The Neuropsychiatric Inventory (NPI) was developed to assess psychopathology in dementia patients. It evaluates 12 neuropsychiatric disturbances common in dementia: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. The severity and frequency of each neuropsychiatric symptom are rated on the basis of scripted questions administered to the patient's caregiver. The NPI also assesses the amount of caregiver distress engendered by each of the neuropsychiatric disorders. A total NPI score and a total caregiver distress score are calculated, in addition to the scores for the individual symptom domains. Content validity, concurrent validity, inter-rater reliability, and test-retest reliability of the NPI are established. Different neurologic disorders have characteristic neuropsychiatric manifestations and distinctive NPI profiles. The NPI is sensitive to treatment effects and has demonstrated the amelioration of behavioral symptoms in Alzheimer's disease by cholinergic agents. The NPI is a useful instrument for characterizing the psychopathology of dementia syndromes, investigating the neurobiology of brain disorders with neuropsychiatric manifestations, distinguishing among different dementia syndromes, and assessing the efficacy of treatment.

The Neuropsychiatric Inventory: Assessing psychopathology in dementia patients

Man's Search for Meaning: An Introduction to Logotherapy.

Little is known about prognostic factors that determine outcomes after in-hospital cardiopulmonary resuscitation. We studied prospectively 294 consecutive patients who were resuscitated in a university teaching hospital. Forty-one patients (14 per cent) were discharged from the hospital; three quarters of them were still alive six months later. A multivariate analysis revealed that pneumonia, hypotension, renal failure, cancer, and a homebound life style before hospitalization were significantly associated with in-hospital mortality (P less than 0.05). None of the 58 patients with pneumonia and none of the 179 in whom resuscitation took longer than 30 minutes survived to be discharged. On the other hand, fully 42 per cent of the patients who survived for 24 hours after resuscitation left the hospital. At the time of discharge from the hospital and again six months later, 93 per cent of the survivors were mentally intact. Although depression was generally present at the time of discharge, it tended to resolve subsequently. However, all patients reported some decrease in functional capacity, often attributed to fear. This persisted at six months after discharge. Age alone did not appear to influence the prognosis for survival after cardiopulmonary resuscitation or the adjustment to chronic illness after discharge from the hospital.

Survival after Cardiopulmonary Resuscitation in the Hospital

Content analysis is much more than a naive technique that results in a simplistic description of data. It allows the researcher to test theoretical issues to enhance understanding of the data. Using applications from the nursing and health literature, this paper will explain key concepts and methodological issues, including strategies for data analysis.

Content analysis: concepts, methods and applications.

Objective To critically review, analyze, and synthesize the literature on parenting stress among caregivers of children with asthma, cancer, cystic fibrosis, diabetes, epilepsy, juvenile rheumatoid arthritis, and/or sickle cell disease. Method PsychInfo, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature were searched according to inclusion criteria. Meta-analysis of 13 studies and qualitative analysis of 96 studies was conducted. Results Caregivers of children with chronic illness reported significantly greater general parenting stress than caregivers of healthy children (d ¼ .40; p ¼� .0001). Qualitative analysis revealed that greater general parenting stress was associated with greater parental responsibility for treatment management and was unrelated to illness duration and severity across illness populations. Greater parenting stress was associated with poorer psychological adjustment in caregivers and children with chronic illness. Conclusion Parenting stress is an important target for future intervention. General and illness-specific measures of parenting stress should be used in future studies.

Parenting Stress among Caregivers of Children with Chronic Illness: A Systematic Review

Research on predictors of postpartum depression (PPD) in Hong Kong (HK) Chinese women is scant. A prospective study with 385 HK Chinese postpartum women was conducted to identify correlations between PPD and demographic variables, and antenatal depression and psychosocial variables, and to determine which of these variables were predictors of PPD. Using the Edinburgh Postnatal Depression Scale (EPDS), we classified 19.8% of participants as postnatally depressed. Fifty-six percent of the variance in PPD was explained by social support and stress factors. However, social support factors accounted for only a small percentage of that variance. The major predictors were antenatal depression, postnatal perceived stress, and childcare stress. HK women may benefit from a culturally appropriate intervention focused on reducing stress in the postpartum period.

