Attrition from an internet-based treatment program for female sexual dysfunction : who is best treated with this approach?

The current study evaluated the attrition from an Internet-based treatment program for female sexual dysfunction (FSD), and determined factors that contribute to this attrition. Of the original, 26 women who were allocated to the treatment group, 12 provided post-intervention data, and of the 27 women who entered the wait list control group, 22 provided post-intervention data. Of 14 control participants who then elected to enter treatment, five provided post-intervention data. Therefore, a total of 40 women entered the FSD program and 23 dropped out. Reasons for attrition included: relationship factors, lack of motivation, and time commitment perceived to be excessive. Significant differences were found in levels of relationship satisfaction and intimacy for those who dropped out and those who completed treatment. These findings suggest that participants with high relationship satisfaction and emotional intimacy with their partner are suitable for treatments of this type

A longitudinal study of children\u27s disordered eating and muscle preoccupation

Recent research has demonstrated high levels of dieting, food preoccupation and muscle preoccupation in preadolescent children. In children, these attitudes and behaviours can constitute health risks. The design of appropriate intervention programs relies on empirical identification of the relevant risk factors. The current study was designed to investigate low self-esteem, perceived parental relations, perceived peer relations, negative affect, perfectionism and BMI as predictors of dieting, food preoccupation and muscle preoccupation in 8 to 10 year old children, over a 10 month period. The results demonstrate the importance of perfectionism as a predictor of dieting and muscle preoccupation in preadolescent boys.<br /

Self-concept clarity and women\u27s sexual well-being

The purpose of this study was to examine the role of self-concept clarity, a core structural aspect of self-concept, in women\u27s sexual well-being. A convenience sample of 261 women aged 18 years and over {M=25.8, &pound;D=7.9) completed an online survey that measured self-concept clarity, three aspects of sexual well-being (sexual self-ef&ntilde;cacy, sexual self-esteem and sexual satisfaction), and four structural dimensions of sexual identity (commitment, synthesis/integration, exploration, and orientation identity uncertainty). A series of multiple mediation analyses, followed by post-hoc bootstrap tests of the difference between mediation effects, revealed that self-concept clarity is indirectly related to the measures of sexual well-being, and that these relationships are mediated by the two &quot;investment-related&quot; dimensions of sexual identity: commitment and synthesis/integration. These results suggest that women with a more broadly and coherently integrated sexual identity are also better able to make healthy and positive choices in the sexual domain and experience more satisfaction with their sex lives, i^ore generally, the results highlight the potential importance of including structural aspects of self-concept in explanations of women\u27s sexual well-being.<br /

Why are some people with neurological illness more resilient than others?

The current qualitative study was designed to evaluate the coping strategies of people living with a chronic progressive neurological illness and their carers. The neurological illnesses were Huntington&rsquo;s disease, motor neurone disease, multiple sclerosis and Parkinson&rsquo;s disease. Participants included 15 people who showed high levels of adjustment and 15 who showed low levels of adjustment. Participants were selected from an earlier study, to ensure that they satisfied the inclusion criteria for the current study. Interviews were completed to determine the strategies used to cope with the demands of the illness. Participants who demonstrated good adjustment were more likely to draw on social support to provide them with the resources to deal with the illness. In contrast, those who evidenced poor adjustment were more likely to draw on external supports to complete tasks for them. The implications of these findings for people with chronic neurological illnesses and their families are discussed.<br /

Sociocultural factors relating to Tongans\u27 and Indigenous Fijians\u27 patterns of eating, physical activity and body size

This paper reviews literature between 1974 and 2007 that addresses the impact of sociocultural factors on reported patterns of eating, physical activity (activity) and body size of Tongans and indigenous Fijians (Fijians) in their countries of origin. There have been changes in diet (more imported and fewer traditional foods), activity (reduced, especially in urban settings), residence (rural-urban shift) and body size (increased obesity and at a younger age). The prevalence of overweight/obesity in Tongans and Fijians has increased rapidly over the last two decades and remains among the highest in the world (&gt;80% in Tonga; &gt;40% in Fiji), with more females reported to be obese than males. The few studies that investigated sociocultural influences on patterns of eating, activity and/or body size in this population have examined the impact of hierarchical organisation, rank and status (sex, seniority), values (respect, care, co-operation) and/or role expectations. It is important to examine how sociocultural factors influence eating, activity and body size in order to i) establish factors that promote or protect against obesity, ii) inform culturally-appropriate interventions to promote healthy lifestyles and body size, and iii) halt the obesity epidemic, especially in cultural groups with a high prevalence of obesity. There is an urgent need for more systematic investigations of key sociocultural factors, whilst taking into account the complex interplay between sociocultural factors, behaviours and other influences (historical; socioeconomic; policy; external global influences; physical environment).<br /

