show issues

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Article ; Online: Prioritising target non-pharmacological interventions for research in Parkinson's disease: achieving consensus from key stakeholders.

Bogosian, Angeliki / Rixon, Lorna / Hurt, Catherine S

Research involvement and engagement

2020 Volume 6, Page(s) 35

Abstract: Background: In 2014 Parkinson's UK conducted a research prioritisation exercise with stakeholders highlighting important clinical research questions. The exercise highlighted the need for effective interventions to be developed and tested to tackle a ... ...

Abstract	Background: In 2014 Parkinson's UK conducted a research prioritisation exercise with stakeholders highlighting important clinical research questions. The exercise highlighted the need for effective interventions to be developed and tested to tackle a range of non-motor symptoms including: sleep quality, stress and anxiety, mild cognitive impairment, dementia and urinary problems. The present work set out to build on this exercise by prioritising types of non-pharmacological interventions to be tested to treat the identified non-motor symptoms. Methods: A Patient and Public Involvement exercise was used to reach consensus on intervention priorities for the treatment of non-motor symptoms. A Delphi structure was used to support the feedback collected. A first-round prioritisation survey was conducted followed by a panel discussion. Nineteen panellists completed the first-round survey (9 people with Parkinson's and 10 professionals working in Parkinson's) and 16 participated in the panel discussion (8 people with Parkinson's and 8 professionals working in Parkinson's). A second-round prioritization survey was conducted after the panel discussion with 13 people with Parkinson's. Results: Physical activity, third wave cognitive therapies and cognitive training were rated as priority interventions for the treatment of a range of non-motor symptoms. There was broad agreement on intervention priorities between health care professionals and people with Parkinson's. A consensus was reached that research should focus on therapies which could be used to treat several different non-motor symptoms. In the context of increasing digitisation, the need for human interaction as an intervention component was highlighted. Conclusion: Bringing together Parkinson's professionals and people with Parkinson's resulted in a final treatment priority list which should be both feasible to carry out in routine clinical practice and acceptable to both professionals and people with Parkinson's. The workshop further specified research priorities in Parkinson's disease based on the current evidence base, stakeholder preferences, and feasibility. Research should focus on developing and testing non-pharmacological treatments which could be effective across a range of symptoms but specifically focusing on tailored physical activity interventions, cognitive therapies and cognitive training.
Language	English
Publishing date	2020-06-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2834246-X
ISSN	2056-7529 ; 2056-7529
ISSN (online)	2056-7529
ISSN	2056-7529
DOI	10.1186/s40900-020-00212-7
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Article ; Online: Predictors of cognitive dysfunction after cardiac surgery: a systematic review.

Bowden, Tracey / Hurt, Catherine S / Sanders, Julie / Aitken, Leanne M

European journal of cardiovascular nursing

2021 Volume 21, Issue 3, Page(s) 192–204

Abstract: Aims: Postoperative cognitive dysfunction (POCD) is often experienced by cardiac surgery patients; however, it is not known if some groups of patients experience this more frequently or severely than others.The aim of this systematic review was to ... ...

Abstract	Aims: Postoperative cognitive dysfunction (POCD) is often experienced by cardiac surgery patients; however, it is not known if some groups of patients experience this more frequently or severely than others.The aim of this systematic review was to identify preoperative and postoperative predictors of cognitive dysfunction in adults following cardiac surgery. Methods and results: Eight bibliographic databases were searched (January 2005 to March 2021) in relation to cardiac surgery and cognition. Studies including adult patients who had undergone open cardiac surgery and using a validated measurement of cognitive function were included. Full-text review for inclusion, quality assessment, and data extraction were undertaken independently by two authors. A total of 2870 papers were identified, of which 36 papers met the inclusion criteria and were included in the review. The majority were prospective observational studies [n = 28 (75.7%)]. In total, 61 independent predictors (45 preoperative and 16 postoperative) were identified as significant in at least one study; advancing age and education level appear important. Age has emerged as the most common predictor of cognitive outcome. Conclusion: Although a number of predictors of POCD have been identified, they have inconsistently been reported as significantly affecting cognitive outcome. Consistent with previous research, our findings indicate that older patients and those with lower educational levels should be prioritized when developing and trialling interventions to improve cognitive function. These findings are less than surprising if we consider the methodological shortcomings of included studies. It is evident that further high-quality research exploring predictors of POCD is required. Registration: This review was registered on Prospero, CRD42020167037.
MeSH term(s)	Adult ; Cardiac Surgical Procedures/adverse effects ; Cognition ; Cognitive Dysfunction/etiology ; Humans ; Observational Studies as Topic ; Postoperative Cognitive Complications/etiology ; Postoperative Complications/etiology
Language	English
Publishing date	2021-10-30
Publishing country	England
Document type	Journal Article ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2151245-0
ISSN	1873-1953 ; 1474-5151
ISSN (online)	1873-1953
ISSN	1474-5151
DOI	10.1093/eurjcn/zvab086
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Article ; Online: Further explorations of illness uncertainty: carers' experiences of Parkinson's disease.

