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Cambridge, United Kingdom

Lebus C.,Addenbrookes Hospital | Parker R.A.,University of Cambridge | Parker R.A.,Institute of Public Health Cambridge | Morrison K.,Arthur Rank Hospice | And 2 more authors.
Journal of Palliative Medicine | Year: 2014

Background: Bereavement is a major life event often leading to psychiatric morbidity. Provision of bereavement care is poorly established in general hospital settings. Objective: We describe a novel bereavement service in a large secondary care institution and assess its impact. Design and measurements: In this descriptive study, data from the first year of operation of the service was obtained. The questions from interviews with relatives stemming from the bereavement care service were reviewed and categorized. Potential predictors of requesting a follow-up meeting were analyzed. Results: Of the 1384 bereaved relatives who were written to, 142 requested follow-up and 119 (8.6%) culminated in a bereavement follow-up meeting. The most common questions asked were for further details regarding the diagnosis (29%), why the patient had deteriorated so quickly (28%), what the diagnosis was (24%), and the sequence of events (24%). Relatives of younger patients and those from specialties other than medicine or surgery were more likely to seek bereavement follow-up (p<0.01 in each case). Conclusion: A specialized bereavement service is feasible in a large hospital trust and allows follow-up of relatives with ongoing questions and concerns, with the opportunity of reducing severe grief reactions. © Mary Ann Liebert, Inc.

Ajose F.O.A.,Lagos State University | Parker R.A.,Institute of Public Health Cambridge | Merrall E.L.C.,Institute of Public Health Cambridge | Adewuya A.O.,Lagos State University | Zachariah M.P.,Lagos State University
Journal of the European Academy of Dermatology and Venereology | Year: 2014

Background Vitiligo and Albinism are two disorders of pigmentation that make the affected African highly visible and strikingly different from their peers. Both pose considerable management challenges, attract significant stigma and profound impairment of quality of life. Objective and Methods To determine and compare psychiatric distress in vitiligo and albinism using the Hospital Anxiety and Depression Scale (HADS). Participants were 87 albinos and 102 vitiligo adult patients seen at an urban tertiary hospital in Nigeria between 2004 and 2009. Results Prevalence of psycho morbidity was 59% (60/102) in vitiligo compared with 26% (23/87) in the albinos. The mean anxiety score was estimated to be 2.55 points lower for albino patients (95% CI: 1.47 to 3.64), and the mean depression score 2.76 points lower (95% CI: 1.84 to 3.68), after adjustment for age, sex and marital status. However, significant differences were not observed when comparing the vitiligo patients with the subset of albino patients with skin cancer. Older patients had significantly higher anxiety and depression scores. Females had significantly higher anxiety scores (but not depression scores) compared to males. Genital involvement in vitiligo was significantly associated with anxiety but not depression. Conclusions We found that the African with vitiligo suffers significantly higher psychiatric distress than the African albino on average. Clinical evaluation of these patients would be incomplete without assessment of their psycho morbidity. There is need for increased focus on cancer prevention strategies in the African albino. © 2013 European Academy of Dermatology and Venereology.

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