ABSTRACT
Major depression is a common illness, with a lifetime prevalence rate of 10-13% for men and 21-24% for women. The experience of having a serious illness such as major depression affects the individual's quality of life and requires significant adaptation in order to cope. The aim of this study was to explore sense of coherence and social support in patients treated for a first episode of major depression in a 1-year follow up. The study design was prospective and longitudinal. A total of 24 patients, aged 18 years or over, with a first episode of major depression were included. Semi-structured interviews and self-assessment questionnaires were used at baseline as well as in a 1-year follow up in order to measure the level of severity of the depression, social support, and sense of coherence. The result showed that 71% of the patients had recovered at follow up. The sense of coherence scores were low at baseline, although the patients who recovered increased their sense of coherence scores significantly. Another factor of importance for recovery was a significant increase in social support. Social support is an important cornerstone in the restoration of a person's sense of coherence. It can be used in interventions that include the patient's family or close social network in combination with support to assist the patient to view his/her situation as comprehensible, manageable, and meaningful, thereby promoting or improving health. Mental health nurses are in a key position to identify patients' strengths and weaknesses so that the support and interventions provided can be tailored to meet the needs of each patient.
Subject(s)
Adaptation, Psychological , Attitude to Health , Convalescence/psychology , Depressive Disorder, Major , Self Concept , Social Support , Adult , Depressive Disorder, Major/prevention & control , Depressive Disorder, Major/psychology , Family/psychology , Female , Friends/psychology , Humans , Internal-External Control , Interview, Psychological , Life Change Events , Male , Middle Aged , Nurse's Role/psychology , Nursing Assessment , Prospective Studies , Psychiatric Nursing/organization & administration , Quality of Life , Severity of Illness Index , Surveys and Questionnaires , SwedenABSTRACT
PURPOSE: To evaluate self-reported quality of life in Ménière's disease patients by a multidimensional approach and to identify predictors of the results. STUDY DESIGN: Cross-sectional. SETTING: Tertiary referral hospital centers. PATIENTS: One hundred-twelve patients with Ménière's Disease. MAIN OUTCOME MEASURE: Questionnaires concerning quality of life: Short Form 12 (SF-12) including the Mental Component Summary (MCS-12) and the Physical Component Summary (PCS-12), Hospital Anxiety and Depression Scale (HAD), Sickness Impact Profile (SIP), the Function Level Scale (FLS) from the American Association of Otology's criteria for reporting results of treatment of Ménière's Disease, Vertigo Symptom Scale (VSS), Hearing Disability Handicap scale (HDHS), Tinnitus Severity Questionnaire (TSQ), and Sense of Coherence (SOC) Scale. RESULTS: The Ménière's patients rated their quality of life significantly worse than did healthy reference groups in both the physical and the psychosocial dimensions. The SOC affected the results of the HAD, the MCS-12, and the psychosocial dimension of the SIP. The VSS affected the results of PCS-12, both dimensions of the SIP, and the FLS. The speech perception subscale of the HDHS affected the MCS-12, and tinnitus severity affected the HAD anxiety subscale. The results of the FLS correlated with the physical dimension of quality of life. CONCLUSION: The Ménière's patients experienced a worse quality of life than did healthy subjects. Vertigo mainly influenced the physical dimension, whereas tinnitus and hearing loss influenced the psychosocial dimension. Sense of coherence had an impact on the psychosocial dimension. The FLS was not sensitive enough to serve as an outcome of treatment results but needed to be complemented by quality of life instruments.
