Emotional Reactions Of Patients Research Articles

Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa

BackgroundAnxiety is a core characteristic of anorexia nervosa and a potential target of exposure therapy, which requires a profound understanding of the patients’ fears in order to be successful. The knowledge about fears in anorexia nervosa that should be targeted during exposure therapy can be enriched by laboratory research to the precise emotional and behavioral responses of anorexia nervosa patients when they are exposed to disorder relevant fear stimuli.MethodsIn the laboratory, patients with anorexia nervosa (n = 15) and healthy controls (n = 51) were exposed to 1. their own body weight and a 10% higher body weight on the scale, 2. a standardized lab breakfast, and 3. five virtual bodies with different BMIs ranging from extreme underweight to lower healthy weight. The participants emotional (anxiety, disgust, satisfaction, acceptance) and behavioral responses (calorie consumption) were assessed. Patients with anorexia nervosa but not the healthy controls then received an intensive exposure treatment (~ 30 individual exposure sessions) targeting their individual fears, next to standard care. After the exposure treatment, it was investigated whether the patients’ responses to the laboratory tasks changed.ResultsAcross all tasks, the patients reported more anxiety than healthy controls. The patients also consumed less calories during the breakfast and accepted the different body weights on the scale less than healthy controls. During the virtual body exposure, the patients’ emotional responses did not differ per avatar but they reacted more negatively towards avatars with healthier weights than did healthy controls. After the exposure treatment, the patients reported less fears and they consumed more calories while their BMIs had increased. They were also more accepting of healthier weights.ConclusionsExposure to food-, body- and weight-related stimuli in the laboratory induces emotional reactions in patients with anorexia nervosa that are informative for the identification of exposure therapy treatment targets. In addition, exposure therapy targeting individual fears in patients with anorexia nervosa led to symptom reduction and is a promising intervention for the treatment of anorectic fears, though more research is needed to optimize its efficacy.

Correlation Between Family Functioning and Health Beliefs in Patients with Stroke in Beijing, China.

To explore the relationship between family functioning and health beliefs in patients with stroke. A total of 253 patients with stroke were selected from Beijing Luhe Hospital, Capital Medical University from May 2021 to November 2021. All patients were of Chinese nationality, and 240 valid questionnaires were obtained. The Family Assessment Device and Champion's Health Belief Model Scale were used to collect patients' family functioning and health beliefs information, and correlation analysis was used to analyse it. The total score for family functioning in patients with stroke was 130.5 (22). The highest mean score was 2.46 for behaviour control, and the lowest score was 2.00 for total function. The items were ranked from high to low in this order: behaviour control, emotional response, role, communication, emotional intervention, problem solving and total function. The total score of the patients' health beliefs was 116 (33), The items were ranked from high to low in this order: were self-efficacy, health motivation, perceived benefit, susceptibility, severity and perceived impairment. The scores for family functioning were negatively correlated with the total scores for health beliefs (P < 0.05). Stroke can reduce the self-care ability of the patients and aggravate the burden of family care. This can lead to abnormal function roles for patients and their families, emotional reactions in patients with stroke and weaker levels of family functioning. The health beliefs scores of patients with stroke were at the middle level, and family functioning was at the general level. There was a negative correlation between the family functioning score and the total score for health beliefs in patients with stroke.

Suspension of fertility treatment during the COVID-19 pandemic: views, emotional reactions and psychological distress among women undergoing fertility treatment

