Improvement In Psychological Status Research Articles

Influencing Factors of Treatment Outcomes Among Patients with Pulmonary Tuberculosis: A Structural Equation Model Approach.

Pulmonary tuberculosis (PTB) is a serious infectious disease, and the factors and pathways that influence final treatment outcomes are unclear. Here, we aimed to assess the factors that influence treatment outcomes in patients with PTB using a structural equation model. Participants completed a questionnaire covering demographics, understanding of PTB, psychological status, and history of medical treatment. Exploratory factor analysis and reliability testing were performed, and a structural equation model was constructed using the SPSS and Amos software. A total of 251 participants were enrolled. Symptoms of depression were observed in 94.4% of participants, whereas 6% showed mild or greater anxiety. Through factor rotation, four common factors were extracted with a total variation of 66.15%. The structural equation model indicated that regular tuberculosis-related follow-up behaviour had a direct and positive effect on the final treatment outcome, with a path coefficient value of 0.20; the level of PTB understanding had a direct positive effect on the testing behaviour for PTB, with a path coefficient of 0.26; patients' psychological characteristics had a direct negative impact on regular testing behaviour, with a path coefficient of -0.13. The psychological characteristics and level of disease understanding of patients exerted indirect effects on the treatment outcome by affecting the way patients approached tuberculosis detection behaviour. Interventions aimed at improving the treatment outcomes of patients with PTB should mainly focus on financial support and improvements in psychological status in addition to a greater understanding and knowledge of PTB. Furthermore, patients should be encouraged to undergo regular PTB testing during the follow up period, as this mediates the effect of other factors on treatment outcomes and also helps in achieving favourable treatment outcomes.

Customized protocol for psychological management of a patient with residual maxillofacial defects

: Maxillofacial surgeons and Prosthodontist deal with rehabilitation of defects of orofacial region but understanding the mental attitude of patients is often ignored or neglected. Success of any prosthesis relies on patient’s compliance and motivation to adjust and cope up with irreversible loss. Evaluation of psychological distress and management of the same is of utmost importance. Literature is deficit with an elaborate systematic classification system to evaluate the impact of maxillofacial defect on the psychological status of patients and role of therapy on improvement post-rehabilitation.: Am of this study is to propose a customized comprehensive protocol for evaluation of psychological status using ICD-11 classification system before and after maxillofacial prosthetic intervention and impact of psychological management tools on the same.: Ten patients with maxillofacial defects reporting for prosthetic rehabilitation were selected. Psychological evaluation tool, ICD-11 classification system was applied pre and post rehabilitation by two independent observers. Customized psychological management protocol was formulated and implemented to note the impact on overall improvement in psychological status of the patient.: Patients with severe personality trait showed varied levels of improvement ranging from no change to mild. Five patients with moderate personality trait showed improvement and change in personality trait to mild on implementation of psychological tools. Statistical evaluation could not be done due to multitude of subjective variables.: ICD-11 can be used as a successful tool for psychological evaluation of patients. Necessary intervention at every level in form of family support, support groups, psychological therapeutic modalities and therapies can improve status of the patient. A well-structured management protocol helps in early recognition of psychological distress and systematic management of the same to improve clinical outcome of the rehabilitation procedure.: Patients with maxillofacial defects experience a progressive cycle of loss and grief. This diminishes their ability to adjust to stress and acceptability towards maxillofacial prosthetic rehabilitation procedure. Assessment of psychological alteration using a standardized classification system and utilization of therapeutic modalities to deal with the same helps in successful rehabilitation and restoration of patient in the society as a whole.

Psychological Changes and Employment Outcomes After Kyphosis Correction in Patients With Ankylosing Spondylitis.

