Physical Symptoms Research Articles

Association between psychological traits and occlusal tactile acuity of healthy individuals.

Tactile acuity is a somatosensory measure of the extent to which humans can discern tactile stimuli. It is influenced by how peripheral signals are processed centrally. In the oral cavity, Occlusal Tactile Acuity (OTA) is the ability to perceive minimal thicknesses between antagonist teeth. The aim of the current study was to assess the association between psychological traits and OTA of otherwise healthy individuals. Sixty-three volunteers (32 males; mean age ± SD: 24.6 ± 2.7 years) participated in this study. Somatosensory amplification, anxiety, depression, physical symptoms and pain catastrophizing were scored using questionnaires, and subgroups of severity were created per variable based on cut-offs. OTA was measured using 9 aluminium foils with thickness (ranging from 8 to 72 μm) and one sham test (without foil). Each thickness was tested 10 times in random order, the participants were instructed to report whether they felt the foil between their molars and the mean percentage of correct answers was computed. A linear mixed model was used with OTA as a dependent variable and psychological domain as an independent variable. Significantly different OTA was observed among the anxiety subgroups (p = .003), supporting a decreased perception of thicknesses 24 and 32 μm (p = .018 and p < .001, respectively) in participants with moderate/severe anxiety compared to those with no/mild anxiety. Significantly different OTA was also observed among the pain catastrophizing subgroups (p = .008), showing decreased perception of thicknesses 32 and 40 μm (p < .001 and p = .007, respectively) in severe catastrophizing levels, compared to no/mild catastrophizing levels. No significant differences were observed for the other variables. Healthy adults with increased anxiety or pain catastrophizing levels show decreased interdental acuity as compared to participants with minor or no psychological impairment.

"There is a lot of shame that comes with this": A qualitative study of patient experiences of isolation, embarrassment, and stigma associated with overactive bladder.

Beyond causing physical discomfort, overactive bladder (OAB) is distressing to patients across a variety of psychosocial domains. In this qualitative component of a larger mixed methods study, we explore patients' lived experience with OAB to understand how this condition impacts individuals on a personal and social level, as well as their experiences interacting with the health care system. A total of 20 patients and 12 physicians completed a questionnaire and semi-structured interview. The interview guide, developed in an iterative fashion by the authors, included questions about treatment decision making as well as experiences living with or treating OAB; this manuscript focuses on the questions probing lived experiences and interactions between patients and physicians. The interviews were recorded, transcribed and inductively coded and analyzed according to the principles of interpretive description to develop themes. Analysis of patient and physician interviews yielded five key themes: isolation due to OAB diagnosis, social stigma associated with noticeable OAB symptoms, embarrassment from interactions with the health care system, feeling invalidated and dismissed by physicians, and OAB patients as a "vulnerable" population with "desperation" for cure. OAB causes patients marked distress beyond their physical symptoms; it causes feelings of isolation from friends and family and makes them feel embarrassed to discuss their condition with loved ones and physicians alike. Efforts to destigmatize OAB, validate patient experiences, and improve access to OAB care may help diminish the psychosocial burden of OAB.

The association between different levels of depression and overactive bladder: A cross-sectional study of the 2005-2018 National Health and Nutrition Examination Survey.

There is growing evidence of a possible correlation between depression and overactive bladder (OAB). However, few studies have classified depression according to its severity. Whether there is an association between different levels of depression and OAB symptoms remains unclear. Participants with complete information about depression, OAB, and covariates in the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were included in this study. Depression symptoms were assessed by the Patient Health Questionnaire-9. OAB symptoms were evaluated by the Overactive Bladder Symptom Score. Weighted multivariate logistic regression models were applied to analyze the relationship between depression and OAB. A total of 30 359 participants were included in this study, consisting of 6245 OAB patients and 24 114 non-OAB participants. The multivariate logistic regression suggested depression independently correlated with OAB (odds ratio [OR] = 2.764, 95% confidence interval [CI] = 2.429-3.146, p < 0.001). Further, mild (OR = 2.355, 95% CI = 2.111-2.627, p < 0.001), moderate (OR = 3.262, 95% CI = 2.770-3.841, p < 0.001), and moderately severe to severe depression (OR = 3.927, 95% CI = 3.246-4.752, p < 0.001) were all associated with OAB. Additionally, depression was also correlated with urgency urinary incontinence (OR = 2.249, 95% CI = 1.986-2.548, p < 0.001) and nocturia (OR = 2.166, 95% CI = 1.919-2.446, p < 0.001). This study indicated different levels of depression, even mild depression, were independent risk factors for OAB. Given the frequent coexistence and potential interactions between depression and OAB, clinicians should be aware of the importance of assessing both physical and psychological symptoms in these patients. Early diagnosis and holistic treatment may improve the treatment outcomes, particularly for those suffering from both conditions.

