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Family Medicine

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Browsing Family Medicine by Author "Gaede, Bernard Martin."

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    The experience of anxiety and depression and their sequelae in breast cancer patients: effects of disease and treatment on patient self-esteem, body image, and the prevalence of hopelessness and suicidal ideation.
    (2021) Van Oers, Helena.; Schlebush, Lourens.; Gaede, Bernard Martin.
    Breast cancer continues to be one of the most commonly diagnosed cancers worldwide. Research suggests that the psychological needs of these patients are frequently unobserved and untreated as healthcare professionals may be insufficiently familiar with the prevalence of comorbid psychological features such as anxiety and depression and how these influence the experience of other psychological phenomena. The aim of this research was to examine the psychological effects of disease and treatment in women diagnosed with breast cancer and determine if these effects differed from those experienced by women with other cancers. While psychological distress in the form of depression and anxiety is well-documented in the literature, there is less specific reference to how these affect and mediate other concerns patients may experience during diagnosis and adjuvant treatment, namely the insult to body image and self-esteem through surgery and other treatment modalities and how these effects cumulatively inform the patient’s experience of hopelessness and possibly, suicidal ideation (SI). The aim was to identify if these forms of distress correlate, and to what degree, with a view to highlighting for oncology healthcare professionals the need to identify and treat those patients who are psychologically at risk. The samples of women with breast cancer (n=80) and other forms of cancer (n=80) was drawn from a population of outpatients receiving treatment at three private oncology clinics in the Durban, South Africa area. Convenience sampling was used and a battery of four questionnaires was completed by patients in addition to collection of relevant demographic data. The results suggest similarities and differences between the two groups. Whilst the two groups did not exhibit notable differences in overall levels of depression and self-esteem, there were significant differences in the experience of body image, with the breast group experiencing greater body image dysphoria. Likewise, in relation to stress, although both groups demonstrated elevated levels of stress in comparison to norms, the breast group evinced higher scores on psychological and behavioural responses to stress. These results suggest that breast cancer patients experience distress differently to patients with other forms of cancer, which may indicate areas for future research.
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    Stress, depression and suicidal ideation amongst family members caring for a patient with brain injury.
    (2021) Walker, Janet.; Schlebush, Lourens.; Gaede, Bernard Martin.
    Background This study investigated the relationship between stress, depression, ill health and suicidal ideation in family members caring for a patient with acquired brain injury. The sample consisted of 80 family caregivers who are members of Headway Gauteng (the brain injury association) located in Johannesburg and Soweto, South Africa. Most were primary caregivers (72.5%) with secondary caregivers making up a smaller percentage (27.5%), their role being to assist and support the primary caregiver. Method and materials The study involved a mixed methodology that incorporated a cross-sectional descriptive and phenomenological approach. This included self-report procedures (structured questionnaires and interviews), post-interview content analyses and three individually administered standardized measures (The Stress Symptom Checklist, The Beck Depression Inventory and Beck’s Hopelessness Scale). Scores were non-normally distributed. Therefore, nonparametric statistical tests were used, including the Kruskal-Wallis, Mann Whitney and Chi-Square Tests with a significance level of p = 0.05. Results The results revealed significant levels of stress, depression, ill health and suicidal ideation in the research participants. Suicidal ideation increased with elevating stress levels and 62.5% (50) of the sample had received a medical and/or psychological diagnosis after they became a caregiver. Five themes were identified as causing the caregivers’ profound stress that highlighted a lack of caregiver support, preparation, referral and education regarding their relative’s acquired brain injury and the stress they experience due to caregiver burden. Most participants (78.7%) did not feel adequately prepared by healthcare professionals (during the acute and sub-acute hospital treatment) for the neuropsychological deficits caused by the acquired brain injury, resulting in reduced coping and family conflict once the patient started receiving home-based care. Predominantly the family caregivers identified the patients’ neuropsychological deficits, such as affect, cognitive ability, behaviour, personality, executive function, and social factors as causing them profound stress. Conclusions This study underscored a significant prevalence of depression, ill health and stress-related suicidal ideation in family members caring for patients with acquired brain injury. Early identification of these problems and referral for appropriate treatment are recommended, along with the need to alert professional healthcare workers to the value of psychological screening for elevated stress and poor coping in family caregivers. Additionally, a collaborative effort between medical and psychological healthcare practitioners is recommended.