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This article discusses the psychological needs of adolescents and young adults (AYA) with myeloproliferative neoplasms (MPN), a rare type of cancer. The article highlights that AYA with MPN face unique challenges due to their developmental stage and that very little is known about the psychological impact and management of this population. The authors conducted a systematic scoping review to synthesize the research on the psychological impact and relevance of psychological support for AYA with MPN. The review identified gaps in the literature and emphasized the need for further research and appropriate support for this population. [Extracted from the article]

Very little is known about the impact of living with non-muscle invasive bladder cancer (NMIBC). NMIBC patients' experiences of their illness–in terms of their perceptions, coping strategies and psychological wellbeing–were explored. This study describes an interpretative phenomenological analysis (IPA) of individuals' accounts of living with NMIBC while on routine surveillance for cancer recurrence. Ten individuals took part in face-to-face semi-structured interviews. Three superordinate themes were derived from the data. The first theme, Being Diagnosed and Treated for NMIBC, concerned the observation that participants considered the physical implications, timeline and practicalities of their illness of primary importance and focused less on its psychological aspects. The second theme, Grappling with the Illness, outlined the impact of the doctor–patient relationship. The final theme, 'I don't treat it as a problem. I treat it as an issue', delineated how participants managed difficult emotions in the context of the illness. Findings from this study demonstrated that participants generally found effective ways to cope with their illness and experience of ongoing surveillance, though delay of emotional responses was common. Clinical implications for healthcare professionals are outlined including the importance of high-quality communication with the urology team. [ABSTRACT FROM AUTHOR]

Objective: Kidney stone disease (KSD) is a common, complex and painful urological condition, but how patients make sense of and respond to the challenges of KSD is poorly understood. Using the common‐sense model of illness self‐regulation (CSM‐SR), we aimed to explore the illness experiences of individuals with KSD. Design: A qualitative design using individual semi‐structured interviews. Methods: Thirty‐three patients with KSD attending outpatient urology services participated in interviews informed by the CSM‐SR. Data were analysed using reflexive thematic analysis. Themes were mapped onto the domains of the CSM‐SR. Results: Five main themes were generated, broadly echoing domains within the CSM‐SR: (1) making sense of KSD, (2) normality paused, (3) the psychological burden of KSD, (4) the tensions of managing KSD, and (5) improving understanding of KSD. Additionally, findings suggested that partners' perceptions of KSD were an additional contextual factor that informed patients' own perceptions and management of KSD. Participants appraised initial KSD symptoms as indicative of a serious health threat. Diagnosis brought some relief, however, KSD wielded multi‐dimensional impacts on patients' perceptions, self‐management and well‐being. Anxiety, including fear of KSD recurrence, and low mood were common psychological burdens across narratives. Conclusion: The majority of the themes identified were commensurate with an extended CSM‐SR. This model has utility in informing how patients perceive and manage KSD. Examining patients' KSD representations and routinely assessing for psychological distress may be of benefit to improve health outcomes for this patient group. [ABSTRACT FROM AUTHOR]

Purpose: Urolithiasis can be a painful condition associated with significant individual and health care burdens. Several studies have shown that anxiety and depression, termed psychological distress, may be associated with urolithiasis. However, there is little consensus on this relationship. We performed a systematic review and meta-analysis on the relationship between urolithiasis and psychological distress and examined rates of psychological distress in this population. Materials and Methods: We searched online databases including MEDLINE (via PubMed), Embase (via Ovid), Web of Science, and the Cochrane Library with predefined search criteria up to March 2022 utilizing the Preferred Reporting Items for Systematic Review and Meta-analyses. Forty-nine peer-reviewed publications were included in this review. We performed a narrative synthesis on included studies, and a random-effects meta-analysis to obtain a single summary estimate for the relationship between urolithiasis and anxiety. Results: Narrative synthesis found evidence for a relationship between urolithiasis and psychological distress, both anxiety and depression. Meta-analysis of 7 studies found a moderate pooled association between urolithiasis and state anxiety. Additionally, higher proportions of urolithiasis patients experienced psychological distress compared to nonurolithiasis samples across studies. Our findings are limited by the observed heterogeneity in assessment protocols within the data set. Conclusions: Our findings suggest a moderate but significant association between anxiety and urolithiasis, as well as a greater than expected number of urolithiasis patients experiencing psychological distress. More high-quality research studies are required to better understand factors that may influence the relationship between urolithiasis and psychological distress. [ABSTRACT FROM AUTHOR]