Is development and persistence of multiple physical symptoms associated with coping? A longitudinal study over a decade

ObjectiveTo examine the development and persistence of multiple physical symptoms (MPS) over a decade including the associations with sociodemographics and coping strategies. MethodA longitudinal study of 16,405 individuals aged 20–64 years participating in the Danish Symptom Cohort (DaSC) was conducted in 2012 with follow-up data in 2022 (DaSC II). MPS were assessed according to the unifying diagnostic construct of bodily distress syndrome, and coping was measured with the Brief Approach/Avoidance Coping Questionnaire. Descriptive statistics and multivariable logistic regression analyses were performed. ResultsAmong individuals not having MPS in 2012, 17 % had developed MPS in 2022. Among individuals having MPS in 2012, 57 % had persistence of MPS in 2022. Individuals who developed or had persistence of MPS at follow-up were more likely to be female, have lower educational level, be immigrant, redeem antidepressants, have lower approach scores as well as higher diversion and resignation scores. ConclusionsIndividuals responding to stressful situations with low approach, high diversion, and high resignation may be at higher risk of developing MPS and have persistence of MPS. As coping can be targeted through psychotherapy, it is important to focus on maladaptive strategies, especially in high-risk groups for developing and maintaining MPS.

Validation of the Integrated Palliative Care Outcome Scale (IPOS) in adults with cystic fibrosis.

A primary palliative care model for cystic fibrosis (CF) recommends using the Integrated Palliative Care Outcome Scale (IPOS) for screening. Validation of the IPOS is needed. This secondary analysis utilized baseline data from a multisite trial of the palliative care model, Improving Life with CF. Adults with CF completed the IPOS, the Memorial Symptom Assessment Scale-CF (MSAS-CF), the CF Questionnaire-Revised (CFQ-R), the Patient Health Questionnaire (PHQ-8), the Generalized Anxiety Disorder (GAD-7), and the Perceived Stress Scale (PSS). IPOS structure was assessed using Cronbach α coefficients and a factor analysis. Construct validity was evaluated through bivariate relationships between IPOS scores and other questionnaire scores, and linear regressions assessing the extent to which the IPOS explains variance in quality-of-life domains. The sample comprised 256 adults with complete IPOS data. α coefficients were .86 for the IPOS total score, .81 for the Physical Symptoms subscale, .79 for the Emotional Symptoms subscale, and .63 for the Communication/Practical Issues subscale. A two-component factor structure best aligned with the current subscales. IPOS scores were significantly associated with other measures; associations with MSAS-CF and CFQ-R subscales differentiated the IPOS Physical and Emotional subscales. The IPOS total score provided unique information about the variance in the CFQ-R Physical Functioning and Respiratory Symptoms domain scores. In adults with CF, the IPOS has acceptable internal consistency and there is evidence of construct validity. These findings support adoption of the IPOS in the primary palliative care model for CF.

Investigating the Relationship between Emotion Regulation Strategies and Anxiety Caused by COVID-19 in Employees of Rehabilitation Centers