Hurt, Catherine S / Cleanthous, Sophie / Newman, Stanton P

Psychology & health

2017 Volume 32, Issue 5, Page(s) 549–566

Abstract: Objective: Dominant models of illness uncertainty define uncertainty as 'an inability to determine the meaning of illness-related events'. Recent research has shown patient uncertainty to be multidimensional encompassing personal issues indirectly ... ...

Abstract	Objective: Dominant models of illness uncertainty define uncertainty as 'an inability to determine the meaning of illness-related events'. Recent research has shown patient uncertainty to be multidimensional encompassing personal issues indirectly affected by illness. The nature of carer uncertainty has yet to be fully explored. The present study aimed to investigate the nature of illness uncertainty in the carers of patients with Parkinson's disease (PD). Design: Eighteen carers of a spouse with PD participated in semistructured interviews. Transcripts were thematically analysed, statements were coded as uncertain if they reflected 'a lack of certainty, or a state of limited knowledge, understanding or worry regarding an existing or future outcome'. Results: The domains of uncertainty expressed by carers closely fitted the five domain framework of patient uncertainty: symptoms and prognosis, medical management, self-management, social functioning and impact. An additional 'carer-role' domain was identified. Conclusions: Carer uncertainty about PD went beyond issues directly related to the illness. The findings have implications for research into uncertainty suggesting that widely used measures may not be accurately capturing the nature of carer uncertainty about chronic illness. The breadth of uncertainty reported has implications for the provision of appropriate support to improve caregiver well-being.
MeSH term(s)	Adaptation, Psychological ; Aged ; Caregivers/psychology ; Caregivers/statistics & numerical data ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Models, Psychological ; Parkinson Disease/psychology ; Parkinson Disease/therapy ; Qualitative Research ; Uncertainty ; United Kingdom
Language	English
Publishing date	2017
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	625255-2
ISSN	1476-8321 ; 0887-0446
ISSN (online)	1476-8321
ISSN	0887-0446
DOI	10.1080/08870446.2017.1283041
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Article ; Online: The impact of chemotherapy on cognitive performance post-surgery in patients with colorectal cancer: A prospective cohort study.

Dwek, Marie-Rose / Newman, Stanton P / Brini, Stefano / Holder, Pru / Machesney, Michael / Propper, David / Rixon, Lorna R / Hirani, Shashivadan P / Hurt, Catherine S

Psycho-oncology

2023 Volume 32, Issue 7, Page(s) 1057–1066

Abstract: Objectives: Subjective reports of cognitive impairment following chemotherapy are frequent in cancer patients. Objective cognitive impairment has been observed in cancer patients regardless of treatment regimen suggesting the relationship between ... ...

