Concern about the grief processes of organ donors' families are reported by medical staff as a reason not to ask for organ donation. Objectives of the current study were to examine the relation between consenting to a post-mortem organ donation procedure and subsequent process of grief in the bereaved. A cross-section survey was conducted in a representative time-sample of 95 bereaved who lost a first-degree family member on intensive care wards in 27 Dutch hospitals. In 36 cases an organ donation procedure took place, in 23 cases consent was refused and in 36 cases no request for organ donation was made to the bereaved. The authors found there were no differences in levels of depression and problems with detachment from the deceased between bereaved (first-degree family members) who participated in an organ donation procedure, those who refused consent, and families who were not approached for poet-mortem organ donation. No differences were found in levels of main outcome measures between three donation conditions. However, dissatisfaction with hospital care was associated with depressive and grief symptoms. The results indicate that consenting to organ donation in itself neither hinders nor furthers the grief process.
Anxiety and depression are studied thoroughly in patients with advanced cancer. However, little is known about the nature of mood disorders in this stage of the disease. We studied positive and negative affect in patients who have had a diagnosis of advanced cancer, and examined how these are related to anxiety and depression, and to other patient and care factors. One hundred and five patients filled out a written questionnaire and were interviewed personally. The PANAS positive affect scores were lower than those in the general population, but the negative affect scores were fairly similar. We found a rather low prevalence of depression (13%) and anxiety (8%) as measured by the HADS. The emotional problems patients mentioned most frequently were anxiety about metastases (26%), the unpredictability of the future (18%) and anxiety about physical suffering (15%). Both positive and negative affect were most strongly related to patient's sense of meaning and peace. We conclude that distinguishing positive and negative affect enhances the understanding of psychological distress of patients with advanced cancer, that seems to be mainly caused by low levels of positive affect. Several theories are discussed to explain this finding, that may contribute to efforts to improve care for these patients.
A questionnaire to assess quality of life in the elderly was developed under the auspices of the European office of the World Health Organization. Stages in construction of the instrument, which was designed for international application, particularly at the primary level, are described. The latest version of the questionnaire is composed of 49 self-assessment item, 31 of which can be grouped into 7 subscales: Physical Function, Self-Care, Depression and Anxiety, Cognitive Functioning, Sexual Functioning, and Life Satisfaction. The remaining 18 items serve as moderators for assessing the influence of social desirability factors and personality characteristics on the individual scores for the 7 core instrument subscales. The questionnaire has been administered to 586 individuals aged 65 years and over recruited in communities in Italy (Padua and Brescia), the Netherlands (Leiden), and Finland (Helsinki). The main psychometric characteristics of the instrument, together with its concurrent validity with the Rotterdam Questionnaire, are illustrated.
The birth giving process was not related to FOC during pregnancy, but the pre-partum level of FOC certainly is predictive of the level of postpartum FOC, suggesting that FOC as measured during gestation may influence the interpretation of the birth experience itself. We did find a positive relationship between both parity and medical interventions during childbirth and FOC postpartum.
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