A retrospective study. To evaluate the psychological changes and employment outcomes following corrective osteotomy in patients with ankylosing spondylitis (AS). To date, no study has investigated the changes in psychological status and subsequent improvement in employment outcome after correction of kyphotic deformities in patients with AS. This study included 48 patients with AS who underwent corrective osteotomy for severe kyphotic deformity. Sagittal alignment was assessed radiographically. Clinical status was evaluated using the Short Form-36 Health Survey, psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS), and employment outcomes were assessed using the Lam Employment Absence and Productivity Scale (LEAPS). The degree of postoperative sagittal alignment correction was measured, and changes in clinical and employment outcomes and psychological status were evaluated. The relationship between the degree of sagittal alignment correction and each evaluation item was analyzed. Following postoperative sagittal alignment correction, all patients could stand erect and look straight. Significant improvements were observed in the clinical and employment outcomes, as well as in patients' psychological status. The degree of sagittal vertical axis correction was significantly correlated with the HADS depression and the LEAPS total scores. The degree of correction of the chin-brow vertical angle was significantly correlated with the Short Form-36 mental health score, the HADS depression and anxiety scores, and the LEAPS total and productivity subscores. Notably, the improvement in the HADS depression score was significantly correlated with the LEAPS total score. This study demonstrated the psychological changes and subsequent improvement in employment outcomes after corrective osteotomy in patients with AS. The degree of sagittal alignment correction was correlated with improvements in psychological status and employment outcomes. 4.

Physiological aid for children with osteogenesis imperfecta

Last decade there is growth of interest to the problem of children with combined physiological disorders and musculoskeletal system, like osteogenesis imperfecta (OI). Objective: to assess the complex physiological aid to patients with OI aged 4 months to 60 years and its influence on the treatment efficacy. Methods: we examined 40 patients with OI aged 4 months to 60 years old. We used Thomas questionaries, tests projects «Non existing animal», Lusher colored test, Kettells test. Diagnosis of interpersonal relations was carried out according to T. Leary’s methodology. Studied the opinion of the subject about himself and the idea of what others see it (Q-sorting). For the study of quality of life (QL) a questionnaire was created according to the tasks of the orthopedic and traumatological clinic and the index of QL (IQL) was calculated. Results: patients with OI belong to the risk group of development of psychopathological manifestations, neurotic disorders due to the relaxation of the barrier of psychological adaptation. Their IQL was (–5.6 ± 0.3) scores, it indicated a low social status. Mental tension on the eve of surgery and in the first week of treatment is indicated by all patients. This is a consequence of the stress-reaction with all its characteristic components: braking in the cortex, excitation in the subcortical formations, dysfunction of the endocrine glands, and changes in homeostasis at all levels. Depression is a general reaction of the body to the long-term effects of severe chronic stress. A psychological correction course of 10 exercises has been developed, which includes muscle relaxation, visualkinesthetic dissociation, techniques of positive imagination. After the course of psychocorrection, patients noted improvement in emotional state, reduction or disappearance of anxiety symptoms, significant improvement in psychological status and QL . Conclusions: comprehensive psychological support and psychocorrection of patients with OI contribute to improved treatment outcomes and, consequently, better positive motivation and full socialization.

The evaluation of psychological status in newly diagnosed chronic obstructive pulmonary disease patients

BACKGROUND: As chronic obstructive pulmonary disease (COPD) and its symptoms may change psychological attributes, psychiatric disorders may be seen in COPD. AIMS: We aimed to assess the effect of taking diagnosis of COPD and using bronchodilator therapy on the psychological status of COPD patients. MATERIALS AND METHODS: It is a cross-sectional study including newly diagnosed COPD outpatients. Spirometry, Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), and St. George's Respiratory Questionnaire (SGRQ) were performed at the first visit (date of new diagnosis) and 6 months later as the second visit. RESULTS: Ninety new diagnosed COPD patients (71 men and 19 women) with a mean age of 61.7 ± 9.8 were included. There were high scores of anxiety in 23.5% and depression in 38.2% (HADS)–52.9% (BDI) patients at the first visit. The symptoms about anxiety reduced to 19%, depression to 33.3% (HADS)/47.6% (BDI) six months later. All the participants who were active smokers had lower spirometric levels (42.9%) at the second visit compared with the first visit levels. There was an improvement in psychological status and quality of life (QOL) (P CONCLUSION: Depression and anxiety states are frequent among COPD patients. Pulmonary symptoms may regress with the bronchodilator therapy at newly diagnosed COPD patients, which can cause an improvement in pulmonary functions, psychological status, and QOL. Psychological aspects need to be carefully assessed in patients with new diagnosis of COPD.

A randomized clinical trial examining the impact of LGG probiotic supplementation on psychological status in middle-aged and older adults.