Background and Objectives: In the current situation, it is essential to determine the level of anxiety in medical and non-medical employees due to the pandemic. Therefore, this research aims to assess the relationship between corona anxiety, emotion regulation strategies, and stress tolerance among the staff of rehabilitation centers in Tehran Province, Iran. Methods: This study was descriptive, cross-sectional, and correlational. The statistical population of the present study included the entire staff of rehabilitation centers served by the Welfare Organization of Tehran Province in 2022. Using simple random sampling, 10 rehabilitation centers were selected as study centers. Subsequently, 200 employees of these centers were selected and tested using Morgan’s sampling table (the male age of the participants was 31.5 years). The data collection instruments included the corona disease anxiety scale, the emotional distress tolerance questionnaire (2005), and the March emotional self-regulation strategies scale (2007). Data were analyzed by SPSS software, version 26. Results: The results showed that the mean of corona anxiety was 18.94 out of a maximum of 54 and the proportion of psychological symptoms of corona anxiety was higher than physical symptoms. The highest score from the participant’s point of view from dimensions of distress tolerance was assigned to the subjective assessment of distress. The mean score for distress tolerance was 52.68 out of a maximum of 75 points and the mean score for employees’ emotion regulation strategies was 134.37 points, which shows that the use of emotional self-regulation strategies is strong. The results of the current research showed that corona anxiety decreases significantly by increasing distress tolerance, absorption of negative emotions, regulation of efforts to relieve distress and distress tolerance, and corona anxiety also decreases significantly. Also, with the increase in the level of emotion regulation strategies, the anxiety of corona decreases significantly. Distress tolerance showed a negative correlation with corona anxiety, and with the improvement of distress tolerance, corona anxiety decreased (P=0.014). Conclusion: Based on the results, increasing and improving distress tolerance and emotional regulation strategies significantly reduced corona anxiety. Also, the experiences and work of experts with more work experience alongside the younger and less experienced forces and their cooperation prepared the ground to reduce the effects of corona anxiety, as well as to improve the level of stress tolerance and emotion regulation strategies of employees.

Quality of Life and Symptoms of Hospitalized Hematological Cancer Patients

Patients with hematological malignancies undergo intensive treatment and prolonged hospitalization, thus having a variety of physical and psychosocial symptoms and worse quality of life (QOL). This study aimed to assess the QOL and investigate the symptoms of hospitalized hematological cancer patients. A cross-sectional study was conducted in the hematology clinics and day units of two general hospitals of Heraklion, Crete. Adult patients with hematological malignancy and an adequate understanding of the Greek language participated. A demographic questionnaire, the European Organization for Research and Treatment for Cancer quality assessment questionnaire (EORTC QLQ-C30), and the MD Anderson Symptom Inventory (MDASI) were used. The sample consisted of 120 patients—42.5% were women, with a mean age of 65.6 years. The mean time from diagnosis was 33 months. The global health status of QoL had an average value of 47.1. The highest levels of QOL were found in the subscale of cognitive function (72.8) and the lowest in the role function (46.1). For the EORTC QLQ-C30 symptoms scale, the lowest score was found in nausea-vomiting (11.0) and the highest in fatigue (59.1). In the MDASI, in part I (core symptoms), higher levels but also medium intensities were reported at fatigue (78.3%, mean 3.5), drowsiness (65.0, mean 3.3), and distress (65.8%, mean 2.8). In part II, enjoyment of life (85.8%, mean 5.1) had the highest, and relation with other people (67.5%, mean 3.7) had the lowest scores. The increase in the severity of the core symptoms (part I) was related to females (rho = 0.193, p &lt;0.05) and comorbidities (rho = 0.220, p &lt; 0.05). It was also associated with a significant decrease in all functional domains and increased fatigue (rho = 0.571, p &lt; 0.05) in the EORTC QLQ-C30 questionnaire. The increased global health status was related to males (rho = −0.185, p &lt; 0.05) and physical functioning with younger age (rho = −0.331, p &lt; 0.05), higher education (rho = 0.239, p &lt; 0.05), fewer months from diagnosis (rho = −0.199, p &lt; 0.05), and low comorbidity (rho = −0.209, p &lt; 0.05). Finally, multiple linear regression analysis revealed that the total average symptom score of the MDASI was the most significant factor influencing the global health status of the EORTC QLQ-C30 (β = −4.91, p &lt; 0.001). The increased global health status of the EORTC QLQ C30 was not significantly related (p &gt; 0.05) to the social characteristics of the patients, such as education or employment, which requires further validation. The QoL of hematological cancer patients significantly decreases during treatments due to a considerable number of symptoms that must be taken into consideration for high-quality, individualized care.

