Physical Symptoms In Patients Research Articles

Effect of Palonosetron on Physical Symptoms of Surgical Patients: A Systematic Review and Meta-Analysis.

Background Postoperative nausea and vomiting (PONV) is a typical and unpleasant physical symptom that occurs in patients after surgery, and it may be one of the most challenging elements of the recovery process. PONV can be caused by a variety of factors, including surgery itself, anesthesia, or medications. Palonosetron is a medication that is now licensed by the Food and Drug Administration for the treatment of this ailment. The efficacy of palonosetron in reducing physical symptoms in patients following surgery was investigated in this meta-analysis and comprehensive review. Methods Following a quick search of databases such as CENTRAL, EMBASE, CINAHL, Google Scholar, the Science quotation index's Web site, the United States clinical trial check-in, the United Kingdom clinical trial check-in, the New Zealand clinical trial check-in, and the Australia check-in, as well as outlines of major anesthesia meetings held in the previous five years, we were able to get a good start on our research. Growing adults who had surgery and were given other drugs were compared to individuals who did get palonosetron in randomized controlled trials. Results A total of 8324 participants were recruited in 10 different clinical studies. It has been shown that palonosetron may significantly reduce the 24-hour PONV incidence and 95% confidence interval (CI) 0.41–0.86. When comparing the 6-hour and 48-hour time periods, the incidences of experiencing PONV were neither statistically different (RR: 0.82, 95% confidence interval: 0.61–1.09) or considerably different (RR: 0.60, 95% confidence interval: 0.33–1.10). Following in a similar vein, there was no significant difference between the groups in the occurrence of PONV after 48 hours (RR: 0.82, 95 percent CI: 0.59–1.14). The most often reported side effects of the medicine were headaches and dizziness, which were the most common. Regardless of the drug used, the difference in adverse reactions was not statistically significant. Conclusion When it comes to the prevention of early PONV, it has been shown that palonosetron is more effective than other medications. Palonosetron, on the other hand, has been demonstrated to be more effective than other medications in preventing vomiting after laparoscopic surgery.

The Comparison of the Effectiveness of Reality Therapy and Compassionate Focused Therapy On Depression, Anxiety, Stress and Physical Symptoms in patients with Irritable Bowel Syndrome

Background and Objectives: Irritable bowel syndrome is the most common digestive system disorder. Despite the long period of study in the treatment of irritable bowel syndrome, only a small number of treatments have proven effective. The current study aimed to compare the effectiveness of reality therapy and compassion-focused therapy in the reduction of depression, anxiety, stress, and physical symptoms in patients with irritable bowel syndrome. Materials and Methods: The present study was conducted on 45 patients with irritable bowel syndrome (diagnosed by a gastroenterologist applying the Rome III criteria) who were assigned to two experimental groups: reality therapy (n=15) and compassion-focused therapy (n=15), as well as the control group (n=15). The experimental groups received eight sessions of reality therapy and compassion-focused therapy. All three groups responded to the Severity of Symptoms of Irritable Bowel Syndrome (IBS-SI) and Depression-Anxiety-Stress Scale(DASS-42) as pre-post and follow-up tests. Results: The results of the repeated measures ANOVA demonstrated a significantly lower mean score in depression, anxiety, stress, and physical symptoms among the experimental group in the post-test. The follow-up test administered eight weeks after the post-test did not show any change in the results. Conclusion: The obtained results supported the effectiveness of reality therapy and compassion-focused therapy in the reduction of depression, anxiety, stress, and physical symptoms in patients with irritable bowel syndrome. There was also no significant difference in the efficacy of these two treatments.

Musculoskeletal physiotherapy in physical sequelae of SARS‐CoV‐2 infection: A case report

Patients infected with severe acute respiratory syndrome-CoV-2 can present physical complications that can make the return to their daily physical activities difficult. Despite the positive results in different pathologies through musculoskeletal physiotherapy, there are few reports in post-COVID-19 patients. This case describes an intervention based on musculoskeletal physiotherapy in a post-COVID-19 adult woman with physical sequelae. As part of an initial evaluation in a woman with physical sequelaes post-COVID-19, it was decided to conduct a musculoskeletal physiotherapy over a course of 5weeks distributed in 15 visits. To evaluate her progress the joint ranges were evaluated according to the American Academy of Orthopedic Surgeons (AAOS), the Numerical pain scale was used, the muscle strength evaluated according to the Daniel Scale, and finally the Unipodal Station Test used. Musculoskeletal physiotherapy improved the patient's physical symptoms. The patient's pain was reduced from a value of 10 to 3; the strength of the musculature increased from a value of 2 to 4; initial joint ranges were expanded from 67% to 100% in various body segments. Finally, the woman managed to stay up to 8s in the monopodal position. Using musculoskeletal physical therapy and measuring progress through quantitative measurements at each visit, a post-COVID-19 woman was able to resume her daily physical activities. This therapy is a valuable tool to recover the musculoskeletal system that proves to be an important advance in the recovery of the quality of life in patients with musculoskeletal sequelae from COVID-19.

