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Author: Maria Emilsson Publisher: Linköping University Electronic Press ISBN: 9176854167 Category : Languages : en Pages : 94
Book Description
Adherence to medication in asthma and attention deficit hyperactivity disorder (ADHD) is important because medication may prevent serious consequences, possibly with lifelong effects. Several factors have been identified that influence adherence to medication in these disorders, but the importance of personality traits, beliefs about medication and illness perception has been insufficiently explored. The overall aim of this thesis was to study adherence to medication in asthma and ADHD, and in particular factors associated with adherence. The participants (n=268) in Study I were recruited epidemiologically and consisted of young adults with asthma, aged 22 years (±1 year). Impulsivity and, in men Antagonism and Alexithymia were associated with low adherence among respondents with regular asthma medication (n=109). The participants (n=35) in Study II were recruited from primary care clinics and consisted of adults (mean age 53 years). In men, Neuroticism was associated with low adherence, but Conscientiousness with high adherence. Beliefs about the necessity of medication were positively associated with adherence behaviour in women. In the total sample, a positive necessity-concern differential of beliefs predicted higher adherence. The participants in Study III, IV (n=101) and V (n=99) were recruited from Child and Adolescent Psychiatric clinics and consisted of adolescents with ADHD on long-term ADHD medication. Study IV assessed the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Exploratory Principal Component Analysis (PCA) loadings of the BMQ-Specific items confirmed the original components, the specific-necessity and specific-concerns. The exploratory PCA for B-IPQ revealed two components; the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the ability to manage the ADHD disorder (items 3, 4 and 7). Adherence correlated positively with BMQ-necessity-concern differential but negatively with beliefs about medication regarding concerns and side effects as well as Antagonism. Adolescents with more beliefs in the necessity, but with less concerns and side effects were less intentionally non-adherent. Adolescents with more perceptions that ADHD affected life showed less unintentional non-adherence. Negative Affectivity was associated with beliefs in the necessity of medication, but also with concern about medication and side effects. Negative Affectivity was positively associated with perceived consequences in life caused by ADHD and less control over ADHD. Hedonic Capacity was associated with less concerns about medication. In conclusion: In asthma and ADHD, adherence was associated with personality and beliefs about medications treatment. The personality traits showed numerous associations with perception about ADHD and beliefs about asthma and ADHD medication. This thesis increases our understanding of these person-related underlying factors of non-adherence, which may enable targeted actions intended to turn non-adherence into adherence as well as to identify individuals at risk for non-adherence. The Swedish translation of BMQ-Specific and B-IPQ proved to be valid and reliable, suggesting that the scales are useful in clinical work to identify risks of low adherence and to increase knowledge about how adolescents perceive ADHD. Följsamhet till läkemedelsbehandling vid astma och ADHD (attention deficit hyperactivity disorder) är viktigt eftersom optimal behandling kan förebygga allvarliga och livslånga konsekvenser. Flera faktorer som påverkar följsamhetsbeteendet har tidigare identifierats exempelvis ekonomiska faktorer, men vikten av personlighetsdrag, uppfattning om läkemedel och sjukdomsuppfattning har tidigare inte undersökts tillräckligt. Det övergripande syftet för avhandlingen var att studera följsamhet till läkemedel hos personer med astma och ADHD och i synnerhet påverkande faktorer. Avhandlingen utgörs av fem delstudier. Personlighet kan beskrivas som grundläggande egenskaper som kännetecknar likheter och skillnader mellan individer, den så kallade egenskapsteorin. Personlighet kan beskrivas utifrån fem grundläggande personlighetsdrag: känslomässig instabilitet, utåtriktning, öppenhet, vänlighet och målmedvetenhet, den så kallade fem-faktor modellen. När det gäller uppfattning om läkemedel så vägs uppfattningen om nödvändigheten av läkemedelsbehandlingen för att kontrollera sjukdomen mot oron för läkemedlens negativa effekter-biverkningar. Följsamhetsbeteendet beror på vilken uppfattning som dominerar. Uppfattning om sjukdom påverkas bland annat av personens uppfattning om hur mycket sjukdomen påverkar personens liv och sjukdomens varaktighet. Resultaten av denna avhandling visar att följsamheten var högre hos tonåringar med ADHD än hos vuxna med astma. Följsamheten till astma- och ADHD-medicinering var signifikant associerad med uppfattning att läkemedel var nödvändigt såväl som personlighetsdragen, särskilt antagonism. Följsamheten var inte associerad med ålder eller kön. Med anledning av att kön är relaterad till andra faktorer bör det beaktas i utredning av följsamhet till läkemedel. Personlighetsdraget känslomässig instabilitet, var relaterat till många uppfattningar om läkemedlen och sjukdomsuppfattningar. Avhandlingen visar på sambandet mellan vissa personrelaterade faktorer och följsamhet till läkemedel, hos personer med astma och ADHD. Den svenska översättningen av frågeformulären: Uppfattning om läkemedel (BMQ-Specific) och Uppfattning om ADHD (B-IPQ) visade sig ha god kvalitet för användning i kliniska utvärderingar och forskning som involverar ungdomar med ADHD.