Objectives: We sought to examine healthcare workers (HCWs) utilisation of formal and informal psychological support resources in the workplace during the first and third waves of the COVID-19 pandemic in Ireland. Methods: A convergent mixed methods approach was undertaken. Four hundred and thirty HCWs in the Mid West and South of Ireland responded to an online survey in terms of their use of psychological support resources during Wave 1 (April/May 2020) of COVID-19. Thirty-nine HCWs undertook in depth interviews at Wave 3 (January/February 2021), and a further quantitative survey was distributed and completed by 278 HCWs at this time. Quantitative data arising at Wave 1 and Wave 3, were synthesised with Qualitative data collected at Wave 3. A Pillar Integration Process (PIP) was utilised in the analysis of the quantitative and qualitative data. Results: Five pillars were identified from the integration of results. These were: a) the primacy of peer support, b) the importance of psychologically informed management, c) a need to develop the organisational well-being ethos, d) support for all HCWs, and e) HCWs ideas for developing the well-being path. These pillars encapsulated a strong emphasis on collegial support, an emphasis on the need to support managers, a questioning of the current supports provided within the healthcare organisations and critical reflections on what HCWs viewed as most helpful for their future support needs. Conclusions: HCWs who utilised supportive resources indicated 'in house' supports, primarily collegial resources, were the most frequently used and perceived as most helpful. While formal psychological supports were important, the mechanism by which such psychological support is made available, through utilising peer support structures and moving towards psychologically informed supervisors and workplaces is likely to be more sustainable and perceived more positively by HCWs. [ABSTRACT FROM AUTHOR]

Objectives: Outcomes for men with localised prostate cancer managed with Active Surveillance (AS) are similar to outcomes for men who have received Active Treatment. This review explore men's perceptions of the factors that influence their decision‐making process when considering AS. Method: A systematic review of studies was conducted up to May 2021, including qualitative studies which explored the decision making of men with localised prostate cancer when considering AS. Evidence was analysed using thematic synthesis. Results: Thirteen papers, including 426 men, met inclusion criteria and were analysed in the review. Approximately half of the men had chosen AS and half had chosen Active Treatment. The choice of AS was not a one‐off decision but rather an ongoing behaviour. Four themes were identified and considered within a temporal model: pre‐diagnosis representations of cancer and treatment; experience of testing and diagnosis; patient decision making; and emotional adjustment to AS. Key barriers and facilitators to men choosing AS were identified. In deciding whether or not to choose AS, men balanced a desire for quality of life against fear of cancer progression. Conclusions: Both cognitive representations and emotional arousal influence how men decided whether or not to opt for AS. Interventions tailored to elicit and address emotional appraisals of risk, and increase trust in AS protocols, may be of value in helping men to make decisions around treatment for localised prostate cancer. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to examine predictors of Return to Productive Roles (RTPR) in individuals with ABI following participation in a community-based RTPR intervention. One hundred and thirty participants were inducted to an ABI-specific RTPR programme. At induction, information on clinical and social demographics, previous education and employment roles were collected. Participants underwent a comprehensive neuropsychological assessment at baseline and completed assessments of disability, mental health and community integration. Participants were followed up at the end of their programme to assess RTPR. Three out of four participants who entered the RTPR programme returned to productive roles. Despite the relatively high levels of anxiety and depression in the sample, people who returned to productive roles were not significantly less anxious or depressed than those who did not. Logistic regression suggested that participants who returned to productive roles following the programme had higher levels of pre-ABI work engagement, less disability and performed better on neuropsychological assessment in terms of their language skills. Results suggest that these factors which cut across specific prior experience, cognitive performance, and social and disability areas of functioning represent barriers to an effective return to productive roles for people with ABI accessing RTPR intervention. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the convergent and divergent validity of the Biber Cognitive Estimation Test (BCET) in individuals with ABI undergoing postacute rehabilitation and to assess the measure’s ability to account for unique variance in community integration following rehabilitation. Participants with ABI referred for postacute rehabilitation (N=201) were assessed on the BCET and a number of other neuropsychological tests that have been demonstrated to rely on aspects of executive processing (Trail-Making Test, Modified Six Elements Test, and verbal fluency measures) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Internal consistency of the total BCET was good; however, interpretable solutions for existing subscales were not discerned. The BCET total score demonstrated positive associations with tests of executive functioning; however, it was also significantly associated with more general aspects of neuropsychological functioning suggesting that it does not solely assess executive processes in ABI patients undergoing rehabilitation. Hierarchical multiple regression suggested that the BCET accounted for significant additional variance in community integration after severity of disability, executive functioning, and more general aspects of neuropsychological status were statistically controlled. While the subscale structure of the BCET may be somewhat inconsistent, the total scale score accounts for some unique variance in pragmatic rehabilitation outcome and may be a useful tool in postacute rehabilitation assessment protocols. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to examine whether a brief structured multicomponent group programme for carers of people with acquired brain injury (ABI) was effective in reducing carer distress, strain, and critical comments between carer and person with an ABI compared to a waiting list control condition.Design: Waiting list controlled study. Pre- and post-test design with outcomes measured at induction, at the end of the intervention, and at the 3-month follow-up.Methods: One hundred and thirteen carers took part in the study: 75 carers in the intervention group and 38 in the waiting list control group (2:1 ratio). All participants completed assessments of caregiver strain (Caregiver Strain Index), perceived criticism towards and from the person with an ABI (Perceived Criticism Scale), and psychological distress (Hospital Anxiety and Depression Scale). The person with an ABI was also assessed on the Functional Independence Measure/Functional Assessment Measure.Results: Using an intention to treat analysis, there were significant effects of group (intervention vs. waiting list control) at the 3-month follow-up on carers' perceptions of stress and strain resulting from caring, and perceptions of criticism received by the carer from the person with an ABI. A subsequent per-protocol analysis showed an additional reduction at 3 months in levels of criticism expressed towards the person with an ABI by the carer. There was no significant effect of the intervention on psychological distress.Conclusions: The structured multicomponent carers programme showed beneficial effects in terms of reducing carer strain and in the reduction of elements of perceived criticism at the 3-month follow-up; however, it did not significantly affect psychological distress in carers, suggesting the need for additional support for this group of carers.Statement Of Contribution: What is already known on this subject? A number of studies have suggested that carers of people with acquired brain injury (ABI) experience greater levels of carer burden and mental health difficulties than carers of other patient groups. Previous interventional studies on ABI are few, and such studies have diverged in the extent to which they have been oriented towards education, psychological support, or management of behavioural difficulties, making results somewhat difficult to apply in community health settings with this potential client group. What does this study add? We develop, describe, and evaluate a brief structured multicomponent carers' training and support programme for carers of people with ABI. Not all outcomes were affected positively by the intervention. While the intervention successfully reduced carer strain and critical comments, distress did not significantly reduce compared to people in a waiting list control group. Carers who were spouses/partners and carers who were parents exhibited comparable levels of strain, distress, and perceived criticism. Younger carers reported significantly higher levels of distress and carer strain at induction to the programme. The positive effects of the programme were maintained for at least 3 months, suggesting that it may have initial validity for improving some of the negative aspects of the carer experience. [ABSTRACT FROM AUTHOR]