Changes over time in sexual and relationship functioning of people with multiple sclerosis

Relationship and sexual satisfaction among people with multiple sclerosis (MS) has received little research attention. This article reports on a longitudinal investigation of the impact of coping style and illness-related variables among people with MS and the general population on sexual and relationship functioning. Both men (n = 120) and women (n= 201) with MS and men (n = 79) and women (n = 160) from the general population participated in the study at two points in time, 6 months apart. People with MS experienced lower levels of sexual activity, sexual satisfaction, and relationship satisfaction and higher levels of sexual dysfunction. Generally speaking, the time 1 levels of the health and coping variables explained little of the variance in the time 2 sexual and relationship variables. However, sexual activity at time 1 contributed significant unique variance to relationship satisfaction at time 2 for MS men, and coping strategies at time I contributed to relationship satisfaction among general population women at time 2. Furthermore, for those respondents who had been diagnosed with MS for less than 7 years, levels of sexual activity at time 2 were predicted by levels of sexual and relationship satisfaction, as well as levels of sexual activity at time 1. These results suggest that strategies used to cope with illness may not play a major role in sexual and relationship satisfaction. However, an examination of these strategies over a longer time frame is needed

A qualitative study of primary health care access, barriers and satisfaction among people with mental illness

Research has found that a substantial proportion of individuals with mental illness have high morbidity and mortality rates, and high under-diagnosis of major physical illnesses. Furthermore, people with a mental illness tend not to seek out or utilise health care services. The reasons for the negative attitudes and behaviour towards health care services among this population have not been investigated. This paper presents findings from a study that investigated the health care service needs of people with mental illness (n = 20), and views from health care providers (n = 16) regarding access to these services by people with a mental illness. Results indicated that psychiatric patients identified a range of barriers to their health care usage and low levels of health care satisfaction. These views were shared with health care professionals. Reasons for these findings and strategies to address these problems so that there is better access to health care services for people with mental illness are discussed. <br /

Anorgasmia in women

This article reports on the etiology and treatment of anorgasmia. Etiological factors include childhood and adolescent experiences, current individual attitudes, and lifestyle factors, as well as the quality and dynamics of past and present committed relationships. It is important to assess the nature of each of the previously mentioned factors in determining the nature of the orgasmic dysfunction as well as assisting in the development of a treatment plan. Treatment approaches for anorgasmia need to address individual factors (e.g., performance anxiety, poor body image) as well as interpersonal problems. A systemic treatment framework would appear to be the most useful approach to treat this sexual dysfunction, as this type of strategy identifies and treats the difficulties experienced by the anorgasmic woman within the total context of her life. Of course, this approach necessitates the involvement of the partner in therapy, and treatment is unlikely to be effective unless the problems experienced by both the woman and her partner are addressed. Limitations of past research in terms of inadequate evaluation of treatment, low sample sizes, and poorly defined interventions are discussed. Finally, directions for future research to advance our understanding of the most effective treatments for anorgasmia are considered. <br /

Defining dual diagnosis : a qualitative study of the views of health care workers

Background: \u27Dual diagnosis\u27 is the term of choice in many countries to describe clients with co-occurring mental health and alcohol and other drug (AOD) issues. However, it is not known if its meaning is consistently represented within and across health care services. This uncertainty has significant implications for referral, consultation and research.Aim: To obtain information about the way that different health care professionals understand the term \u27dual diagnosis\u27.Method: Twenty-nine health care workers across five service types (medical, mental health, AOD, dual diagnosis and community health) in Victoria, Australia were interviewed about their understanding of the term \u27dual diagnosis\u27.Results: The findings indicated that service providers working in AOD and Mental Health had a shared general understanding of what was meant by \u27dual diagnosis\u27, despite uncertainties about more specific inclusion criteria. In contrast, medical and community health staff lacked a similar shared understanding, and were more likely to recommend change, but offered no consensus on alternatives.Conclusion: The results indicate that while the term \u27dual diagnosis\u27 has value in efficiently directing attention to the complexity of treatment issues, health practitioners cannot assume it will convey the intended meaning outside mental health or AOD services. Clear articulation of the intended definition may be a necessary requirement in wider health care communication. <br /

Intervention for depression among palliative care patients and their families: A study protocol for evaluation of a training program for professional care staff

Background: Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.Methods and Design: A randomised controlled trial will be implemented across two palliative care services to evaluate the &ldquo;Training program for professional carers to recognise and manage depression in palliative care settings&rdquo;. Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.Discussion: This study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.<br /