The Effectiveness of TranscranialDirect Current Stimulation (TDCS) on Anxiety, Depression, and Physical Symptoms of People with Chronic Pain

Introduction: Chronic pain and the experience of living with it are unique. Individual perception of pain is affected by physical, psychological, and social variables. This study aimed to determine the effectiveness of transcranial direct current stimulation (tDCS) on anxiety and depression and physical symptoms of patients with chronic pain.Method: This study was a semi-experimental study with pre-test, post-test, and follow-up with the control group. The statistical population of the study included all outpatients of men and women referred to all medical centers in Tehran in 2019 who had received a definitive diagnosis of chronic pain by neurologists, rheumatologists and psychiatrists, and other relevant specialists. The sampling method in this study had two stages: first, through available sampling, selected from several women with a definite diagnosis of chronic pain, and then, based on inclusion criteria and conducting a pre-test session with interviews. A clinical trial conducted by a researcher under the supervision of a psychiatrist based on DSM-5 diagnostic criteria, 30 women (15 for each group) of women who had the highest scores (as baseline) after completion The questionnaires were selected by simple random sampling method and after random allocation, they were replaced in two groups of intervention and control. Data were obtained using the Beck depression questionnaire and the Beck anxiety questionnaire. Repeated variance analysis was used to analyze the data. The above analysis was carried out using SPSS.22 software.Results: The results showed that the effectiveness of transcranial direct current stimulation (tDCS) was effective on anxiety and depression and physical symptoms of people with chronic pain.Conclusion: It can be concluded that transcranial direct current stimulation (tDCS) is effective in reducing anxiety, depression, and physical symptoms of people with chronic pain and can be used to improve psychological problems in people with chronic pain.

A Motivational Interviewing Intervention Improves Physical Symptoms in Patients with Heart Failure: A Secondary Outcome Analysis of the Motivate-HF Randomized Controlled Trial

ContextHeart failure (HF) patients experience high burden of physical symptoms during their disease trajectory. ObjectiveTo evaluate the effects of Motivational Interviewing (MI) on the burden of physical symptoms in HF patients. MethodsWe performed a secondary analysis of data from the MOTIVATE-HF randomized controlled trial. A sample of 510 patients (median 74 years, 58% male) and their caregivers (median 55 years, 75.5% female) was randomly allocated to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard of care). The MI intervention consisted of one face-to-face session plus three telephone calls conducted within two months from enrollment. Symptoms’ burden was assessed with the Heart Failure Somatic Perception Scale (HFSPS) with the dimensions of Chest Discomfort, Dyspnea, Early and subtle and Edema. Data were collected at baseline and at 3, 6, 9, and 12 months after enrollment. ResultsAt 12 months, Chest Discomfort improved in Arms 1 and 2 vs Arm 3 (Δ: -8.13, 95% CI: -14.61; -1.65). Dyspnea improved in Arms 1 and 2 vs Arm 3 both at 9 and 12 months (Δ: -7, 95% CI: -13.18; -0.82 and -6.78, 95% CI: -13.19; -0.38); HFSPS total score improved in Arm 1 and Arm 2 vs Arm 3 at 9 months (Δ: -4.55, 95% CI: -9.05; -0.05). Over 1 year, Chest Discomfort and HFSPS total score in Arm 2 improved compared to Arm 3 (β= -2.61, 95% CI: -4.21; -1.00, P = 0.0015 and β=-1.35, 95% CI: -2.50; -0.21, P = 0.02). ConclusionMI reduces the burden of physical HF symptoms, particularly when caregivers are involved in the intervention.