Loneliness and low fruit and vegetable consumption among adults in Japan

BackgroundLoneliness is the distressing feeling that arises when a person's network of social relations is perceived as being inadequate in some way. Research has linked loneliness to a number of detrimental health outcomes. There is also some evidence that lonely individuals are more likely to engage in poorer health behaviors. However, as yet, there has been comparatively little attention paid to the relation between loneliness and dietary behavior. In particular, there has been little focus on the association between loneliness and fruit and vegetable intake.ObjectiveThe aim of this cross-sectional study was to examine the association between loneliness and low fruit and vegetable consumption in the Japanese general population.MethodsData were analyzed from 3,410 Japanese adults collected in an online survey in early 2023. Information was obtained on past-week fruit and vegetable consumption with a single-item measure, while loneliness was assessed with the Three-Item Loneliness Scale. Information was also collected on sociodemographic characteristics, physical health status, health-risk behaviors and depressive symptoms. Logistic regression was used to assess associations.ResultsOne in twenty (5.3%) adults reported low fruit and vegetable consumption. In a fully adjusted analysis loneliness was associated with higher odds for low fruit and vegetable consumption (OR: 1.14, 95%CI: 1.04–1.26). In sex- and age-stratified analyses loneliness was significantly associated with low fruit and vegetable consumption in both women and middle-aged adults, although confidence intervals overlapped for this association across all of the sex and age groups in the fully adjusted analyses.ConclusionsLoneliness is associated with low fruit and vegetable consumption among adults in Japan. As loneliness and inadequate fruit and vegetable intake have both been linked to poorer health outcomes, the results of this study underscore the potential importance and public health benefits of reducing loneliness in Japan.

Clinical and genetic profiles of patients with hereditary and wild type transthyretin amyloidosis: the transthyretin cardiac amyloidosis registry in the state of Sao Paulo, Brazil REACT-SP

Abstract Introduction Transthyretin amyloidosis (ATTR) is a multisystem disease caused by the deposition of fibrillar protein in organs and tissues. ATTR genotypes and phenotypes are highly heterogeneous. Purpose We designed the Transthyretin Cardiac Amyloidosis Registry in the state of São Paulo (REACT-SP), aiming to describe the demographic, genetic, clinical, and diagnostic test results and treatment of patients with ATTR. Methods We present data on physical signs and symptoms, cardiac and neurological assessments, and genetics in patients enrolled in the Transthyretin Cardiac Amyloidosis Registry in the state of São Paulo, Brazil. Results Six hundred-forty-four patients were enrolled, 505 with the variant form (ATTRv) and 139 with wild-type (ATTRwt). Sixteen different mutations were detected, the most common being Val50Met (48.3%) and V142Ile (40.8%). Overall, more than half of the patients presented cardiological involvement, and the difference in this proportion between the ATTRv and ATTRwt groups was significant (43.9 vs. 89.9%; p&amp;lt;0.001). The neurological phenotype also differed between ATTRv and ATTRwt (56.8 vs. 31.7%; p&amp;lt;0.001). The mixed phenotype was found in 25.6% of the population, without a significant difference between the forms of amyloidosis. A group of patients remained asymptomatic (10.4%), with a lower proportion of asymptomatic ATTRwt patients. The median time between the onset of symptoms and diagnosis was 1,853 (IQR 1277–2997) days, which was longer in ATTRv patients than in ATTRwt patients (p&amp;lt;0.001). Sinus rhythm was reported in 74.2%, atrial fibrillation in 17.0%, low voltage in 28.6%, repolarization abnormalities in 39.8%, and pseudo infarction in 27.4%. Echocardiography showed median Left Ventricular Ejection Fraction (LVEF) was 60%, Interventricular Septum (IVS) 14 mm, Posterior Wall Thickness (PWT) 13 mm, Left Atrium (LA) 41 mm, Left Ventricular Diastolic Diameter (LVDD) 45 mm, Left Ventricular Systolic Diameter (LVSD) 30 mm, basal Right Ventricular Diastolic Diameter (RVDD) 35 mm and Left Ventricle (LV) longitudinal strain 9.1%. There was some degree of LV diastolic dysfunction in 38.4%, apical sparing in 31.3%, and thrombus or masses in 1.0%. Late Gadolinium Enhancement (LGE) was absent in 29% and was subendocardial in 35.5%, transmural in 13.7%, mesocardial in 13.7%, and epicardial in 8.2%. Conclusions This study details the clinical and genetic spectrum of patients with ATTR in São Paulo, Brazil. This preliminary analysis highlights the considerable phenotypic heterogeneity of neurological and cardiac manifestations in patients with variant and wild-type ATTR.

