ABSTRACT
BACKGROUND AND OBJECTIVES: The situation-symptom congruence hypothesis (SSCH; (Keller & Nesse, 2006), grounded in evolutionary theory, argues that different types of adversity should lead to distinct patterns of depressive symptoms that help individuals deal with adaptive challenges. Situation-symptom congruence hypotheses were tested in this study using experience sampling methodology. METHODS: Two hundred and sixty-five individuals, including 54% who scored at least 16 on the Center for Epidemiologic Studies Revised Depression Scale, responded to text prompts daily for up to 9 days, reporting depressive symptoms as well as the most stressful event or issue they had experienced or focused on within the past 24 h. RESULTS: Multilevel modeling analyses indicated that the relationships between stressors and depressive symptom patterns were largely consistent with SSCH predictions. All stressors were significantly associated with symptoms hypothesized to be adaptive in response to those stressors. Moreover, in separate analyses, nine of the ten symptoms examined were either predicted by the stressors hypothesized to lead to that symptom or negatively related to stressors hypothesized to not elicit those symptoms. LIMITATIONS: It is unclear whether the results generalize to those diagnosed with a major depressive disorder; the study did not assess actual life events. CONCLUSIONS: Findings suggest that depressive symptoms may, in part, be adaptations that have evolved through natural selection to help individuals cope with adverse situations.
Subject(s)
Depression , Depressive Disorder, Major , Adaptation, Psychological , Depression/diagnosis , Humans , Stress, Psychological/complicationsABSTRACT
BACKGROUND: Limited research explains the quality of life (QOL) among burn survivors during post-hospitalization rehabilitation. PURPOSE: To determine the QOL of military and civilian burn survivors treated in the military burn center. METHODS: In this longitudinal study, QOL was examined in 131 burn survivors (88 civilians; 43 military). Participants completed the Abbreviated Burn Specific Health Scale (BSHS-A) and the Satisfaction with Life Scale (SWLS) over 5 time points post-discharge. DISCUSSION: Civilian and military participants reported improved QOL over time on most BSHS-A subscales. Military participants had higher global BSHS-A scores at discharge, but at 6 months plateaued while civilians improved and had higher global BSHS-A scores at 18 months. Scores on the SWLS were consistently higher for military participants than for civilians. CONCLUSION: Military versus civilian patients may have different expectations about their ability to rehabilitate. The post-hospitalization period needs to be better understood to develop appropriate QOL interventions.
Subject(s)
Burn Units , Burns/psychology , Burns/therapy , Military Personnel , Quality of Life , Survivors/psychology , Adolescent , Adult , Aged , Female , Hospitalization , Humans , Longitudinal Studies , Male , Middle Aged , Patient Satisfaction , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
In palliative medicine, constipation is the third most common symptom after pain and anorexia, causing some patients to discontinue opioid therapy. Women experience higher incidence of constipation than men. The prevalence of infrequent bowel movements (<3 times/wk) and adherence to an established bowel regimen among women receiving opioids were studied. Referral to the palliative care team decreased the prevalence of infrequent bowel movements from 72% to 45%, and algorithm adherence increased from 38% to 78%. Education of oncology nurses decreased the prevalence of infrequent bowel movements among patients with cancer from 71% to 60%, and algorithm adherence increased from 0% to 10%. Patients benefit from stool softeners and stimulants when receiving opioids.