A motivational interviewing intervention improves the burden of physical symptoms in patients with heart failure: A secondary outcome analysis of a randomized clinical trial

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Center of Excellence for Nursing Scholarship, Rome, Italy Background. Patients with heart failure (HF) experience a variety of physical symptoms. Symptoms are perceived by patients as burdensome and, as such, negatively affect quality of life. Besides, physical symptoms are among the first reasons for seeking emergency care and hospitalization. Findings from the MOTIVATE-HF trial show that motivational interviewing (MI) leads to better self-care. However, whether MI also reduces the burden of physical symptoms is not yet known. Purpose. To evaluate the effectiveness of MI on the burden of physical symptoms in patients with HF. Methods. Secondary outcome analysis of the MOTIVATE-HF trial. The study was a three-arm, multicenter randomized controlled trial with a 12-month follow-up. Patients with HF and their informal caregivers were enrolled and randomly divided into three arms: MI performed only with patients (Arm 1); MI performed both with patients and caregivers (Arm 2); usual care (Arm 3). Patients with a diagnosis of HF in NYHA functional class II-IV were recruited in three Italian centers. Participants underwent one face-to-face MI session, followed by three phone calls within two months from enrollment. Physical symptoms were measured with the Heart Failure Somatic Perception Scale (HFSPS) with the dimensions of dyspnea, chest discomfort, early and subtle, and edema. Higher scores at the HFSPS and its dimensions indicate worse physical symptom. Data were collected at baseline, and 3 (T1), 6 (T2), 9 (T3) and 12 (T4) months after enrollment. T-test was used to compare differences in HFSPS scores in Arms 1 and 2 versus Arm 3 at each follow-up. Changes over time were analyzed with mixed linear longitudinal models. Results. A sample of 510 patients (median 74 years, 58% male) and their caregivers (median 55 years, 75.5% female) were randomized to Arm 1 (n = 155), Arm 2 (n = 177) and Arm 3 (n = 178). Chest discomfort improved in Arms 1 and 2 versus Arm 3 at T4 (mean difference(Δ): -8.13, P = .014). Dyspnea also improved in Arms 1 and 2 than Arm 3 both at T3 and T4 (Δ: -7, P = .027 and Δ: -6.78, P = .038, respectively). HFSPS total score improved in Arms 1 and 2 versus Arm 3 at T3 (Δ: -4.55, P = .048). Over the year of observation, the mixed linear longitudinal models showed a significant improvement in Chest discomfort and total HFSPS score in Arm 2 versus Arm 3 (β = -2.61, P = .002 and, β = -1.35, P = .02). Conclusions. The results of this secondary analysis indicate that MI may be effective in decreasing the burden of physical symptoms in HF patients, especially if also caregivers are involved in the intervention. Since symptom burden is among the first reasons for seeking emergency care and hospitalization in HF, MI might be a viable option to improve symptom burden via self-care.

Evaluation of the COVID-19 pandemic effect on the development of somatic symptoms in patients with mood disorders: a case-control study

Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals.In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25.The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P < 0.05). The results also showed a significant and direct relationship between the two questionnaires (P < 0.05).According to the results, although the prevalence of somatic symptoms increased in both groups, the prevalence of somatic symptoms is significantly higher in the mood disorder group.

Effectiveness of Acceptance and Commitment Therapy on Safety Performance, Quality of Life and Somatic Symptoms in Patients with Irritable Bowel Syndrome

Background and Objectives: The aim of this research was to evaluate the effectiveness of acceptance and commitment based therapy on immune function, quality of life and physical symptoms in patients with irritable bowel syndrome. Material and Methods: This research was an experimental with pre-test, post-test and 90 days later follow-up with the control group. The research sample were selected as available and included 30 patients with irritable bowel syndrome. Using available sampling method with the consent of the patients, They randomly sampled into two groups of 15 experimental and control, using availa be sampling method with the consent of the patients. The experimental group received acceptance and commitment group therapy for 8 sessions, while the control group did not receive any intervention. Both groups were assessed before and after the intervention and in the follow-up stage using quality of life questionnaires, irritable bowel syndrome evaluation questionnaire (Rome IV) and fecal calprotectin test for immune function. Data analysis was performed first by repeated measures analysis of variance and then by repeated measures analysis of variance by considering the protein variable in the pre-test stage as a covariate variable. Results: In the repeated measures method, the results showed that the effect of time on all three variables of safety function (F = 8.597, P = 0.001), physical condition (F = 63.95, P = 0.0001) and quality of life (F = 65.93, P = 0.0001) is significant. In the method of repeated measures with covariate, the effect of time on the safety performance variable is not significant (F = 0.217, P = 0.645) and it is significant in the variables of physical condition (F = 11.302, P = 0.0001) and quality of life (F = 13.154, P = 0.0001). The results of intergroup test also indicated the significance of the effect of treatment (control and experiment) in all three variables studied in both methods. Conclusion: The findings of the research showed that acceptance and commitment therapy can play an effective role in reducing physical symptoms and improving patients' immune function and improving their quality of life. Therefore, this treatment is recommended as an adjunctive therapy in patients with irritable bowel syndrome.