Postpartum depression and related psychosocial variables in Hong Kong Chinese women: findings from a prospective study

"Doing the month" is the traditional ritual for Chinese postpartum women. A qualitative study involving in-depth interviews with 20 Hong Kong Chinese women was conducted to examine the women's perceptions of stress and support in "doing the month." Four central themes were identified as follows: bound by the environmental constraints, difficulties in following the prescriptions of the rituals, conflicts between the parties involved, and attainment of the maternal role. The study revealed that "doing the month" is not necessarily protective and supportive of the postpartum women. It raises the critical question of how women can adapt the ritual to fit modern life. The study findings suggest that midwives and health care providers should provide culturally appropriate advice for new mothers. Suggestions are given on bridging the gap between traditional and modern postpartum practices.

Perceived stress and support of the Chinese postpartum ritual "doing the month".

This study was conducted to identify the process and outcomes of empowerment as experienced by Hong Kong Chinese patients with cancer through participation in cancer self-help groups. The study involved in-depth individual interviews of self-help group members (n = 12) and participant observation of the group meetings over a period of 6 months. The empowered outcomes at a personal level included interconnectedness, confidence and hope, support and affirmation, and a feeling of usefulness. At a social level, expanded social network and opportunities to participate in more activities were reported. Collective efficacy also was demonstrated, although this happened only occasionally through participation in the group. One main theme that runs through the process of participation is empowerment among the members. On the basis of the efficacy demonstrated by self-help groups in this study, nurses should strongly consider referral of patients to such groups. Self-help groups serve as an important resource for patients with cancer in the Hong Kong Chinese community.

Empowerment of Chinese patients with cancer through self-help groups in Hong Kong.

Abstract Forty-nine families who experienced a death following childhood cancer were interviewed 7–9 years after the death. Interviews were analyzed using grounded theory technique for qualitative data for the purpose of examining the long-term responses of families to childhood death. In contrast to bereavement theories which claim that grief is usually resolved within two years, findings of this study suggest that many parents and siblings still experience pain and loss after 7–9 years. Analysis suggests that the death of a child creates an “empty space” for surviving family members. Three patterns of grieving were described by family members in response to this sense of emptiness: “getting over it,” “filling the emptiness,” and “keeping the connection.” Differences and similarities of these patterns are enumerated. The perceived significance of the relationship to the pattern of grief is hypothesized. Situations which stimulate a recurrence or continuation of the “empty space” are suggested and changes...

The process of grief in the bereaved family

Forty-nine families who experienced a death following childhood cancer were interviewed 7–9 years after the death. Interviews were analyzed using grounded theory technique for qualitative data for the purpose of examining the long-term responses of families to childhood death. In contrast to bereavement theories which claim that grief is usually resolved within two years, findings of this study suggest that many parents and siblings still experience pain and loss after 7–9 years. Analysis suggests that the death of a child creates an “empty space” for surviving family members. Three patterns of grieving were described by family members in response to this sense of emptiness: “getting over it,” “filling the emptiness,” and “keeping the connection.” Differences and similarities of these patterns are enumerated. The perceived significance of the relationship to the pattern of grief is hypothesized. Situations which stimulate a recurrence or continuation of the “empty space” are suggested and changes...

Ida M. Martinson

Papers

Postpartum depression and related psychosocial variables in Hong Kong Chinese women: findings from a prospective study

Perceived stress and support of the Chinese postpartum ritual "doing the month".

Empowerment of Chinese patients with cancer through self-help groups in Hong Kong.

The process of grief in the bereaved family

The empty space phenomenon: The process of grief in the bereaved family