Abstract	Objectives: Subjective reports of cognitive impairment following chemotherapy are frequent in cancer patients. Objective cognitive impairment has been observed in cancer patients regardless of treatment regimen suggesting the relationship between cognitive impairment and chemotherapy is not clear cut. Little research has explored the effects of chemotherapy on cognition following surgery in colorectal cancer (CRC). The present study explored the effects of chemotherapy on cognitive performance in a sample of CRC patients. Methods: 136 participants were recruited into a prospective cohort study: 78 CRC patients undergoing surgery and adjuvant chemotherapy, 58 CRC patients undergoing surgery only. A battery of neuropsychological tests was administered to participants 4 weeks post-surgery (T1), 12 weeks after first chemotherapy (T2) and 3 months after last chemotherapy (T3) or equivalent time-points. Results: Using the criterion of scoring at least two standard-deviations below the group norm on at least one neuropsychological test, 45%-55% of all CRC patients showed cognitive deficits 10 months after surgery (T3) and 14% on at least 3 tests. However, cognition did not significantly differ between patients who had chemotherapy and those who did not. A time by group interaction effect was found on the composite cognition score using multi-level modelling suggesting a greater improvement in cognition in the surgery only group over time (p < 0.05). Conclusions: CRC patients display cognitive impairment 10 months after surgery. Chemotherapy did not worsen cognitive impairment but did appear to slow cognitive recovery relative to those undergoing surgery only. The findings demonstrate a clear need for supportive cognitive interventions for all CRC patients following treatment.
MeSH term(s)	Humans ; Prospective Studies ; Longitudinal Studies ; Cognitive Dysfunction/etiology ; Cognition ; Chemotherapy, Adjuvant/adverse effects ; Neuropsychological Tests ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/surgery
Language	English
Publishing date	2023-05-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1118536-3
ISSN	1099-1611 ; 1057-9249
ISSN (online)	1099-1611
ISSN	1057-9249
DOI	10.1002/pon.6147
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Zs.A 3550: Show issues

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Article ; Online: Changing behaviour 'more or less'-do theories of behaviour inform strategies for implementation and de-implementation? A critical interpretive synthesis.

Patey, Andrea M / Hurt, Catherine S / Grimshaw, Jeremy M / Francis, Jill J

Implementation science : IS

2018 Volume 13, Issue 1, Page(s) 134

Abstract: Background: Implementing evidence-based care requires healthcare practitioners to do less of some things (de-implementation) and more of others (implementation). Variations in effectiveness of behaviour change interventions may result from failure to ... ...

Abstract	Background: Implementing evidence-based care requires healthcare practitioners to do less of some things (de-implementation) and more of others (implementation). Variations in effectiveness of behaviour change interventions may result from failure to consider a distinction between approaches by which behaviour increases and decreases in frequency. The distinction is not well represented in methods for designing interventions. This review aimed to identify whether there is a theoretical rationale to support this distinction. Methods: Using Critical Interpretative Synthesis, this conceptual review included papers from a broad range of fields (biology, psychology, education, business) likely to report approaches for increasing or decreasing behaviour. Articles were identified from databases using search terms related to theory and behaviour change. Articles reporting changes in frequency of behaviour and explicit use of theory were included. Data extracted were direction of behaviour change, how theory was operationalised, and theory-based recommendations for behaviour change. Analyses of extracted data were conducted iteratively and involved inductive coding and critical exploration of ideas and purposive sampling of additional papers to explore theoretical concepts in greater detail. Results: Critical analysis of 66 papers and their theoretical sources identified three key findings: (1) 9 of the 15 behavioural theories identified do not distinguish between implementation and de-implementation (5 theories were applied to only implementation or de-implementation, not both); (2) a common strategy for decreasing frequency was substituting one behaviour with another. No theoretical basis for this strategy was articulated, nor were methods proposed for selecting appropriate substitute behaviours; (3) Operant Learning Theory makes an explicit distinction between techniques for increasing and decreasing frequency. Discussion: Behavioural theories provide little insight into the distinction between implementation and de-implementation. Operant Learning Theory identified different strategies for implementation and de-implementation, but these strategies may not be acceptable in health systems. Additionally, if behaviour substitution is an approach for de-implementation, further investigation may inform methods or rationale for selecting the substitute behaviour.
MeSH term(s)	Conditioning, Operant ; Evidence-Based Practice ; Health Behavior ; Humans ; Implementation Science ; Models, Psychological ; Motivation ; Punishment
Language	English
Publishing date	2018-10-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2225822-X
ISSN	1748-5908 ; 1748-5908
ISSN (online)	1748-5908
ISSN	1748-5908
DOI	10.1186/s13012-018-0826-6
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Article ; Online: A patient-initiated treatment model for blepharospasm and hemifacial spasm: a randomized controlled trial.