Cognitive decline is common in older adults and more than 5 million Americans suffer from Alzheimer's disease (AD). A number of physiological processes including systemic inflammation, excess adiposity, and impaired glucoregulation arise from a combination of genetic and behavioral factors and increase risk for developing AD or other forms of dementia. Recent research suggests that the gut microbiome may moderate these pathological processes and possibly influence cognitive outcomes. This paper reviews the methodology for a double-blind, randomized clinical trial examining the influence of Lactobacillus GG (LGG) probiotic supplementation on mood and cognitive functioning in middle-aged and older adults. Our two primary hypotheses include: 1) Participants randomized to the probiotic group will show greater improvements in psychological status compared to participants in the placebo group; 2) Participants randomized to the probiotic group will show greater improvements in executive functioning and processing speed, as evidenced through performance on neuropsychological testing, than participants in the placebo group. We anticipate these results will inform future efforts on the feasibility of LGG probiotic supplementation as an intervention for psychological status and cognitive functioning and further elucidate the link between the gut microbiome and cognitive health.

WS18.5 Does lung transplantation have an effect on the improvement of psychological status in patients with adult cystic fibrosis?

WS18.5 Does lung transplantation have an effect on the improvement of psychological status in patients with adult cystic fibrosis?

Changes in Psychological Status and Health-Related Quality of Life Following Total Shoulder Arthroplasty.

There has been little documentation of the effects of total shoulder arthroplasty (TSA) on psychological status and health-related quality of life (HRQoL). We investigated changes in psychological status (depression and anxiety) and HRQoL following TSA and assessed the effect of preoperative psychological status on postoperative clinical and functional outcome. We hypothesized that TSA would improve both psychological status and HRQoL. We prospectively enrolled 46 patients undergoing TSA for osteoarthritis. Preoperatively and at 3, 6, and 12 months postoperatively, all of the subjects completed the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons Scale (ASES), the Subjective Shoulder Value (SSV) measure, the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). From 3 months after surgery, significant improvement in HADS-depression, HADS-anxiety, and WHOQOL-BREF scores as well as in the other outcome measures of VAS pain score, ASES score, and SSV were observed. The prevalence of depression and anxiety decreased from a rate of 15.2% and 19.5%, respectively, preoperatively to a rate of 6.5% for each at 12 months postoperatively. Preoperative HADS-depression and HADS-anxiety scores did not correlate with any of the clinical and functional outcome measures at 12 months after surgery. This study showed significant improvement in psychological status and HRQoL as well as in pain and functional ability from 3 months after TSA in patients with osteoarthritis. Preoperative depression and anxiety did not predict poor postoperative outcome. Our findings suggest that TSA offers an excellent chance of improving psychological status and HRQoL. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Prospective Placebo-controlled Randomized Trial to compare the Efficacy of Ketamine as an Adjuvant to Epidural Steroids in preventing Repeat Blocks in Chronic Low Back Pain

ABSTRACT Introduction Low back pain behaves as a “silent epidemic,” ranking first among complications related to work. Often there is a large gap between a patient's desired pain reduction and the minimum percentage of improvement that would make a treatment worthwhile. Consequently, debate continues as to the value of epidural steroid injections, supremacy of one adjuvant over others, various doses, and concentrations in optimizing pain management. Objective To compare the efficacy of ketamine vs normal saline as an adjuvant to epidural steroids in chronic low back pain. Study design Randomized prospective placebo-controlled study. Materials and methods The study was conducted on 60 patients of age group 18 to 70 years having chronic lower backache with or without radiculitis of minimum 3 months duration and having no relief with conventional treatment. The patients selected were randomly allocated into two groups of 30 patients each: Group I (n = 30) given triamcinolone 40 mg, preservative-free ketamine 30 mg (0.6 mL) made up to 6 mL solution with 0.25% bupivacaine and group II (n = 30) given 0.6 mL normal saline instead of ketamine. Outcome measures The primary outcome measured was number of patients requiring repeat blocks and number of repeat blocks administered in 3 months. Other outcome measures were functional improvement quantified by visual analog scale (VAS) and Oswestry disability index (ODI) as well as improvement in psychological status by depression scoring, all taken at 2 weeks interval for 3 months. The periprocedural complications were also noted at the end of the study. Results In managing lumbar radicular pain with lumbar epidural steroid injection (LESI), ketamine's role as an adjuvant proved to be advantageous for long-term relief by its inhibition of dorsal horn “wind up” phenomenon through N-methyl-D-aspartate (NMDA) receptor antagonism, thus reducing frequency of repeat blocks in group II (ketamine). Conclusion Thus to conclude, ketamine's advantage as a drug that prolongs pain relief from LESI is an avenue for further research and promises a bright future in the field of interventional pain medicine. How to cite this article Gupta R, Bawa C, Singh S, Mahajan L, Kaur B, Kaur T. Prospective Placebo-controlled Randomized Trial to compare the Efficacy of Ketamine as an Adjuvant to Epidural Steroids in preventing Repeat Blocks in Chronic Low Back Pain. Curr Trends Diagn Treat 2017;1(1):15-21.