Summary: Background and aims: Intestinal failure (IF) is likely to be the source of significant emotional distress for patients; however, little is known about the system of beliefs held by patients on home parenteral nutrition (HPN) that may underpin such distress. The present study aimed to: (1) examine the ‘common-sense’ representation of IF in patients on HPN; (2) investigate whether there were any differences in such representations with regard to primary diagnosis, clinical history or aspects of treatment; and (3) test the relative importance of psychological, disease and treatment factors in accounting for IF-specific emotional outcome (feelings of anger, upset, anxiety, low mood, and fear). Methods: Sixty-one patients with IF on HPN completed an assessment of their beliefs about causes of their condition, consequences, symptoms experienced, personal and treatment control, chronicity and recurrence, and emotional representations (feelings of anger, upset, anxiety, low mood, and fear). Standard clinical information was also gathered from patients. Results: Neither primary diagnosis, age, duration since start of HPN, number of nights on HPN, gender, presence of a stoma, or age at onset of HPN showed any significant differential effect on emotional representations. The principal predictors of emotional representations were: (1) poorer appraisals of patients’ ability to exert personal control over aspects of their condition and treatment; and (2) the perception that the condition and treatment makes little sense to the patient (illness coherence). Conclusions: The current study demonstrates that the illness and their treatments per se are insufficient to account for patients’ emotional distress. Rather, cognitive variables, chiefly beliefs about personal control and illness coherence account for more of the variance in emotional outcome than any other clinical or health-related variable assessed in the current study. [Copyright &y& Elsevier]

