Caregiver education in Parkinson’s disease: formative evaluation of a standardized program in seven European countries

The formative evaluation of a standardized psychosocial education program for patients with Parkinson's disease (PD) and their caregivers. The results of the participation of the caregivers are presented next to the data of the patients. Caregivers (n = 137) and patients with PD (n = 151) participated in the 8-week program in separate groups. Measurements were performed on psychosocial problems (BELA-P/A-k), health state (EQ-5D VAS), quality of life (PDQ-39) and depression (SDS) 1 week before and 1 week after the program. Participants rated their mood on a visual analogue scale before and after each session, and they filled in an evaluation questionnaire after the last session. Scores on the BELA-P/A-k improved significantly on the 'bothered by scale' as well as the 'need for help scale'. No improvements were found on EQ-5D VAS, PDQ-39 and SDS. Mood ratings improved significantly after each session. Most participants evaluated the program as positive. Feedback led to improvements in the program, which are incorporated in a final manual. The program was feasible to run in the different countries. This exploratory study led to improvements in the program and recommendations for further research. A study on the effectiveness of the program is the next step.Pathophysiology of paroxysmal and chronic degenerative progressive disorder of the central and periferal nervous syste

Psychological impact of testing for thrombophilic alterations.

We investigated the psychological impact of testing for the presence of thrombophilic alterations. The enrolled subjects received counseling from a physician before blood sampling and after receiving results, with a view to provide clear information about the aim of thrombophilia screening (TS). Participants were requested to complete a pre-test questionnaire during this interview and a post-test questionnaire 20 days after receiving the TS results. One hundred ninety-seven subjects completed the pretest questionnaire and 140/197 (71.1%) returned the post-test one. The TS results were altered in 36 (25.7%, R506Q mutation n = 19; G20210A mutation n = 9; antithrombin deficiency n = 1; LAC phenomenon n = 4; hyperhomocysteinemia n = 3) and normal in 104 subjects. We assessed: perceived health status (PHS), state of anxiety, health fears, depressive reactions, moods, perceived well-being, and perceived daily-life stress. For both groups, both at pre- and post-test, none of the psychological variable scores showed significant worsening, regardless of whether TS resulted altered or normal. Anxiety significantly (

Psychological factors associated with medication adherence following renal transplantation

Background: A relationship exists between non-adherence and clinical outcomes in health care, including renal transplantation. The aim of this study was to identify the psychological variables associated with nonadherence to medication after renal transplantation. Methods: This cross-sectional study involved 34 patients, 38% male, with a mean age of 49 yr (range 26\u201370) and a mean of six yr post-transplantation. Adherence to medication was measured by two items: (i) the frequency of not taking medications and (ii) the frequency of not taking medications exactly as prescribed. The psychological variables were: dispositional coping style (COPE) and five items measuring barriers and perceived characteristics of the medication regimen. Descriptive and multivariate analyses were utilized to examine the data. Results: Twenty-four per cent of patients reported less than perfect adherence. Individuals who were younger, who perceived less autonomy in the management of treatment and who were characterized by an active coping style were less likely to adhere to medication. Individuals who perceived less autonomy and a higher level of interference of treatment with their life patterns were less likely to take medication exactly as prescribed. Conclusions: The finding of this study suggests that adherence to medications after renal transplant is associated with psychological variables, such as coping style and perceived autonomy in the management of treatment. Understanding of the patients perspective may help to develop effective interventions to increase the levels of adherence to medications that may result in better clinical outcomes

Psychological factors associated with medication adherence following renal transplantation

BACKGROUND: A relationship exists between non-adherence and clinical outcomes in health care, including renal transplantation. The aim of this study was to identify the psychological variables associated with non-adherence to medication after renal transplantation. METHODS: This cross-sectional study involved 34 patients, 38% male, with a mean age of 49 yr (range 26-70) and a mean of six yr post-transplantation. Adherence to medication was measured by two items: (i) the frequency of not taking medications and (ii) the frequency of not taking medications exactly as prescribed. The psychological variables were: dispositional coping style (COPE) and five items measuring barriers and perceived characteristics of the medication regimen. Descriptive and multivariate analyses were utilized to examine the data. RESULTS: Twenty-four per cent of patients reported less than perfect adherence. Individuals who were younger, who perceived less autonomy in the management of treatment and who were characterized by an active coping style were less likely to adhere to medication. Individuals who perceived less autonomy and a higher level of interference of treatment with their life patterns were less likely to take medication exactly as prescribed. CONCLUSIONS: The finding of this study suggests that adherence to medications after renal transplant is associated with psychological variables, such as coping style and perceived autonomy in the management of treatment. Understanding of the patient's perspective may help to develop effective interventions to increase the levels of adherence to medications that may result in better clinical outcomes