Daridorexant as a new dual orexin receptor antagonist for insomnia - a literature review

Introduction and purpose of review: Insomnia is a prevalent disorder responsible for multiple negative effects on human health. Its treatment involves both non pharmacological and pharmacological methods, however many common insomnia medications are recommended not to be used long term. Daridorexant is a new dual orexin receptor inhibitor, recently approved by the EMA for use in the European Union. The aim of this study is to present current knowledge concerning daridorexantsafety, efficacy and general characteristics. Methods: Pubmed database literature review has been performed. Relevant studies regarding daridorexant and insomnia have been assessed. Product characteristics available on EMA, FDA and Idorsia Pharmaceuticals websites have also been inspected. Current state of knowledge: Studies suggest that daridorexant is generally safe and significantly improves the night-time and daytime functioning of people suffering from insomnia, by enabling them to fall asleep in shorter periods of time and stay asleep for longer. It increases time spent in both REM and non-REM phases proportionally and does not disturb physiological sleep architecture. It shows no residual effects in the morning and can be used long-term, with no reduced efficacy and with no signs of physical dependence or withdrawal symptoms. It rarely leads to serious adverse effects and is contraindicated only in a few groups of patients. Conclusions: Daridorexant is a recently approved dual orexin receptor inhibitor with a promising long-term use safety and efficacy profile. As it is a new medication, further investigation concerning the side effects observed over time should be advised.

Trust, belief and transitions: people’s experiences of multidisciplinary inpatient treatment for persistent physical symptoms. A qualitative study

Purpose People with Persistent Physical Symptoms experience physical symptoms that are not wholly explained by a medical disorder or disease. Multidisciplinary treatment is recommended for people with severe difficulties and is provided in a small number of specialist centres in the UK. Only brief descriptions of this treatment are available, and the experiences of people receiving this treatment as an inpatient have not been explored. This study aimed to explore how people with persistent physical symptoms experience inpatient treatment from a specialist multidisciplinary team, and to identify which factors facilitated their engagement in the rehabilitation. Materials and Methods 18 people who had received inpatient multidisciplinary treatment for persistent physical symptoms participated in semi-structured interviews. The transcripts were analysed using reflexive thematic analysis. Results Participants’ experiences were influenced by whether they felt believed by the healthcare team, and whether they could place their own trust and belief in the staff team and the treatment approach. Their experiences involved a series of transitions; both in environment and understanding. Conclusions Improvements are possible for people receiving inpatient multidisciplinary treatment for severe PPS. Trusting relationships between patients and staff members take time to develop but play a major role in patients’ experiences of treatment.

Prevalence of Suicidal Ideation in Patients With COVID-19 Admitted to a Hospital in Qazvin, Iran

Background and Objectives: Many patients with COVID-19 show long-term physical and mental symptoms. This study aims to determine the prevalence of suicidal ideation in patients with COVID-19 hospitalized in a hospital in Qazvin, Iran. Methods: This is a cross-sectional study. The study population consists of all patients with COVID-19 admitted to Bou Ali Sina Hospital in Qazvin city. A two-part questionnaire was used to collect data; the first part surveys demographic characteristics, history of death due to COVID-19 in relatives, history of underlying disease, days of hospitalization, history of intubation, and history of hospitalization in intensive care units. The second part was the Beck Scale for Suicide Ideation. The collected data were analyzed in SPSS software, version 23 using ANOVA and logistic regression analysis. Results: Participants were 206 patients with COVID-19. The data showed that 12.8% of patients had high suicidal ideation. Younger patients were at a high risk of suicide (Mean age: 31.96±12.59 years) (P&lt;0.001). In addition, patients who were single (P&lt;0.001) and had a history of death due to COVID-19 in relatives or friends had higher suicidal ideation (P=0.005). Conclusion: About 12.8% of patients with Covid-19 admitted to the study hospital had a high suicidal ideation. There is no considerable difference between the prevalence of suicidal ideation reported in this study and the data reported for the general population of Iran before the pandemic.

Peer support in paediatrics: A literature review.