Research questionWhat are the views and emotional reactions of patients towards the suspension of fertility treatment during the COVID-19 pandemic, and what are the factors affecting their psychological distress? DesignA cross-sectional study conducted in an academic fertility centre. Online questionnaires were distributed between 18 April 2020 and 23 April 2020 to patients whose treatment cycle had been postponed or discontinued. The outcome measures included agreement with the reproductive society guidelines to postpone treatments; willingness to resume treatments, given the choice; patients’ emotional reactions; and psychological distress level, measured by the Mental Health Inventory validated scale. A multivariate linear regression was conducted to identify factors associated with psychological distress. ResultsBecause of the small number of male respondents, only women were included in the analysis (n = 181). Forty-three per cent expressed disagreement with the guidelines and 82% were willing to resume treatments, given the choice. Sadness and anxiety were the most common emotional reactions expressed towards the guidelines. In the multivariate analysis, COVID-19-related anxiety (B = 0.145, P = 0.04) and disagreement with treatment suspension (B = –0.44, P = 0.001) were found to be significantly associated with patients' psychological distress. Background characteristics of patients did not contribute significantly to their distress. ConclusionsSuspension of fertility treatment during the initial phase of the COVID-19 pandemic was associated with patients' negative emotional reactions. Anxiety related to COVID-19 and disagreement with treatment suspension were found to be significantly associated with psychological distress among women undergoing fertility treatment, regardless of their background characteristics. Our findings suggest the need to monitor the mental health of patients and provide psychological support should a shutdown of fertility care re-occur.

Thematic Analysis of the Organ Transplantation News in Turkish Press

BackgroundOrgan transplantation, which is one of the most important developments in medical technology and a successful treatment against irreversible life-organ insufficiency, gives people a second chance at life and increases their quality of life. The aim of this qualitative research is to detect how often organ transplantation news is reported in the Turkish press and to analyze the content of this news. MethodsThe data in this qualitative study were obtained from the first 3 most widely read newspapers (Posta, Hürriyet, and Sabah) in Turkey between January and July 2018. Data were analyzed using thematic analysis. ResultsWhen the newspapers were examined, only 17 texts on organ transplants were obtained during a period of 6 months. Six themes were defined after the data analysis. These themes were (1) information on the organ transplantation process, (2) emotional reactions, (3) medical knowledge, (4) importance of organ donation, (5) organ transplant in Turkey, and (6) legal regulation. Most news focused on the emotional reactions of patients and their families and information on the organ transplantation process. ConclusionsWhen we looked at the whole content in Turkish press, there was a place for organ transplantation. However, it is considered that in press news, where people access information easily, more space should be given to organ transplantation to create awareness of how vital it is in changing some people’s lives; health professionals and journalists need to work collaboratively to reach this aim.

Psychoemotional reactions at the stage of clinically isolated multiple sclerosis syndrome

A prospective study of functional disability and its relationship to the emotional response of a patient to the diagnosis of 30 patients with clinically isolated syndrome (CIS) of Multiple Sclerosis (MS) was performed. The aim of the study was to evaluate the typical emotional reactions in patients with CIS MS and to determine their impact on patients' functional failure in the future. The study was conducted in three stages. In the first stage, before the infusion of methylprednisolone, an emotional response and a degree of functional failure were assessed. Evaluation of the reliability of emotional emotional reaction was performed after 7 days. Re-evaluation of psycho-emotional response and functional disability was performed during recurent MS attack. A total of 30 patients were included in the study, with an average age of 32.07 ± 8.54 years, including 27 women and 3 men. The most frequent emotional reactions were found to be anxiety (60%), shock reaction (16.56%) of patients, categorical denial of diagnosis (13.33%). Relief was less frequent — 6.67% and sorrow in 3.33% of patients. The reliability of the emotional response was re-evaluated after 7 days (Cronbach's α 0.993). The time interval from the moment of CIS MS to the second attack and diagnosis of MS was 6.33 ± 3.467 months. The EDSS score at the time of the second attack was 2.92 ± 0.081 points. A one-way ANOVA procedure was also used for the multivariable analysis to establish the statistical difference of the EDSS score for different levels of the Reaction score. A statistically significant correlation was established between the response values and the Expanded Disability Status Test (EDSS) total score at P &lt;0.01, as well as the EDSS score at the second clinical attack. It was found that the emotional background of the patient influences the prognosis and functional failure in the dynamics.

