Health prevention seeks to avoid the onset of disease or symptoms by eliminating or at least minimizing environmental factors that increase the risk of illness. This article describes Ability OnLine, an innovative program designed to reduce the isolation young people can experience in a healthcare facility or when confined to their home. The electronic bulletin board is a friendly platform for disabled and chronically ill children to easily communicate with their peers and adult and teen mentors.
We evaluated the effectiveness of a pet visitation program in helping children and their families adjust to hospitalization on a pediatric cardiology ward. Thirty-one pet visits were observed and followed by interviews with patients and parents. Analysis of data suggested that pet visits relieved stress, normalized the hospital milieu, and improved patient and parent morale. The benefit received by the subjects correlated with the amount of physical contact and rapport developed with the visiting animal.
Advances in medical technology now permit children who need ventilator assistance to live at home rather than in hospitals or institutions. What does this ventilator-dependent life mean to children and their families? The impetus for this essay comes from a study of the moral experience of 12 Canadian families--parents, ventilator-dependent child, and well siblings. These families express great love for their children, take on enormous responsibilities for care, live with uncertainty, and attempt to create "normal" home environments. Nevertheless, they experience social isolation, sometimes even from their extended families and health care providers. Their lives are constrained in many ways. The challenges faced by parents of technology-dependent children raise questions of justice within society and within families.
Ehlers-Danlos syndrome (EDS) is a relatively rare, inherited connective tissue disorder and skin hyperextensibility, joint hypermobility, chronic joint and limb pain, blood vessel and tissue fragility are frequent symptoms. The aims of this study were to describe the degree to which individuals with EDS accept and cope with perceived limitations related to the syndrome, and to determine the relationships between acceptance of disability (AD), sense of coherence (SOC), functional health status and background data. Four questionnaires were mailed: the AD scale Modified (ADM), the SOC Scale, the Sickness Impact Profile (SIP) and a background form. The respondents with EDS were recruited through the EDS National Association in Sweden and the response rate was 74% (69 females and eight males). The Ethical Committee at Huddinge University Hospital (ref. no. 152/95) approved the study. This study has shown that the level of AD and SOC in individuals with EDS is similar to other patient groups, e.g. individuals with ostomy and with diabetes. Further, the SOC was in concordance with that of the general population. Those working full-time accepted their disability to a greater degree than those on sick leave or disability pension. A multiple regression analysis showed that a greater AD was associated with a higher level of SOC and a better functional health status. The SOC and SIP together accounted for 50% of the variance in the ADM. For health promotion in nursing practice it is important to have insight into the problem areas which may influence the overall life situation for an individual with EDS. A key issue for nurses is to identify individuals with low acceptance of their disease and/or low SOC in order to support these persons' adaptation process. Future research on EDS may be directed towards projects focusing on the development and implementation of models to strengthen the level of AD and SOC in this group.
Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.
Behavioural problems are leading welfare issues in domestic dogs. In particular, anxiety-related behavioural problems, such as fearfulness and noise sensitivity are highly prevalent conditions that cause distress to fearful dogs. To better understand the environmental factors associated with non-social fear, including noise sensitivity, fear of novel situations, and fear of surfaces and heights, a large online survey including data on 13,700 Finnish pet dogs was performed by the dog owners. After fulfilling inclusion criteria, this data consisted of 9,613 dogs with fear of fireworks, 9,513 dogs with fear of thunder, 6,945 dogs with fear of novel situations, and 2,932 dogs with fear of surfaces and heights. Logistic regression analyses revealed that dogs with frequent non-social fear had experienced less socialisation during puppyhood, were more often neutered, had inexperienced owners, lived without conspecifics, participated less frequently in activities or training, and lived in more urban environments. In addition, we identified several breed differences, and a tendency of more common non-social fear in small dog breeds, which suggests a genetic background. Non-social fearfulness has a negative effect on well-being of the dogs. Our findings suggest that the socialisation and the living environment and the value of other dogs' company and owner interaction via activities and training may improve the well-being of the dogs.
To determine how a group of 29 male military patients with coronary artery disease (CAD-MIL group) have adapted physically and psychosocially, we compared results from standard questionnaires with those from 39 healthy military men (WELL-MIL group) and 27 male civilian patients with coronary artery disease (CAD-CIV group). There was no difference in the degree of severity of coronary artery disease between the two groups with the disease. The WELL-MIL group reported a higher activity level than the CAD-MIL group, which reported a higher activity level than the CAD-CIV group. Both the CAD-MIL group and WELL-MIL groups had lower levels of state anxiety compared with the CAD-CIV group, and the CAD-MIL group had a better overall psychosocial adjustment score compared with that of the CAD-CIV group. Thus, male military patients with coronary artery disease reported better physical and psychosocial adjustment to their illness than a group of male civilian patients with a similar degree of disease severity. but they were less physically active than healthy military men.
Present-day society has produced changes in family living patterns and conditions and this has resulted in new stressors and health problems. Most children and adolescents with chronic diseases and disabilities, who were previously cared for at hospitals and institutions for long periods, are now integrated in society and they are expected to live a normal life in the conditions that currently prevail. The number of young people with long-term illnesses/disability has increased worldwide during the last decades. There is lack of studies relating to the way young people regard their daily lives and factors that are important for their well-being. The aim of this study was to describe the meaning of feeling good in daily life in adolescents living with a long-term illness or disability. Eight boys and seven girls, aged between 12 and 19 years, with different conditions of long-term illness or disability, participated in the study. Tape-recorded interviews were conducted between the years 2003-2004 and the data were analysed using content analysis. The results revealed that the adolescents with long-term illness generally experienced well-being like everybody else. Three themes were found to be important in order to feel good: 'a feeling of acceptance of illness/disability as a natural part of life', 'a feeling of support' and 'a feeling of personal growth'. This study concludes that adolescents with long-term illness or disabilities experience well-being when they are allowed to prepare for living a normal life integrated in society.
Several studies have suggested that there may be an increased prevalence of affective disorders in people with motor neuron disease (MND). However, the literature is inconsistent, possibly because of small sample sizes in the existing studies. The Canadian province of Alberta has a universal health care system in which physician contacts are recorded along with ICD-9-CM diagnostic codes. In this analysis, diagnostic codes indicative of MND and affective disorders were used. Stratified analysis and logistic regression were used in the analysis. There were 336 cases of MND leading to a prevalence of 14.5 per 100,000 in provincial residents > or =20 years old. Affective disorders were identified in 8.6% of the total population during the same year. The crude odds ratio for affective disorders in MND was 2.3 (95% CI = 1.7-3.0). However, the prevalence of affective disorders declined with increasing illness duration.
A comparative assessment of the extent and structure of the various forms of professional burnout among doctors-organizers as well as therapeutists and surgeons depending on age was given. It is shown that the professional burnout in doctors-organizers conjugates with a high level of emotional tension manifested in avoidance of over-saturated emotional and professional communication outside professional activities, increased irritability and temper, reluctance to exercise empathy towards colleagues and compassion for patients. The comparison of three age groups of physicians to each other in terms of the level and features of the burnout was adduced; the results demonstrate the significant differences between the age periods of 30 and 40 years and over 41 years old. Physicians in the age group of 30-40 years old are inclined to depersonalization at a relatively low level of reduction of professional achievement. It was found that age specificity of formation of the syndrome of professional burnout among surgeons was caused by the increased tendency to development of professional burnout syndrome of young and middle-aged surgeons at low levels of professional burnout among older people.