Creating an overview of the existing literature about peer support in paediatrics, with a focus on children with chronic diseases. An online search was conducted in MEDLINE and Web of Science. English, Dutch or French articles published between 1 January 2000 and 10 May 2023 were included, based on title and abstract. In this review, 47 articles were included, identifying following themes: Health-Related Quality of Life (n = 8), peer support for parents/siblings (n = 6), social environment (n = 2), and peer support programme for children (n = 31) subdivided in: general concept (n = 13), online (n = 11), camps (n = 6), and development of a peer support programme (n = 1). Peer support aims to improve disease-related knowledge, coping, and management of the disease, as well as creating a positive mindset and decreasing the disease burden. There is no consensus regarding which peer group design was superior. Peer groups aim to increase knowledge and psychological adaptation, and decrease physical symptoms and side effects. It is desired to start the peer mentor programme within 1 year after diagnosis or during a critical incident. Further investigation needs to determine the optimal age to start these groups and the format (online or in-person). Communication between mentors and their mentees was crucial in the succeeding of the programme, as well as creating a safe environment to share experiences. Even though research is still needed concerning peer-to-peer support for children, there is already a lot known about similar programmes for parents of children with chronic diseases.

Psychopathological Profile of Patients with Moderate-to-Severe Plaque Psoriasis and Its Correlation to DLQI: Results from a Prospective, Monocentric Clinical Study

Background: Psoriasis is associated with a high psychological burden and comorbidities, such as depression and anxiety. The aim of this study was to evaluate the psychopathological profile of patients with moderate-to-severe plaque psoriasis under systemic treatment and to explore the association between DLQI and alexithymia, depression, and other psychopathological disorders. Methods: In this monocentric, prospective clinical study, 104 adult patients with moderate-to-severe plaque psoriasis were evaluated according to the disease severity (measured by PASI) influence of psoriasis on their quality of life (measured by DLQI) and their psychopathological profile (measured by the BDI, TAS-20, and SCL-90 questionnaires). Results: The psoriasis patients exhibited high levels of psychopathological symptoms, particularly for depression, obsessive-compulsive behavior, somatization, interpersonal sensitivity, and anxiety. More than half of the psoriatic patients (56.7%) were diagnosed with minimal depression, 26.9% with mild depression, and 16.3% with moderate or severe depression. The symptoms of possible and confirmed alexithymia were present in 19.2% and 15.4% of the patients, respectively. The patients with alexithymia appeared to experience a more significant impact on their QoL. Specifically, the percentage of patients with alexithymia/possible alexithymia who had a DLQI of ≥2 was 77.8% vs. 51.5% in those without alexithymia. Conclusions: Our study illuminates the intricate connection between the disease severity and psychological components that impact the QoL of patients with moderate-to-severe plaque psoriasis. It is advised that clinicians adopt a comprehensive approach to managing psoriasis, which involves addressing both the physical symptoms of the condition and the psychological impact. In cases of patients with a DLQI of ≥2, despite adequate clinical responses, evaluating the possible coexistence of general psychopathology is recommended.

Spiritual care competences of healthcare workers in emergency and intensive care-aprospective questionnaire study

In intensive and emergency care, patients and their relatives are confronted with potentially existential crises. Spiritual care can be an additional resource to address related psychosocial and physical symptoms and to support patients and their relatives. Accordingly, healthcare workers need spiritual skills to recognize and respond to these needs. What spiritual competencies do healthcare workers in intensive and emergency care have? Are there differences between professions and genders? What factors influence spiritual competencies? The prospective questionnaire study included physicians participating in intensive care and emergency medicine courses and nurses who were training or working in intensive and emergency care. Self-reported spiritual competencies were assessed using the Spiritual Care Competence Questionnaire (SCCQ), which captures the following areas: perceptual competence, team-spirit, documentation competence, self-awareness and proactive opening, knowledge about other religions, competence in conversation techniques and proactive empowerment-competence. We included 465 physicians (50% female, years in profession: mean = 4.0, standard deviation [SD] = 3.5) and 86nurses (80% female, years in profession: mean = 12.7, SD = 10.7). The average SCC was2.3 (SD 0.4) out of amaximum of 4points, with higher spiritual competences among spiritual and religious respondents. There were differences in specific competencies between the professions and genders. Women indicated ahigher level of competence in the area of perception and conversation skills, physicians in documentation skills. Overall, there is aclear need to train healthcare staff in the field of intensive care and emergency medicine.