Objectives. The purpose of this study was to examine the relative contribution of medical variables, illness perceptions, coping and alexithymia to the variance in stress, distress and disability in patients with psoriasis. Design. Cross-sectional study. Method. A group of 225 patients with psoriasis completed the Hospital Anxiety and Depression Scale (HADS), The Penn State Worry Questionnaire (PSWQ), the COPE, the Illness Perception Questionnaire (IPQ), Toronto Alexithymia Scale (TAS-20), and two measures specific to psoriasis, the Psoriasis Disability Index (PDI), and the Psoriasis Life Stress Inventory (PLSI). The severity of patients' psoriasis was clinically assessed by dermatologists on the Psoriasis Area and Severity Index (PASI). Results. In general, demographic variables, clinical history and extent of disease were consistently the least useful variables in terms of explaining variance in stress, distress or disability. Their utility was limited to accounting for small but significant variations in disability, but even in this case, they accounted for just over half as much variance as illness perceptions. Illness perceptions were uniformly the most important variables in terms of the variance accounted for in outcome. Coping varied widely in its explanatory power; its effects were negligible in both disability (PDI) and everyday stress (PLSI), and it was moderately important in accounting for additional variance in depression and anxiety. However, coping was important in explaining the variance in pathological worrying. Alexithymia accounted for significant additional variance chiefly for anxiety and to a lesser extent for depression, worrying and psoriasis-related life stress. Conclusion. The observed importance of cognitive factors in stress, distress and disability invite us to consider the utility of multivariate models of outcome in psoriasis. [ABSTRACT FROM AUTHOR]

The profession of clinical psychology is predominantly populated by women, yet women are significantly underrepresented in the higher levels of the profession. The aim of this study was to explore the perceptions and experiences of gender difference and implicit bias within the profession of clinical psychology. Through 16 semistructured interviews with psychologists at four different trajectories of their clinical psychology career (10 assistant psychologists, 2 clinical trainees, 3 qualified clinicians, and 1 principal (management grade) clinical psychologist), participants explored their perceptions and experiences with gender discrimination, stereotyping, and implicit discrimination within their roles. An interpretative phenomenological analytic (IPA) approach was employed and superordinate and subordinate themes were derived from the interview data. The superordinate themes included: "Priming a manager--think male," "Sideways Sexism," and "Glass Ceiling or Sticky Floor?." Participants' experiences were described by a number of issues relating to primed and assumed leadership, societal expectations and pressures, how women relate to other women, the experience of a different kind of scrutiny, and sacrifice and compromise. In order to challenge gender inequality in clinical psychology, it would be helpful for gender bias to be increasingly spoken about and acknowledged explicitly. Furthermore, the idea that an effective psychology manager should exert masculine qualities needs to be challenged. [ABSTRACT FROM AUTHOR]

Psoriasis produces significant psychosocial disability; however, little is understood about the neurocognitive mechanisms that mediate the adverse consequences of the social stigma associated with visible skin lesions, such as disgusted facial expressions of others. Both the feeling of disgust and the observation of disgust in others are known to activate the insula cortex. We investigated whether the social impact of psoriasis is associated with altered cognitive processing of disgust using (i) a covert recognition of faces task conducted using functional magnetic resonance imaging (fMRI) and (ii) the facial expression recognition task (FERT), a decision-making task, conducted outside the scanner to assess the ability to recognize overtly different intensities of disgust. Thirteen right-handed male patients with psoriasis and 13 age-matched male controls were included. In the fMRI study, psoriasis patients had significantly (P<0.005) smaller signal responses to disgusted faces in the bilateral insular cortex compared with healthy controls. These data were corroborated by FERT, in that patients were less able than controls to identify all intensities of disgust tested. We hypothesize that patients with psoriasis, in this case male patients, develop a coping mechanism to protect them from stressful emotional responses by blocking the processing of disgusted facial expressions. [ABSTRACT FROM AUTHOR]

Psychological stress is believed to exacerbate inflammatory skin disease but the underlying mechanisms are poorly understood. We investigated the impact of acute social stress – Trier public speaking test – on: epidermal Langerhans’ cell (LC) frequency; and cutaneous nerve fiber expression of protein gene product (PGP) 9.5 and calcitonin gene-related peptide (CGRP). Thirty-six healthy volunteers each had a pair of baseline 6 mm biopsies taken from sun-protected buttock skin. A second pair of biopsies was taken from contralateral buttock 4 hours (n=5) or 24 hours (n=15) after the Trier stressor. Controls (n=16) did not perform the Trier and had biopsies 24 hours apart. One of each pair of biopsies (baseline; 4 or 24 hours) was processed for counts of epidermal CD1a+ LC; the other examined for PGP 9.5 and CGRP expression. We observed a significant (P<0.01) 16.4% reduction in epidermal LC frequency 24 hours post-stressor as compared with baseline; there was no significant change from baseline in non-stressed controls. At 24 hours, PGP 9.5 and CGRP were increased (P=0.025) and reduced (P=0.03), respectively, from baseline in the stressed group compared with controls. These data suggest that acute social stress reduces epidermal LC frequency and modulates cutaneous neuropeptide expression thereby supporting the concept of a “brain–skin” axis.Journal of Investigative Dermatology (2008) 128, 1273–1279; doi:10.1038/sj.jid.5701144; published online 8 November 2007 [ABSTRACT FROM AUTHOR]