Quality of life among dialysis patients: Predictive analysis of illness intrusiveness and spiritual beliefs.

Objective: To investigate the predicting effect of illness intrusiveness and spiritual belief determining dialysis patients' quality of life. METHODS: The correlational study was conducted from September 2018 to July 2019 in Rawalpindi and Islamabad, Pakistan, and comprised adult patients of either gender experiencing dialysis issues for one year at the Pakistan Institute of Medical Sciences, the Pakistan Kidney Patients Association, the Islamabad Dialysis and Nephro Care Centre, the Bahria International Hospital and the Shifa Hospital Kidney Centre. Data was collected using the Illness Intrusiveness Scale, the Daily Spiritual Experience Scale, the World Health Organisation Quality of Life Scale, and a demographic sheet. Data was analysed using SPSS 23. RESULTS: Out of 200 patients, 116(58%) were males and 84(42%) were females. Female patients had higher mean values for illness intrusiveness value 62.08±14.47, spiritual belief 33.45±14.75 psychological health 18.00±3.88 and environmental health 25.15±4.93. Male dialysis patients had higher mean values for physical health 19.11±7.51 and social relationship 10.50±2.45. Illness intrusiveness was a significant negative predictor of physical health (p<0.000), psychological health (p<0.001), social relationship (p<0.000) and environmental health (p<0.05). Spiritual belief was a significant positive predictor of physical health (p<0.01), psychological health (p<0.001), social relationship (p<0.05) and environmental health (p<0.05). Conclusion: High level of illness intrusiveness in dialysis patients tended to decrease life quality. Those having a higher level of spiritual belief tended to develop a better approach to life quality.

Maladaptive schema modes as the predictor of post-traumatic stress disorder among trauma survivors.

OBJECTIVE: To study the relationship between dysfunctional schema modes and post-traumatic stress disorder among trauma survivors. METHODS: The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from March to August 2019, and comprised patients of traumatic brain injury and orthopaedic trauma. Data was collected using Schema Mode Inventory and the Clinician Administered Post-Traumatic Stress Disorder Scale version 5. Data was analysed using SPSS 23. RESULTS: Of the 281 patients, 203(72.2%) were males, 78(27.8%) were females, and 157 (55.9%) were aged 18-40 years. Besides, 137(48.8%) had orthopaedic trauma, 96(34.2%) traumatic brain injuries, and 48(17%) had multiple injuries. Post-traumatic stress disorder symptoms and dysfunctional schema modes were higher in patients with moderate injuries with a mean of 42.14±7.36. Intentionally injured patients 42.70±6.92 and female trauma survivors 42.05±8.26 had more symptoms. CONCLUSIONS: Maladaptive schema mode could lead to post-traumatic stress disorder symptoms among trauma survivors with history of orthopaedic injury, traumatic brain injury and multiple injuries.

Recurrent bilateral frontal lobe lesion with maladaptive schema modes and post-traumatic stress disorder symptoms: a case study.

The frontal lobe is responsible for high-order functioning, such as memory, attention, decision-making, and personality. Lesions in the frontal lobe may lead to different physical and psychological problems. The current study was conducted to examine the emotional, cognitive, and behavioural states and coping strategies of a patient with recurrent bilateral frontal lobe lesion. It also attempted to determine post-traumatic stress disorder (PTSD) symptoms in a patient. This study described the case of an adult with recurrent bilateral frontal lobe tumour. It covered the clinical presentation, administration of Urdu translation of the Schema Mode Inventory (SMI) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and analysis of the case. The results of the study showed that the recurrent bilateral frontal lobe brain tumour patient engaged in child mode and had a dysfunctional coping style and a maladaptive punitive parent mode. Furthermore, the patient also had moderate PTSD symptoms.

The relationship between post-traumatic stress disorder and acquired brain injury among civilian patients.

PURPOSE: Patients with acquired brain injury are a vulnerable group in Pakistan with limited psychosocial services available to them. The current study sought to determine the incidence of post-traumatic stress disorder (PTSD) in ABI patients with traumatic and non-traumatic injury. PATIENTS AND METHODS: A cross-sectional research design was used. The assessment of PTSD was carried out by using the Clinician Administered PTSD Scale (CAPS-5). In the study, there were 132 adults older than 18 years who have ABI-either traumatic or non-traumatic. The study was conducted in a public hospital in Islamabad, Pakistan, and the data was collected one-month post brain injury. RESULTS: The results showed that traumatic brain injury (TBI) patients have more PTSD symptoms as compared to non-TBI patients (p = 0.00). Intrusive (p = 0.00) and hyper arousal symptoms (p = 0.04) of PTSD were higher in TBI than in non-TBI patients. There was statically non-significant mean difference in symptoms of PTSD among male and female patients (p = 0.34). The moderately brain injury patients have high PTSD symptoms as compared to mild brain injury patients (p = 0.04). Further, the frequency of severe and extreme PTSD symptoms was high in TBI patient as compared to non TBI patients (p = .05) CONCLUSION: PTSD severity and PTSD symptoms such as intrusive and avoidance symptoms were higher in TBI patients than in non-TBI patients. This study contributed to the literature by assessing the onset of PTSD in patients with acquired brain injury. This study also provided knowledge to plan psychosocial interventions for patients with acquired brain injury having PTSD symptoms.