Initial symptoms and late complication in Lyme neuroborreliosis from the perspective of patients and relatives: a qualitative study

BackgroundLyme borreliosis is by far the most common vector-borne infection in Western Europe. The most severe manifestation of Lyme borreliosis is Lyme neuroborreliosis (LNB). In LNB symptoms vary from mild to severe and may include late complications that involve both physical and/or neurocognitive constraints. An estimated 25–28% of the LNB population suffers from late complications. This study investigates patient and relative perspectives on everyday life with LNB symptoms, diagnosis, and treatment to identify areas for improvement of healthcare.MethodsA focus group was conducted at Odense University Hospital, Denmark. The focus group comprised 16 participants, nine patients diagnosed with LNB who had been treated at the Clinical Center for Emerging and Vector-borne Infections, and seven relatives of the patients’ choice. The focus group lasted 2 ½ hours and was audio recorded as well as documented in field notes.ResultsData analysis was grounded in the conceptual framework of critical psychology and resulted in three main themes: (1) Burden of LNB symptoms in everyday life, (2) A break in the conduct of everyday life caused by LNB and (3) Need for transparent pathways to specialist knowledge.ConclusionsBefore diagnosis and treatment, each patient reported varying degrees of non-treatable pain, and cognitive and/or musculoskeletal symptoms. Visible physical symptoms were rare. All patients had experienced that their bodily symptoms remained unaddressed throughout numerous encounters with the healthcare system. The course of LNB comes with a break in patients’ everyday lives and self-understandings affecting their ability to work and manage everyday activities. Patients and relatives strongly recommend a specialised LNB clinic.

Factors Related to Premenstrual Syndrome in Young Women at MTsN Labuhanbatu in 2024

Premenstrual syndrome (PMS) is a complex and poorly understood condition consisting of one or more of a number of physical and psychological symptoms that begin in the luteal phase of the menstrual cycle. World Health Organization (WHO) in 2020 PMS has a higher prevalence in Asian countries compared to western countries. The purpose of this study was to determine the factors associated with Premenstrual syndrome in adolescent girls at MTsN 1 Labuhanbatu in 2024. This research design uses an analytic survey, namely research trying to explore how and why the phenomenon occurs. Then analyze the dynamics of the correlation between phenomena, both between related factors (Indipendent) and effect factors (Dependent). The approach used in this research is cross sectional. The population in this study was 291 people. The sample in this study amounted to 74 people. Data analysis used univariate analysis and bivariate analysis using the chi-square test. The results of statistical tests with stress categories obtained using the chi-square test at a confidence level of 95% are known that psig 0.000 is smaller than 0.05, the results of chi-square tests with consumption patterns at a confidence level of 95% are known that psig 0.000 is smaller than 0.05, the results of statistical tests with premenstrual syndrome incidence obtained using the chi-square test at a confidence level of 95% are known that psig 0.000 is smaller than 0.05. In conclusion, it is known that there is a relationship between stress, consumption patterns and exercise with the incidence of premenstrual syndrome in adolescent girls at MTsN 1 Labuhanbatu in 2024. It is suggested that the results of this study can add insight, knowledge and experience about premenstrual syndrome that can occur at any time.

Assessment of the sentiments expressed by traumatic brain injury patients and caregivers: A qualitative study based on in-depth interviews

IntroductionTraumatic Brain Injury (TBI) is a significant public health concern that causes death, disability, and economic burden. Its repercussions affect physical, cognitive, emotional, and behavioral aspects of long-term care needs. Despite improvements in communication among multidisciplinary teams, the management of TBI remains fragmented. ObjectiveThis study aimed to assess patients and caregivers’ experiences through sentiment analysis. Materials and methodsA qualitative cross-sectional study utilized structured topic modeling (STM) to analyze in-depth interview data. The study involved 29 patients with TBI and 27 caregivers in Madrid (Spain), using a survey design. The interviews were conducted, transcribed, and coded independently over 5 months. Sentiments such as anticipation, fear, and emotional concerns were analyzed using three dictionaries. The STM analysis identified four key concepts: desire for independence, potential improvement, need for injury information, and psychological consequences. STM diagnostic graphs were used to determine the number of topics relevant to the evaluation of patient and caregiver concerns. Furthermore, an analysis was conducted across four topics. ResultsThe average age of the patients was 44.2 ± 14.9 years (69 % males). Regarding TBI severity, 59 % of patients had severe TBI, whereas the remaining 41 % had experienced moderate TBI. Among the caregivers, the majority were parents (30 %), partners (24 %), or siblings (24 % each). Among the 51 participants, sentiments were analyzed using three dictionaries. While there were no significant age differences (Z = 0.24, p = 0.815), the STM model was adjusted for significant sex differences (p = 0.017) between patients and relatives. Anticipation and fear prevailed in both groups, highlighting the shared emotional patterns. DiscussionThe analysis of diagnostic graphs indicated the optimal number of topics for evaluation, emphasizing key concerns across different phases of TBI. Patients' main worries shifted from physical symptoms to limitations in daily life and independence. Caregivers highlighted the importance of staff interactions, misinformation challenges, and the need for psychological care. ConclusionKey patient concerns, including dependency on daily activities, limitations in autonomy, and caregiver burden, emphasize crucial areas for enhancement in multidisciplinary treatment. Moreover, the lack of long-term psychological support is a significant barrier to optimal patient and caregiver well-being.