Author: Maria Emilsson Publisher: Linköping University Electronic Press ISBN: 9176854167 Category : Languages : en Pages : 94
Book Description
Adherence to medication in asthma and attention deficit hyperactivity disorder (ADHD) is important because medication may prevent serious consequences, possibly with lifelong effects. Several factors have been identified that influence adherence to medication in these disorders, but the importance of personality traits, beliefs about medication and illness perception has been insufficiently explored. The overall aim of this thesis was to study adherence to medication in asthma and ADHD, and in particular factors associated with adherence. The participants (n=268) in Study I were recruited epidemiologically and consisted of young adults with asthma, aged 22 years (±1 year). Impulsivity and, in men Antagonism and Alexithymia were associated with low adherence among respondents with regular asthma medication (n=109). The participants (n=35) in Study II were recruited from primary care clinics and consisted of adults (mean age 53 years). In men, Neuroticism was associated with low adherence, but Conscientiousness with high adherence. Beliefs about the necessity of medication were positively associated with adherence behaviour in women. In the total sample, a positive necessity-concern differential of beliefs predicted higher adherence. The participants in Study III, IV (n=101) and V (n=99) were recruited from Child and Adolescent Psychiatric clinics and consisted of adolescents with ADHD on long-term ADHD medication. Study IV assessed the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Exploratory Principal Component Analysis (PCA) loadings of the BMQ-Specific items confirmed the original components, the specific-necessity and specific-concerns. The exploratory PCA for B-IPQ revealed two components; the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the ability to manage the ADHD disorder (items 3, 4 and 7). Adherence correlated positively with BMQ-necessity-concern differential but negatively with beliefs about medication regarding concerns and side effects as well as Antagonism. Adolescents with more beliefs in the necessity, but with less concerns and side effects were less intentionally non-adherent. Adolescents with more perceptions that ADHD affected life showed less unintentional non-adherence. Negative Affectivity was associated with beliefs in the necessity of medication, but also with concern about medication and side effects. Negative Affectivity was positively associated with perceived consequences in life caused by ADHD and less control over ADHD. Hedonic Capacity was associated with less concerns about medication. In conclusion: In asthma and ADHD, adherence was associated with personality and beliefs about medications treatment. The personality traits showed numerous associations with perception about ADHD and beliefs about asthma and ADHD medication. This thesis increases our understanding of these person-related underlying factors of non-adherence, which may enable targeted actions intended to turn non-adherence into adherence as well as to identify individuals at risk for non-adherence. The Swedish translation of BMQ-Specific and B-IPQ proved to be valid and reliable, suggesting that the scales are useful in clinical work to identify risks of low adherence and to increase knowledge about how adolescents perceive ADHD. Följsamhet till läkemedelsbehandling vid astma och ADHD (attention deficit hyperactivity disorder) är viktigt eftersom optimal behandling kan förebygga allvarliga och livslånga konsekvenser. Flera faktorer som påverkar följsamhetsbeteendet har tidigare identifierats exempelvis ekonomiska faktorer, men vikten av personlighetsdrag, uppfattning om läkemedel och sjukdomsuppfattning har tidigare inte undersökts tillräckligt. Det övergripande syftet för avhandlingen var att studera följsamhet till läkemedel hos personer med astma och ADHD och i synnerhet påverkande faktorer. Avhandlingen utgörs av fem delstudier. Personlighet kan beskrivas som grundläggande egenskaper som