Arbitration proceedings caused by communication problems

Functioning communication is one of the basic elements of a trusting doctor-patient relationship. Good medical communication is more important than ever in times of increasing personnel and time constraints. The aim of this study was to examine to what extent medical communication has an influence on the initiation of arbitration procedures. The analysis was based on arbitration cases of plastic surgery, which were processed and completed by the Arbitration Board for Medical Liability Issues of North Germany between 2005 and 2015. After eliminating cases with incomplete data, 280 cases were evaluated. The documents were examined for possible communication errors and other triggers of the proceedings. If communication errors were present, these were analysed more closely. Furthermore, it was verified if treatment errors were suggested to patients, e. g. by physicians in charge of aftercare. 53.6 % of all cases emerged from communication errors in primary care, mainly caused by the attending surgeon (93.7 %). The outpatient follow-up treatment was identified as the most critical period (48.7 %). The most common problem was that patients felt they were not taken seriously (30.9 %). Further aspects were non-availability of the treating doctor (12.2 %), insults or disrespect (8.5 %), inadequate provision of information (8.5 %), and a lack of therapeutic enlightenment (8.1 %). In 43.9 % of the cases, treatment errors were suggested to patients, primarily by the after-treatment physician (70.3 %). The results show that inadequate medical communication has a considerable influence on the overall satisfaction of patients. Statements that appear normal to the surgeon may cause significant emotional reactions in patients. This study shows that arbitration procedures are not only triggered by "real" treatment errors and damage, but also by communication problems. Good communication and empathy help to reduce dissatisfaction and the risk of possible legal disputes.

Child’s Behavior and its Relationship with the Level of Maternal-Child Anxiety During Dental Care

Objective: To evaluate the association between child's behavior and level of maternal and child anxiety during dental care. Material and Methods: The sample consisted of 100 children aged 6-11 years of both gender, scheduled for the first dental appointment at the dental clinic in a private school of Salvador, Brazil. The emotional reactions of patients were evaluated before the dental visit through the Venham Picture Test (VPT) instrument of anxiety evaluation. Mothers completed a specific questionnaire (Corah anxiety scale) to assess their anxiety about dental treatment. During dental care, prophylaxis and clinical examination by DMF-T and dmf-t indexes were performed. The child’s behavior during the dental treatment was evaluated by the Frankl's Behavior Rating Scale. Fisher's exact test and chi-square were used to evaluate the association between variables (α = 5%). Results: It was observed that 24.0% of children presented anxiety according to VPT. There was a significant association between level of anxiety and pain and dental caries as the main dental complaint (p <0.001), and between child's behavior and variables maternal anxiety (p = 0.01) and childhood anxiety (p <0.001). Conclusion: It could be concluded that there was a positive association between child's non-cooperative behavior during dental care and maternal and child anxiety.

Emotional reactions in patients after frontal lobe stroke

Emotional reactions have been documented after tumor lesions and the other damages of the brain. The aim of this paper was to examine the correlation between frontal lobe lesions and emotional reactions in patients with stroke. The research included 118 patients after stroke. Lesion localization was defined on computed axial tomography records, whereas the area and perimeter of lesion were measured by AutoCAD 2004 software. Examinations by means of the Hamilton Rating Scale for Anxiety and Depression (HRSA and HRSD) were carried out 11-40 days after stroke. Statistic data were processed by simple linear/nonlinear regression, Cox's and the generalized linear model. A higher frequency of emotional reactions, i.e. anxiety, was determined in women after stroke (p = 0.024). A negative correlation between the lesion size and the intensity of anxiety manifestations was determined (Spearman's r = -0.297; p = 0.001). Anxiety was more frequent in patients with frontal lobe lesions in the dominant hemisphere (interaction: frontal lesion * hand dominant hemisphere, p = 0.017). Also, HRSD score values showed the tendency for lesser decline in case of greater frontal lobe lesions in relation to lesions of other regions of prosencephalon (interaction: frontal lesion * lesion area, p = 0.001). The results of this study indicate the correlation between evolutionary younger structures of the central nervous system and emotional reactions of man. Therefore, it is necessary to undertake proper early psychopharmacotherapy in the vulnerable group of patients.

Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

BackgroundThe purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients’ reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany.MethodsWe conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework.ResultsThree interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions.ConclusionsFuture PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

The Impact of Sexual Abuse in Patients Undergoing Colonoscopy

BackgroundSexual abuse has been linked to strong effects on gastrointestinal health. Colonoscopy can provoke intense emotional reactions in patients with a sexual abuse history and may lead to avoidance of endoscopic procedures.ObjectiveTo determine whether care around colonoscopy needs adjustment for patients with sexual abuse experience, thereby exploring targets for the improvement of care around colonoscopic procedures.MethodsQuestionnaires were mailed to patients (n = 1419) from two centers within 11 months after colonoscopy. Differences in experience of the colonoscopy between patients with and without a sexual abuse history were assessed and patients' views regarding physicians' inquiry about sexual abuse and care around endoscopic procedures were obtained.ResultsA total of 768 questionnaires were analyzed. The prevalence of sexual abuse was 3.9% in male and 9.5% in female patients. Patients born in a non-western country reported more sexual abuse (14.9%) than those born in a western country (6.3%; p = 0.008). Discomfort during colonoscopy was indicated on a scale from 0 to 10, mean distress score of patients with sexual abuse was 4.8(±3.47) compared to 3.5(±3.11) in patients without a sexual abuse history (p = 0.007). Abdominal pain was a predictor for higher distress during colonoscopy (β = −0.019 (SE = 0.008); p = 0.02, as well as the number of complaints indicated as reason for colonoscopy (β = 0.738 (SE = 0.276); p = 0.008). Of patients with sexual abuse experience, 53.8% believed gastroenterologists should ask about it, 43.4% said deeper sedation during colonoscopy would diminish the distress.ConclusionsSexual abuse is prevalent in patients presenting for colonoscopy. Patients with a sexual abuse history experience more distress during the procedure and indicate that extra attention around and during colonoscopy may diminish this distress.

Cataract surgery: emotional reactions of patients with monocular versus binocular vision

OBJETIVO: Verificar reações emocionais relacionadas à cirurgia de catarata entre pacientes com visão monocular (Grupo 1) e binocular (Grupo 2). MÉTODOS: Foi realizado um estudo tranversal, comparativo por meio de um questionário estruturado respondido por pacientes antes da cirurgia de catarata. RESULTADOS: A amostra foi composta de 96 pacientes no Grupo 1 (69.3 ± 10.4 anos) e 110 no Grupo 2 (68.2 ± 10.2 anos). Consideravam apresentar medo da cirugia 40.6% do Grupo 1 e 22.7% do Grupo 2 (p<0.001) [...]

Beliefs and emotional reactions in patients with benign paroxysmal positional vertigo: a longitudinal study

ObjectivePsychologic studies in patients with benign paroxysmal positional vertigo (BPPV) are scarce, considering the high frequency of the disorder. We performed a repeated-measures design questionnaire study in a cohort of patients with BPPV before and after treatment to investigate the dynamics of the psychologic findings and possible treatment consequences. MethodsThirty-seven consecutive patients with idiopathic BPPV participated in the study. During the first visit and 2 to 3 months after therapy, the patients completed 4 questionnaires: the Dizziness Handicap Inventory, the Illness Perception Questionnaire-Revised, the Intolerance of Uncertainty Scale, and the State-Trait Anxiety Inventory. ResultsThe scores for all questioned items did not change before and after treatment except for the physical handicap scores. Correlation was found between the grade of functional and emotional impact of the disease and belief in consequences as well as anxiety levels of the patients. Moreover, uncertainty scores were in correlation with emotional impact, anxiety levels, and perceived consequences of the disease. The belief in personal control of the condition was correlated with the belief in treatment control and understanding of the disease. ConclusionThe main finding in this study is the lack of a significant change in beliefs and emotional reactions in patients with BPPV after treatment of their condition. Physicians dealing with BPPV should be aware that the disease is not solely a somatic condition but has a serious impact on the patient's mental state. Selected patients might benefit from anxiolytic medication.

