Social Functioning

Palliative care aims at improving the patient’s quality of life. The assessment of this quality of life (QoL) is crucial for the evaluation of palliative care outcome. Many patients require hospital admissions for symptom control during their cancer journey and most of them die in hospitals, although they would like to stay at home until the end of their lives. In 1986, the European Organization for Research and Treatment (EORTC) initiated a research programme to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. This questionnaire measures cancer patients’ physical, psychological and social functions and was used in a wide range of clinical cancer trials with large numbers of research groups and also in various other non-trial studies. The aim of this study was to evaluate the psychometric properties, especially the reliability, validity and applicability of the EORTC QLQ-C30 in a German sample of t...

Psychological distress has been considered a key component in the psychosocial functioning and functional disability of the elderly, but the determining factors of social functioning and psychological distress in the elderly people are not yet fully known. The aim of this study is to perform a gender analysis of the relevance of psychological distress and psychosocial factors in the social functioning of the elderly. A cross-sectional study with a sample of 589 men and 684 women from the general Spanish population aged between 65 and 94 years was conducted. All participants were evaluated through questionnaires and scales that assess psychological distress, social functioning, stress, coping styles, self-esteem and social support. Results: Women scored higher than men in psychological distress, chronic stress, emotional coping and instrumental social support, whereas men scored higher than women in self-esteem and rational coping. Psychological distress was significantly associated in women and men with worse social functioning, which was also lower in older people and in women with lower self-esteem. Psychological distress has a considerable impact on the social functioning of the elderly, and gender is a relevant factor in the psychological distress experienced and its predictors.

Although previous research has demonstrated that referral to pre-dialysis clinics is associated with favourable objective outcomes, the benefit of a pre-dialysis clinic from the perspective of patient-perceived subjective outcomes, such as quality of life (QOL), is less well defined. A retrospective incident cohort study was conducted to determine if pre-dialysis clinic attendance was a predictor of better QOL scores measured within the first six months of hemodialysis (HD) initiation. Inclusion criteria were HD initiation from January 1 1998 to January 1 2000, diagnosis of chronic renal failure, and completion of the QOL questionnaire within six months of HD initiation. Patients receiving HD for less than four weeks were excluded. An incident cohort of 120 dialysis patients was identified, including 74 patients who attended at least one pre-dialysis clinic and 46 patients who did not. QOL was measured using the SF 36-Item Health Survey. Independent variables included age, sex, diab...

The effect of enzyme replacement therapy on health-related quality of life in 25 adults with type 1 Gaucher disease was investigated over a 2-year period. Quality of life was assessed using the SF-36 Health Survey (SF-36). Psychological functioning was assessed using the Symptom Checklist--90R. The results indicated significant improvement in 7 of 8 SF scale scores beginning at 18 months of therapy (P < 0.05 to 0.001). The SF scale showing improvement first was Vitality (energy level and fatigue) at 6 months of therapy (P < 0.01). The SF-36 scales showing the largest improvements were Role-Physical and Social Functioning (P < 0.001). Compared to the general US adult population, the study population's health profile was significantly lower prior to starting therapy but by 24 months of therapy there were no differences between the two. No differences were found in psychological functioning compared to a US adult normative group at the start of therapy. However, within the...