PP.13.16] EFFECTS OF COMBINATION OF ANGIOTENSIN II RECEPTOR ANTAGONIST WITH CALCIUM ANTAGONIST IN HYPERTENSIVE PATIENTS WITH CORONARY HEART DISEASE AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

Objective: To evaluate the effects of valsartan/amlodipine (V/A) fixed combination for standard therapy of arterial hypertension (AH) and coronary heart disease (CHD) in smokers with chronic obstructive pulmonary disease (COPD) Design and method: 36 smoker male with AH (DBP 90–110 mmHg and/or SBP 140 −180 mmHg), CHD and COPD were randomized into 2 groups (gr): I gr (n = 18, 55,8 ± 5,9 yrs) which received angiotensin-converting enzyme inhibitor and II gr (n = 18, 58,0 ± 4,9 yrs) which treated with the fixed combination V/A (160 mg/5–10 mg). All pts received selective beta-blockers, 16.7% of pts I and II grs - diuretics. The duration of the study was 4 months. The trail includes bicycle exercise stress test (PE); echocardiography; spirometry (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1); 24-hour ambulatory BP monitoring; questionnaires as SGRQ and Quality of Life SF-36. Results: Treatment with V/A significant (p < 0.001) decreased of office SBP (−39.2 ± 9.7 mmHg), DBP (−16.9 ± 5,7 mmHg), pulse BP (−22.2 ± 5.9 mmHg) vs the absence of such dynamics in pts of I gr. Also the average 24 h SBP/DBP was reduced by −10.6/9.3% (p < 0.001), daytime SBP/DBP by −11.6/9.8% (p < 0.01), nighttime SBP/DBP by −9.6/8.4% (p < 0.01). After V/A therapy there was observed increasing of the duration of the PE (22.2%, p < 0.01), threshold power (23.6%, p < 0.01), time before the development of angina pectoris (8.6%, p < 0.05) and myocardial ischemia (8.3%, p < 0.05). In pts of I gr there was a decrease of the duration of the PE (−10.2%, p < 0.05) and time to the development of angina pectoris (−29%, p < 0.05). In II gr we have found positive changes in structural parameters of the heart and decrease of mean pulmonary artery pressure. After V/A therapy there was increase of FVC (by 14.8%, p < 0.05), prebronchodilator FEV1 (by 11.7%, p < 0.05) and FEV1 after administration of salbutamol (by 12.5%, p < 0.05). After V/A therapy there was the improvement of psychological status and quality of life. Conclusions: Combination therapy with V/A have complementary mechanisms of action, effectively decreases the levels of office and ambulatory BP, mean pulmonary artery pressure, respiratory symptoms, improves exercise tolerance, and health-related quality of life in smokers with co-morbidities.

An Innovative and Portable Multimodal Pain Relief Device for the Management of Neuropathic Low Back Pain - a Study from Kashmir (Southeast Asia).