Lawes-Wickwar, Sadie / McBain, Hayley / Brini, Stefano / Hirani, Shashivadan P / Hurt, Catherine S / Flood, Chris / Dunlop, Nicola / Solly, Dianne / Crampton, Bridget / Newman, Stanton P / Ezra, Daniel G

BMC neurology

2022 Volume 22, Issue 1, Page(s) 99

Abstract: Background: To test, in a two-arm, single center, superiority, randomized controlled trial, the effectiveness of and costs associated with a patient-initiated treatment model for people with hemifacial spasm (HFS) and blepharospasm (BEB) in comparison ... ...

Abstract	Background: To test, in a two-arm, single center, superiority, randomized controlled trial, the effectiveness of and costs associated with a patient-initiated treatment model for people with hemifacial spasm (HFS) and blepharospasm (BEB) in comparison to usual care. Methods: One hundred and thirty patients with HFS or BEB, aged 18 years or over, were recruited from a nurse-led botulinum toxin type A clinic at an eye hospital in the United Kingdom (UK), completed baseline measures and were randomized (1:1). The intervention group determined their own botulinum toxin type A (BoNT/A) treatment schedule during the trial period (9 months) and received an information leaflet with a "hotline" number to book an appointment. Usual care appointments were scheduled by treating clinicians. Data analysts were blind to study group. The primary outcomes were disease severity and functional disability, as measured by the Jankovic Rating Scale and Blepharospasm Disability Index, respectively. Secondary outcomes included quality of life, anxiety and depression, satisfaction with care, confidence in the service, economic costs and employment days lost. Results: Sixty-five patients were randomized to each group. The intervention demonstrated no statistically significant difference to usual care for any of primary outcomes. On secondary outcomes the levels of anxiety differed significantly (F Conclusions: We did not observe differences between the patient-initiated treatment model and usual care for people with BEB or HFS, on any primary outcome measure, quality of life, or depression. The patient-initiated treatment model may, however, have the potential to save healthcare costs and reduce anxiety. Patients using this new model were also equally as satisfied in the service and confident in their care as those receiving treatment as usual. Trial registration: Clinicaltrials.gov ID NCT02577224 , 16th October 2015.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blepharospasm/drug therapy ; Botulinum Toxins, Type A/therapeutic use ; Health Care Costs ; Hemifacial Spasm/drug therapy ; Humans ; Middle Aged ; Quality of Life ; Young Adult
Chemical Substances	Botulinum Toxins, Type A (EC 3.4.24.69)
Language	English
Publishing date	2022-03-17
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-022-02603-7
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Article: Acceptability and Feasibility of a Mindfulness Intervention Delivered via Videoconferencing for People With Parkinson's.

Bogosian, Angeliki / Hurt, Catherine S / Hindle, John V / McCracken, Lance M / Vasconcelos E Sa, Debora A / Axell, Sandra / Tapper, Katy / Stevens, Jemima / Hirani, P Shashi / Salhab, Marya / Ye, Wenrong / Cubi-Molla, Patricia

Journal of geriatric psychiatry and neurology

2021 Volume 35, Issue 1, Page(s) 155–167

Abstract: Mindfulness-based group therapy is a rapidly growing psychological approach that can potentially help people adjust to chronic illness and manage unpleasant symptoms. Emerging evidence suggests that mindfulness-based interventions may benefit people with ...

Abstract	Mindfulness-based group therapy is a rapidly growing psychological approach that can potentially help people adjust to chronic illness and manage unpleasant symptoms. Emerging evidence suggests that mindfulness-based interventions may benefit people with Parkinson's. The objective of the paper is to examine the appropriateness, feasibility, and potential cost-effectiveness of an online mindfulness intervention, designed to reduce anxiety and depression for people with Parkinson's. We conducted a feasibility randomized control trial and qualitative interviews. Anxiety, depression, pain, insomnia, fatigue, impact on daily activities and health-related quality of life were measured at baseline, 4, 8, and 20 weeks. Semi-structured interviews were conducted at the end of the intervention. Participants were randomized to the Skype delivered mindfulness group (n = 30) or wait-list (n = 30). Participants in the mindfulness group were also given a mindfulness manual and a CD with mindfulness meditations. The intervention did not show any significant effects in the primary or secondary outcome measures. However, there was a significant increase in the quality of life measure. The incremental cost-effectiveness ratio was estimated to be £27,107 per Quality-Adjusted Life Year gained. Also, the qualitative study showed that mindfulness is a suitable and acceptable intervention. It appears feasible to run a trial delivering mindfulness through Skype, and people with Parkinson's found the sessions acceptable and helpful.
MeSH term(s)	Feasibility Studies ; Humans ; Mindfulness ; Parkinson Disease/therapy ; Quality of Life ; Videoconferencing
Language	English
Publishing date	2021-01-28
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1035760-9
ISSN	0891-9887
ISSN	0891-9887
DOI	10.1177/0891988720988901
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Article ; Online: Measuring Illness beliefs in neurodegenerative disease: why we need to be specific.