Telephone-Based Acceptance and Commitment Therapy for Caregivers of Persons with Dementia: Results of a Randomized Controlled Trial

ABSTRACT Objectives Family caregivers of persons with dementia (PwD) experience high levels of distress. We used a randomized-controlled trial to investigate the effects of telephone-based acceptance and commitment therapy (tbACT) for family caregivers. Methods Caregivers were randomly allocated to an intervention group (tbACT, n = 41) or an untreated control group (CG, n = 40). The intervention consisted of eight weekly sessions of tbACT. Depression and anxiety (primary outcomes), physical symptoms, pre-death grief, care-related thoughts, acceptance (secondary outcomes), quality of life, coping and well-being (well-being/coping outcomes) were assessed pre- and post-assessment. A 6-month follow-up was conducted. Results Compared to CG participants, tbACT participants had at post-assessment significantly lower depressive symptoms; fewer physical symptoms (rheumatic pain); better physical health; more resource utilization (coping with daily hassles, social support); better coping with the care situation and better emotional well-being. During the six-month follow-up, tbACT participants showed less pre-death grief, fewer physical symptoms, and more utilization of resources related to coping with daily hassles. Conclusions tbACT is a feasible and promising psychotherapeutic intervention for family caregivers of PwD. Because of small sample size our results are preliminary. Clinical Implications Most of the effects of tbACT were not maintained 6 months after the intervention, suggesting that booster sessions may be helpful.

Initial Symptom Severity and Recovery of Sport-Related Concussion in Team Versus Individual Sport Athletes.

Recovery after sport-related concussion is variable, and potential differences between team vs individual sport athletes are not fully understood. In a cohort of athletes with concussions, we sought to compare these groups across (1) symptom severity score, (2) individual symptom cluster scores, and (3) recovery metrics. A retrospective, cohort study of 13 to 23-year-old athletes treated at a regional sport concussion center between November 2017 and April 2022 was conducted. Athletes were categorized into team vs individual sport athletes, with additional classification of individual sports based on strong vs minimal team elements (ie, the degree of interdependence displayed by athletes). The primary outcomes were symptom severity score, measured by either the Sport Concussion Assessment Tool-5th Edition or the Immediate Post-Concussion Assessment and Cognitive Testing, and physical, cognitive, emotional, and sleep symptom cluster scores. Secondary outcomes were recovery metrics, including time to return-to-learn, symptom resolution, and return-to-play. Of the 1051 athletes, 954 (90.8%) were in team sports and 97 (9.2%) in individual sports. In multivariable linear regression, individual sport athletes had higher emotional symptom severity compared with team sport athletes (β = 0.09 [0.01, 0.17], P = .034) when adjusting for sex, attention-deficit/hyperactivity disorder, psychological disorders, time to clinic, on-field evaluation, and Immediate Post-Concussion Assessment and Cognitive Testing vs Sport Concussion Assessment Tool-5th Edition scale. There were no significant differences in return-to-learn (P = .104), symptom resolution (P = .941), or return-to-play (P = .279) on univariate regressions. In the current single-center, pilot study of athletes with a sport-related concussion, individual sport athletes exhibited more emotional symptoms than team sport athletes. These preliminary data lend early support that individual sport athletes may be more at risk of emotional symptoms than team sport athletes after a sport-related concussion. Clinicians may use these findings to identify athletes who may be particularly vulnerable to emotional symptoms.