We developed a portable multimodal system with seven different mechanisms of pain relief incorporated into a lumbar belt called the Comfort-N-Harmony Belt (C&H belt).Here, we describe the technical details of the system and also summarize the effects of this multimodal pain relieving technology as an adjuvant to analgesics versus analgesics alone, on the level of pain, improvement of psychological status, disability, and the quality of life in the patients with neuropathic low back pain (LBP).We tracked the volunteers who were following up at a tertiary health care center for the complaints of neuropathic LBP of minimum three months duration and were on analgesics alone with no relief in the severity of the pain. Study group A (n = 45) consisted of volunteers with LBP on C&H belt therapy, along with the usually prescribed analgesic intake, and group B (n = 45) with LBP volunteers on analgesics, plus a similar looking but plain leather belt (placebo). For pain, the VAS (Visual Analogue Scale); for anxiety and depression, the (HADS) Hospital Anxiety-Depression Scale; for disability, the RMDQ (Roland Morris Disability Questionnaire); and for quality of life, (NHP) Nottingham-Health-Profile were used before and after the study period. There were no significant differences in demographic variables between the groups (p < 0.05). After the study period of one month, VAS, RMDQ, NHP-pain, NHP-physical activity, and HADS scores in both groups were significantly improved compared to the pre-treatment scores (p < 0.05). Group A also showed significant improvements in the scores of NHP-energy level and NHP-social isolation (p < 0.05). The post-treatment scores did not significantly show any difference between the two groups (p > 0.05). However, in comparison of pre- and post-treatment scores, the pre-treatment score values of RMDQ, NHP-pain, NHP-physical activity, and NHP-social isolation were much higher in group A compared to the group B, but still these scores were, in a statistically significant manner, improved in group A compared to the group B after the study period was over (p < 0.05).Multiple pain relieving mechanisms in a portable device-based system, when used along with analgesics, are effective in relieving pain, improving function and quality of life, and help in relieving the associated anxiety and depression in patients with chronic neuropathic LBP than the analgesics alone in the Kashmiri (Southeast Asian) population.

Contribution of isokinetic muscle strengthening in the rehabilitation of obese subjects

AimsOur objective was to evaluate the specific effect of isokinetic muscle strength enhancement in the rehabilitation of obese subjects by comparing two groups (isokinetic muscle exercising associated with aerobic exercising or only aerobic exercising). Patients and methodsThis was a randomized, prospective study from January 2008 to December 2009 involving 40 obese patients randomized into two groups. The first group G1 (n=20) followed a program of aerobic training and isokinetic exercising of the extensor and flexor muscles of lower limbs and spine. The second group G2 (n=20) followed only a program of aerobic exercising. All patients completed their rehabilitation protocols comprising 3 sessions per week for two months. The parameters evaluated before and after the program were anthropometric parameters (weight, stature, body mass index, body fat and lean body mass percentages), cardiovascular parameters by stress test on electromagnetic ergo-cycle, an assessment of muscle strength by isokinetic dynamometer and an assessment of psychological status and quality of life. ResultsWe recruited 36 women and 4 men. Initially, the 2 groups were comparable. After training, in both groups we noted an improvement in anthropometric parameters, with an average weight loss of 1.83kg/week (P<0.001), an improvement in cardiovascular parameters with a decrease in heart rate at rest and under effort, and in systolic and diastolic arterial blood pressure values at rest and under effort (P<0.01 in both group), an improvement in parameters of muscle strength with increase in moment of maximum strength of extensor and flexor knee and spine muscles for all three test speeds, and an improvement in psychological status and in quality of life. The improvement of all these parameters was statistically greater in G1 (P<0.05). ConclusionIsokinetic muscle strengthening increases the effects of aerobic exercising in the obese by improving muscle strength, increasing lean body mass and reducing body fat.

Assessment of Psychological Factors, Erectile Dysfunction, and Quality of Life before and after Revascularization Procedures

The purpose of the present study was to examine the relationship between psychological factors, Erectile Dysfunctional (ED) and Quality of Life (QoL) before and after Coronary Artery Bypass Graft (CABG) and Percutaneous Transluminal Coronary Angioplasty (PTCA) procedures, in an Iranian sample of cardiovascular patients. To do so, one hundred ninety patients scheduled for CABG and PTCA operations were selected and administered relevant questionnaires a day before the surgery. Subsequently, the same patients filled out the same questionnaires two months following the procedure. Data analysis showed an increase in QoL while revealing a decline in men’s sexual functioning after the PTCA procedure although no change was observed in women. Also, an improvement in psychological status of all patients was observed following both revascularization procedures.