Emotional reactions in patients and spousal caregivers following early discharge from hospital after a first stroke: A pilot study

Emotional reactions in patients and spousal caregivers following early discharge from hospital after a first stroke: A pilot study

Corticotropin releasing factor in urine—A possible biochemical marker of fibromyalgia: Responses to massage and guided relaxation

The purpose of this preliminary study was to evaluate the relationship between a possible biochemical marker of stress, 24-h urinary concentrations of Corticotropin Releasing Factor-Like Immunoreactivity (CRF-LI), and ratings of stress-related symptoms like depression and anxiety, as well as to evaluate pain and emotional reactions in patients with fibromyalgia (FM). Another purpose was to study the effects of massage and guided relaxation, with respect to change in the same variables. Urine sampling and ratings were performed before treatments, after and 1 month after completed treatments. Concentrations of CRF-LI was analysed with radioimmnoassay technique. For the assessment of depression, anxiety and pain the CPRS-A questionnaire was used and for rated pain and emotional reactions the NHP questionnaire was used. The 24-h urinary concentration of the CRF-LI was found to be related to depression, mood and inability to take initiative. After treatment the urinary CRF-LI concentrations and the rated levels of pain and emotional reactions were found to have decreased. In conclusion, the 24-h urinary CRF-LI concentration may be used as a biochemical marker of stress-related symptoms such as depression in patients with FM and possibly also other conditions characterized by chronic pain. Therapies such as massage and guided relaxation may be tried for the amelioration of pain and stress but further studies are required.

Solving family-related barriers to truthfulness in cases of terminal cancer in Taiwan. A professional perspective.

The study investigated the puzzling factors and solutions of family-related barriers to truthfulness with patients with terminal cancer through a nationwide survey conducted in Taiwan. Two-hundred twenty-nine valid questionnaires were retrieved (91.6%) from 250 palliative care workers at 15 Taiwan hospices. Most of the respondents were nursing staff (72.5%), and only 38 respondents were physicians (16.6%). Canonical correlation analysis was used to examine the association between the puzzling factors and solutions, which revealed that the value of the first variate was 0.39 (P < .05). Results showed that the puzzling factors of barriers and canonical loadings were families do not know how to tell the truth (.85), families believe it is unnecessary to tell aged patients the truth (.71), and patients can be happier without knowing the truth (.70). The valid solutions correlated significantly with the above puzzling factors and were ranked in the following order: communicate with and encourage families to accept patients' prognoses (.83), discuss the sickness gently with patients and determine what patients know (.76), and tell the families about the possible emotional reactions in patients and how to provide support (.72). In conclusion, for solving family-related barriers to truthfulness in cases of terminal cancer, the results suggest that health professionals communicate with families first and discuss the possible emotional reactions from patients, give patients enough time to reflect on their sicknesses and discuss further what patients have been told, and then disclose information based on patients' expectations and support them.

The art of touching: The culture of 'body work' in nursing

In this paper the authors argue that touch in nursing has a double meaning: on the one hand, it is a utilitarian and technical activity in which the bodies of nurses and patients are objects; on the other hand, touching is intimate, emotional and human and the bodies of both actors are subjects. The attention of studies on nursing and in nursing practices is often limited to the emotional reactions of patients. However, body care in nursing requires a constant listening to the body of both patients and nurses. Touching in nursing reflects cultural ideas, values and norms in a society. When the emotional response of nurses to touch is also taken into account, touching is developed into an art that re-creates good contacts and human relationships in a medical setting. In an ethnographic study carried out within a psychiatric setting, using methods of participant observation, the authors demonstrate how touch is related to age, gender, power, and social relationships which, in turn, influence emotional response. Such a response serves as a marker for determining if care is satisfying and how it is valued in the culture.

Memory enhancement for emotional stimuli is impaired in early Alzheimer's disease.