Hurt, Catherine S / Julien, Camille L / Brown, Richard G

Journal of health psychology

2013 Volume 20, Issue 1, Page(s) 69–79

Abstract: Positive perceptions of illness are typically associated with good health outcomes. However, this may not be true for all domains of illness perception in neurodegenerative diseases because of their progressive incurable nature. The appropriateness of ... ...

Abstract	Positive perceptions of illness are typically associated with good health outcomes. However, this may not be true for all domains of illness perception in neurodegenerative diseases because of their progressive incurable nature. The appropriateness of current measures of illness belief in these conditions is not known. The validity and reliability of the Illness Perception Questionnaire-Revised was evaluated in 215 participants with Parkinson's disease. A confirmatory factor analysis supported the structure of the Illness Perception Questionnaire-Revised with the exception of the treatment control domain. It is important to consider the nature of neurodegenerative diseases and limits of symptom control when planning interventions.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Parkinson Disease/psychology ; Psychometrics/instrumentation ; Reproducibility of Results ; Surveys and Questionnaires/standards
Language	English
Publishing date	2013-09-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2021897-7
ISSN	1461-7277 ; 1359-1053
ISSN (online)	1461-7277
ISSN	1359-1053
DOI	10.1177/1359105313498627
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Article ; Online: An exploration of worry content and catastrophic thinking in middle-aged and older-aged adults with and without Parkinson's disease.

Wright, Anwen / Hurt, Catherine S / Gorniak, Sarah / Brown, Richard G

International journal of geriatric psychiatry

2015 Volume 30, Issue 4, Page(s) 376–383

Abstract: Objective: Worry is a common and distressing problem in Parkinson's disease (PD). However, little is known about the nature and content of worry in PD and how it might differ to non-PD populations. The study aimed to explore the content and nature of ... ...

Abstract	Objective: Worry is a common and distressing problem in Parkinson's disease (PD). However, little is known about the nature and content of worry in PD and how it might differ to non-PD populations. The study aimed to explore the content and nature of worry in middle-aged and older-aged adults with and without PD. Method: Four groups of participants, 20 PD patients (10 high worry and 10 low worry) and 19 middle-aged and older-aged adults (10 high worry and nine low worry), completed the catastrophising interview (CI) for three worry topics. Worriers were classified (high/low) on the basis of Penn State Worry Questionnaire scores. Data were analysed using framework analysis. Results: High worriers showed a greater diversity of worry topics than low worriers. Health worries differentiated high and low worriers in the non-PD sample but were common across all PD participants. The CI revealed that the root concern of worry was often different to that initially described. In particular, PD high worriers were more likely to express underlying concerns about negative self-perception and death/severe incapacity. Conclusion: The CI was able to identify the root cause of worry, demonstrating the value of this technique in the exploration and treatment of worry and psychological distress. Exploring worry content may help to distinguish patients with problematic worry, with worries about self-perception and death/severe incapacity characteristic of high worriers. Therapeutic interventions designed to alleviate problematic worry and distress in PD need to take account of the realities of living with PD and the potentially realistic nature of worries that may appear catastrophic in a healthy population.
MeSH term(s)	Adult ; Aged ; Anxiety Disorders/psychology ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/psychology ; Self Concept ; Surveys and Questionnaires
Language	English
Publishing date	2015-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	806736-3
ISSN	1099-1166 ; 0885-6230
ISSN (online)	1099-1166
ISSN	0885-6230
DOI	10.1002/gps.4146
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