kännetecknar likheter och skillnader mellan individer, den så kallade egenskapsteorin. Personlighet kan beskrivas utifrån fem grundläggande personlighetsdrag: känslomässig instabilitet, utåtriktning, öppenhet, vänlighet och målmedvetenhet, den så kallade fem-faktor modellen. När det gäller uppfattning om läkemedel så vägs uppfattningen om nödvändigheten av läkemedelsbehandlingen för att kontrollera sjukdomen mot oron för läkemedlens negativa effekter-biverkningar. Följsamhetsbeteendet beror på vilken uppfattning som dominerar. Uppfattning om sjukdom påverkas bland annat av personens uppfattning om hur mycket sjukdomen påverkar personens liv och sjukdomens varaktighet. Resultaten av denna avhandling visar att följsamheten var högre hos tonåringar med ADHD än hos vuxna med astma. Följsamheten till astma- och ADHD-medicinering var signifikant associerad med uppfattning att läkemedel var nödvändigt såväl som personlighetsdragen, särskilt antagonism. Följsamheten var inte associerad med ålder eller kön. Med anledning av att kön är relaterad till andra faktorer bör det beaktas i utredning av följsamhet till läkemedel. Personlighetsdraget känslomässig instabilitet, var relaterat till många uppfattningar om läkemedlen och sjukdomsuppfattningar. Avhandlingen visar på sambandet mellan vissa personrelaterade faktorer och följsamhet till läkemedel, hos personer med astma och ADHD. Den svenska översättningen av frågeformulären: Uppfattning om läkemedel (BMQ-Specific) och Uppfattning om ADHD (B-IPQ) visade sig ha god kvalitet för användning i kliniska utvärderingar och forskning som involverar ungdomar med ADHD.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309439124 Category : Social Science Languages : en Pages : 171
Book Description
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Author: Eduardo Sabaté Publisher: World Health Organization ISBN: 9789241545990 Category : Medical Languages : en Pages : 232
Book Description
This report is based on an exhaustive review of the published literature on the definitions, measurements, epidemiology, economics and interventions applied to nine chronic conditions and risk factors.
Author: Somnath Banerjee Publisher: BoD – Books on Demand ISBN: 9535110861 Category : Medical Languages : en Pages : 330
Book Description
ADHD in children and adolescents is a neurodevelopmental disorder, which is recognized by the clinicians all over the world. ADHD is a clinical diagnosis based on reliable history, reports from home and school and a physical examination to rule out any other underlying medical conditions. ADHD can cause low self-esteem in the child and impair quality of life for the child and the family. It is known that ADHD is a chronic illness and that clinicians needed to use chronic illness principles in treating it. The last 10 years have seen an increase in the number of medications that have been approved for the treatment of ADHD. This book has tried to address some of the issues in ADHD.
Author: Issy Pilowsky Publisher: John Wiley & Sons ISBN: 9780471965732 Category : Health & Fitness Languages : en Pages : 290
Book Description
Pilowsky presents a general introduction to the early recognition and management of abnormal illness behaviour, and suggests ways to identify such behaviour, offer appropriate psychological care and provide specialist psychiatric help.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309121787 Category : Medical Languages : en Pages : 488
Book Description
Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309132967 Category : Medical Languages : en Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Author: Leslie Neal-Boylan Publisher: John Wiley & Sons ISBN: 1118277856 Category : Medical Languages : en Pages : 432
Book Description
Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use.
Author: Maria Emilsson
Author: Maria Emilsson
Author: National Academies of Sciences, Engineering, and Medicine
Author: 
Author: 
Author: Eduardo Sabaté
Author: Somnath Banerjee
Author: Issy Pilowsky
Author: Institute of Medicine
Author: Institute of Medicine
Author: Leslie Neal-Boylan