Emotional arousal is associated with enhanced memory in neurologically intact individuals, but it is unknown whether this effect is obtained in Alzheimer's disease (AD). The current study compared emotional memory and emotional reactions in patients with early AD and in older controls. Participants viewed emotionally arousing (both pleasant and unpleasant) and neutral photographs while cognitive and electrophysiological reactions were assessed. Memory was tested by free recall and recognition. Emotional reactions were normal in the AD group, but the emotional memory effect (enhanced memory for emotional vs. neutral stimuli) was impaired. Recall results indicated that this effect was normal for pleasant stimuli but abnormal for unpleasant stimuli. These results suggest that the neural basis for the emotional memory effect may be disrupted in AD. Findings are discussed in terms of the role of the amygdala in mediating emotional memory.

First-trimester multifetal pregnancy reduction: Acute and persistent psychologic reactions

OBJECTIVE: Our purpose was to determine acute and persistent psychologic impacts of multifetal pregnancy reductions andpatients' ability to cope with fetal loss while simultaneously bonding to surviving infants. STUDY DESIGN: The first 100 women to undergo a multifetal reduction were invited to participate in a retrospective telephone study assessing their emotional reactions and attitudes toward multifetal reduction. The semistructured interview elicited demographic and obstetric data and contianed scales used in previous studies of reproductive loss, which assessed repetitive thoughts about reduced fetuses, catastrophic fears, and lingering depressive feelings. RESULTS: More than 65% of the sample recalled acute feelings of emotional pain, stress, and fear during the reduction procedure. Mourning for the lost fetuses was reported by 70% of women, but most grieved for only 1 month. Thoughts about reduced fetuses occurred moderately frequently after the reduction but rarely at follow-up. Persistent depressive symptoms were mild, although moderately severe levels of sadness and guilt continued for many. Nonetheless, 93% wold make the same decision again. Emotional reactions of patients who miscarried differed little. The small subsample who continued to be most affected were younger ( p < 0.02), were more religious ( p < 0.003), and had viewed the multifetal pregnancy on ultrasonography more often ( p < 0.009). CONCLUSIONS: Multifetal reductions, although highly stressful psychologically, are well tolerated. Sadness and guilt may persist, especially for an identifiable subgroup. Normal maternal bonding and achievement of parenthood goals facilitate grief resolution. The large majority were reconciled to the termination of some fetuses to preserve the lives of a remaining few.

Involvement with the psychosocial concerns of patients. Observations of practicing family physicians on a university faculty.

Physician involvement in patients' psychosocial problems, including family concerns, is a vital aspect of comprehensive medical care. This study was conducted to better understand the extent to which experienced family physicians on a university faculty address psychosocial issues and involve family members during routine outpatient office visits. Five family physicians on a university faculty were videotaped during 200 office visits (40 per physician). Each visit was then rated on one of two five-point scales based on the extent to which psychosocial issues were addressed with individual patients and family members. Interrater reliability was 73%. Most interviews were focused solely on medical issues. The physicians regularly elicited the patient's opinions in a collaborative manner. Psychosocial issues (ie, family, job) were discussed in approximately 25% of the interviews, emotional reactions of patients or family members were addressed less frequently, and counseling was rarely conducted. Greater involvement in psychosocial issues was associated with longer office visits. The experienced physicians in this sample actively elicited patient's views of medical problems (ie, a "patient-centered" approach). The infrequent discussion of psychosocial concerns of the patient may be related to time limitations. Based on patients' opinions, specific attention to psychosocial issues may be most beneficial during well-child examinations and care of chronic illnesses.

Up Front: Sex and the Post-Mastectomy Woman

This little book was fascinating. Obviously it was written for the laity. But physicians do not concern themselves enough with the frustrations and emotional reactions of patients. The impact of a cancer diagnosis—the horror of deformity, the fear of loss of social acceptance—are all dealt with adequately. The picture is painfully clear. And the reader cannot fail to empathize with the embarrassment of prostheses ("falsies") and complications of breast reconstruction. The book is open and honest in its depiction of everyday worries. It reads almost like a novel. I finished it in one sitting, just could not put it down. Of course, I reread it another day. The author seems to take it for granted that everyone goes to a psychotherapist—at least she does— and often. Perhaps Linda Dackman is more sensitive or "neurotic" than most of us are. Yet, she teaches us a lesson.