Open heart surgery patients’ education. a source of anxiety?

In recent years the interest of health care professionals has focused on the process of patient pre and post operative education and in what way the psychological status is affected. They particularly emphasized the need to design effective and individualized trainings programs which concern preoperative and postoperative information, cardiac rehabilitation after open heart surgery so as to enhance patient’s comfort and anxiety reduction.The main idea of the programme is to change patient’s behaviour regarding modifiable risk factors and improve their quality of life. Moreover, the aim of the individual educational programme is to understand the surgical procedure, complications may occur, maintaining treatment compliance at a high level, the improvement of psychological status and quality of life not only for the patient but for its family too.Cardiac surgery is a very difficult process that causes a lot of stress and one of the most important nurse’s roles is to provide information and patient support throughout their recovery period.

The contribution of the association of isokinetic muscle strengthening exercises in a training protocol for obese women (about 80 cases)

To evaluate the contribution of combined training protocol involving aerobic exercises associated with the isokinetic strength training in obese women and to compare it to an aerobic training protocol alone. Prospective study including 80 obese patients randomized into two groups: a group of aerobic training (AT) who underwent a training program on treadmill and a group of combined training (CT) who underwent treadmill exercises associated with program of isokinetic strength training of the extensor and flexor muscles of both lower limbs and spine. Evaluation was performed before, one week after, and one year after the end of the protocol. The evaluation comported anthropometric and cardiovascular parameters, muscle strength, dosage of biological parameters and an assessment of psychological status and quality of life. After rehabilitation, a significantly greater improvement of anthropometric parameters in the CT were noted compared to AT with an improvement of the weighting reduction of 23.82% in the CT versus 12.3% in the AT group ( p < 0.001) and BMI decrease of 19.07% in the CT versus 11.11% in the AT ( p < 0.001). The improvement of biological parameters and cardiovascular parameters were also statistically more significant in the RC ( p < 0.001). In the two groups amelioration in the peak of torque of both knees and spine extensor and flexor muscles was noted in the three test speeds. This improvement was significantly more important in the RC ( p < 0.001). Also, we found an improvement in psychological status and quality of life in the two groups, which was significantly more important in the RC ( p < 0.001). The improvement of all parameters was maintained at the first year. Several recent publications have recommended the association of aerobic exercises and muscle strengthening in the rehabilitation to effort of obese [1] . However, no study has particularly used isokinetism as means of muscle strengthening. Our study confirmed the beneficial effect of the combination of isokinetic strength training to aerobic training on anthropometric, biological and cardiovascular parameters well as muscle strength in obese women.

An Analysis of the Concept of Partnership in the Couples Undergoing Infertility Treatment

The elements of a partnership in the couples undergoing infertility treatment are not well understood. This article aims to fill the gap by using Rodger's evolutionary method of concept analysis. The attributes of the concept partnership that were identified are a process of joint hardship, sharing, intracouple communication, and mutual support. The antecedents are love and attraction for each other, agreement, and interpersonal skills. The consequences are marital benefit, improvement in psychological status, and quality of life. A middle-range model for partnership in relationship to infertile couples is proposed. The understanding of the phenomenon of partnership will enable the researchers to develop interventions, identify the appropriate assessment instruments, and to determine directions for future research on effort to support infertile couples through their hardship.

Application of psychological nursing among the achalasia of cardia patients with peroral endoscopic myotomy

Objective To explore the application of psychological nursing among the achalasia of cardia (AC) patients with peroral endoscopic myotomy (POEM). Methods From June 2011 to June 2012 in the First Teaching Hospital of Xinjiang Medical University and the Soochow University, a total of 80 patients confirmed AC underwent POEM operation, treated with psychological nursing in perioperative period. The improvement of psychological status before and after intervention were compared by Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD) and the Eckardt score. Results Before operation, the average score of Eckardt was (8±3), but 3 and 6 months after intervention this score decreased to (2±2) and (2±1) with statistical differences (H=155.613, P<0.01). Before operation, 19 patients acquired the score of HAMA over 14 and 20 patients over 20 scores, but this number fell to 3 cases after 3 months operation (χ2=11.522, P<0.01). Conclusions The psychological nursing combined with POEM is a effective way to alleviate anxiety and clinical symptom for AC patients, and minimizes complications and is safe in clinical. Key words: Psychological nursing; Achalasia of cardia; Peroral endoscopic myotomy; Psychological intervention