The quality of life among children with idiopathic scoliosis during their adolescence has been reported to be affected by the brace itself. However, a controversy exists whether brace treated scoliotics experience a poor quality of life, thus there is a need for the development of a brace-oriented instrument, as the now-existing questionnaires that are commonly used, such as the SRS -22, take into consideration the effects of both the conservative and the surgical treatment on quality of life of scoliotic children. The aim of the present study is to assess the validity and reliability of Brace Questionnaire (BrQ), a new instrument for measuring quality of life of scoliotic adolescents who are treated conservatively with a brace. Methodology of development involved literature review, patient and health care professionals' in-depth interviews and content validity analysis on patients. A validation study was performed on 28 brace treated scoliotic children aged between 9 and 18 years old. BrQ was assessed for the following psychometric properties: item convergent validity, floor and ceiling effects, internal consistency reliability, clinical validity and responsiveness to change. BrQ is self administrated and developmentally appropriate for ages 9 to 18 years old and is consisted of 34 Likert-scale items associated with eight domains: general health perception, physical functioning, emotional functioning, self esteem and aesthetics, vitality, school activity, bodily pain and social functioning of scoliotic children treated conservatively with a brace. The subscales of these eight dimensions can be combined to produce a total score. Higher scores mean a better quality of life. An item convergent validity >/= 0.40 was satisfied by all items in the present study. A satisfactory internal consistency reliability for the BrQ was recorded (Cronbach's alpha coefficient was 0.82). There were no floor or ceiling effects. The correlation between BrQ overall scores and mild and moderate scoliosis was statistically significant (p < 0.001), revealing high clinical validity. An increase in effect sizes for the patient with improved scoliotic curves indicates that the BrQ is responsive to change in health status. BrQ is reliable, valid and responsive to change in adolescents with IS who are treated conservatively with a brace.

Lack of standardized phenotypic definition has made outcome studies of Asperger syndrome (AS) difficult to interpret. This paper reports psychosocial functioning in 20 male adolescents with AS, defined according to current ICD-10 criteria, and a comparison group of 20 male adolescents with severe conduct disorder. Subjects were gathered from clinical referral. Evaluation used standardized interviewer rated assessments of social functioning and psychiatric morbidity. The AS group showed severe impairments in practical social functioning despite good cognitive ability and lack of significant early language delay. High levels of anxiety and obsessional disorders were found in AS; depression, suicidal ideation, tempers, and defiance in both groups. Results are compared with those from other studies. Relevance to clinical ascertainment and treatment is discussed.

The psychometric properties of the Hopelessness Scale for Children (HSC) were evaluated with a sample of 834 normal adolescents and 93 adolescent suicide attempters. Factor analyses studies revealed two factors with both groups. Internal consistency with item-total score correlations were acceptable, while moderate test-retest reliability was found over a 10-week period with the normal sample. Support for the validity of the HSC was provided via studies with the suicide attempter group in which positive correlations with depression and depressive attributional style were found. Predicted differences between the suicide attempters, an outpatient psychiatric sample, and normal controls were also found. However, some items did not appear to discriminate suicide attempters from controls. Results are discussed in terms of the utility of the HSC with adolescents and adolescent suicide attempters and with regard to differences between child and adult samples in hopelessness.

The need for a drive theory in group analysis and psychoanalysis is argued for; especially against the background of recent advances in genetics. The old drive theories were not adequate and created confusion on several levels. With the application of the social drive a direct understanding of our social nature becomes possible. A discrete social function of the personality is

The historical evolution of van chai from within the administrative structure of farming villages is explained, and their geographical distribution described. The social and management functions and administration of the ‘floating village’ type of van chai is explained with particular reference to the lagoons of Thua Thien Hue Province. The van chai is the focus for the spiritual activities of fishing, so in each fishing community founded by migrants along the South-Central coast a van chai was established to worship the Whale God. These reflected the traditional folk and professional beliefs and mutual assistance within the community. Analysis of the religious and social functions and organization of the ‘guild-type’ van chai of the South-Central coast is based on Van Thuy Tu, Phan Thiet City, Binh Thuan Province. The general design principles of pre-existing management systems in Vietnam are examined in terms of rights, rules, monitoring and accountability, conflict resolution, and sanctions.

This paper reviews the current status of research on the phenomenology, etiology, maintenance, assessment, and treatment of childhood and adolescent social anxiety disorder (SAD). Despite being one of the most prevalent disorders of childhood and adolescence, SAD paradoxically stands as one of the least recognized, researched, and treated pediatric disorders. The small treatment outcome literature provides preliminary support to the