Evaluation of exercise training on work capacity, functional mobility, and quality of life in hemodialysis patients

IntroductionPatients with chronic renal failure are restricted in their physical and social aspects of life because of their treatment and comorbid medical conditions.Aim of the workThe aim of this study was to evaluate the effect of an exercise training program on functional work capacity, functional mobility, and quality of life (QOL) in patients with renal failure on hemodialysis.Patients and methodsThirty patients with chronic renal failure on maintenance hemodialysis participated in a regular exercise training program three times/week for 12 weeks. Each exercise session consisted of a warm up, cycle or trade mill exercises, stretching exercise, and cool down. All patients were subjected to a cardiovascular graded exercise tolerance test, the sit-to-stand-to sit test, and the 6-min walk test. A questionnaire was used to assess the QOL of the study group 1 week before and after the exercise training program. Fifteen normal individuals, age and sex matched with our patients, were used as controls to compare the respiratory function.ResultsThere was a significant improvement in work capacity before and after the training exercise program, respectively (7.24 ± 0.90 to 9.62 ± 1.1; P < 0.001); also, there was a highly significant improvement in functional mobility. The QOL had improved after the exercise training program on four of five scales of the 36 questionnaire.ConclusionA suitable exercise training program is essential for improvement of work capacity and mobility, and improvement of psychological status and QOL.

Six-Month Outcomes for Patients Attending a Substance Abuse Clinic in Hong Kong: A Retrospective Study

The aim of this retrospective study was to demonstrate the effectiveness of the services offered in the two Substance Abuse Clinics (SACs) in the New Territories East Cluster (NTEC) of Hong Kong. The case notes of 99 patients were reviewed. The Christo Inventory for Substance-Misuse Services (CISS) at intake and six months later were recorded. The CISS total scores were 5.9 ± 2.6 and 4.4 ± 2.3 (t=6.345, p<0.001) at intake and at the six-month follow-up, respectively. The majority of the subjects (64.6%) showed improvement at the six-month followup. They demonstrated significant improvement in psychological status (t=0.5202, p<0.001), drug/alcohol use (t=4.589, p<0.001), general health (t=4.500, p<0.001), degree of criminal activity (t=2.803, p = 0.006) and high-risk behaviour (risky sexual behaviour and/or the use of injectable substances; t=2.755, p=0.007), whereas there was no statistically significant improvement in the areas of social functioning, occupation, working relationships, ongoing support and treatment adherence. The current services provided by the SACs are effective and lead to a better overall outcome, although further improvement is needed in relation to the specific areas of occupation, ongoing support and treatment adherence.

Wii-based Movement Therapy benefits stroke patients with low and very low movement ability

Purpose – Stroke patients with low and very low functional movement are not usually considered suitable for rehabilitation. Without therapy the more-affected side will not improve and may lose any residual function. Poor movement ability reduces independence and limits the social engagement of such patients. The purpose of this paper was to investigate whether Wii-based Movement Therapy was suitable and beneficial for stroke patients with low and very low movement ability. Design/methodology/approach – In total, 13 patients aged 22-77 years and three months to 21 years post-stroke completed the standardised 14-day protocol of Wii-based Movement Therapy. Therapy is a structured and targeted programme, tailored to the individual needs and deficits of each patient. Functional ability was assessed using a suite of tools. Increased use of the more-affected hand and arm in everyday life was assessed using the Quality of Movement subscale of the Motor Activity Log. Findings – Functional movement of the more-affected hand and arm improved by 40 per cent on the Fugl-Meyer Assessment. Hand-use in everyday tasks more than doubled and improvements were also seen in lower-limb function, balance, and cardiovascular function. Qualitative improvements in psychological status were also noted. Practical implications – The paper demonstrates that stroke patients with low and very low movement ability post-stroke can benefit from upper-limb rehabilitation. Wii-based Movement Therapy is a viable and effective option with high patient compliance. Originality/value – The patients in this study became less disabled. Improving movement ability of stroke survivors will not only increase their independence in activities of daily living but will also reduce the burden of care on patients, their families and the community.