Attachment Style Mediates the Relationship between Trauma and Somatic Distress among Individuals with Serious Mental Illness

Objective: Individuals with mental illnesses severe enough to require psychiatric hospitalization often have significant trauma histories, have developed maladaptive attachment styles, and experience comorbid somatic distress. Gaining an understanding about the interaction of such factors may lead to prioritizing interventions that target factors that mediate the relationship between trauma and adverse somatic distress. Prior research has examined various mediation models, but results have been mixed and conducted only on outpatient samples. Method: Participants (47.7% female) in a large sample (N = 2702) with a mean age of 34.62 (SD = 14.7) were enrolled in a specialist inpatient program and completed self-report measures pertaining to demographics, attachment insecurity, lifetime trauma exposure, and somatic distress within 72 hours of admission. The dimensions of attachment insecurity (i.e., attachment anxiety and attachment avoidance) were tested as parallel mediators in the relationship between lifetime trauma exposure and somatic distress. Results: The mediation analyses revealed that attachment anxiety and avoidance partially mediated the relationship between lifetime trauma exposure and somatic distress. Conclusions: These results are the first to date to implicate both attachment anxiety and avoidance as mediators between trauma exposure and somatic distress in a high acuity sample. Although the results do not imply causality, they do call attention to social-cognitive factors related to somatic distress and highlight the importance of considering attachment styles as a possible contributor to comorbid physical symptoms in patients with trauma exposure.

Influence of Patient-Reported Treatment Satisfaction on Psychological Health and Quality of Life Among Patients Receiving Divya-Swasari-Coronil-Kit Against COVID-19: Findings from a Cross-Sectional "SATISFACTION COVID" Survey.

IntroductionThe correlation among treatment satisfaction with demographic characteristics, health symptoms or psychological health, and quality of life with the prophylactic regime against COVID-19 is rather unexplored. This real-world exploratory study was conducted to determine patient-perspectives regarding their treatment satisfaction receiving Divya-Swasari-Coronil-Kit with correlative impacts on psychological health (PH) and Quality of life (QoL) based on four hypotheses each relating to PH, QoL, Demographic characteristics, and Treatment satisfaction.MethodsThis cross-sectional, web-based survey collected data on demographic characteristics and psychological health with DASS-21; QoL with 5-level 5-dimension EuroQol instrument; and treatment satisfaction using Treatment Satisfaction Questionnaire for Medication (TSQM) V9. Pearson correlation coefficient analysis was used to examine the relation between TSQM and PH and the demographic variables. Factor analysis was used for multi-collinearity tests, and multiple linear regression analysis was used to explore demographic variables and TSQM.ResultsOut of 421 initial screenings, 367 patient-participants were included in the analysis. The mean age of included participants was 33.61 ± 9.47 years. Marital status and socio-economic class positively correlated with TSQM. Physical symptoms in patients are positively correlated with depression, anxiety, and stress; and in contrast, negatively with QoL. Global satisfaction with Divya-Swasari-Coronil-Kit medication negatively correlated with depression, anxiety, stress, effectiveness, convenience; whereas global satisfaction correlated positively with QoL.ConclusionPresent study (SATISFACTION COVID) indicates that treatment satisfaction due to avaliablity and treatment of Divya-Swasari-Coronil-Kit has constructive and beneficial implications on psychological health, Quality of life and demographic factors. In addition, web-based patient-reported perspectives may well be a feasible way to provide better insights into treatment satisfaction, in relation to psychological health and Quality of life.

اثربخشی درمان مبتنی بر پذیرش و تعهد بر اضطراب، افسردگی و نشانه های جسمانی افراد مبتلا به درد مزمن

Background and Objective: Chronic pain is among the most common causes of referring to primary medical care centers. The aim of this study was to determine the effectiveness of acceptance and commitment therapy on anxiety, depression, and physical symptoms in patients with chronic pain. Materials and Methods: This study was a quasi-experimental study with pre-test, post-test, follow-up, and a control group. Participants included 60 patients with chronic pain who were referred to medical centers in Tehran in 2019, who were selected in a two steps sampling method. First, a questionnaire was circulated among patients with chronic pain at medical centers who were selected via convenience sampling method. Then, 60 participants were randomly selected from patients who received the highest scores, then randomly assigned to intervention (30 patients) and control (30 patients) groups. Data were collected using the Beck Depression Inventory and Beck Anxiety Inventory. The experimental group received acceptance and commitment therapy in eight sessions of 90 minutes once a week for two months, but the control group did not receive any treatment. Both groups responded to the research questionnaires in three stages: pre-test, post-test, and two-month follow-up. Data analysis was performed using repeated measure ANOVA using SPSS software version 22. Results: The mean (SD) age of participants in the experimental group was 43.7 (8.9) and in the control group 45.2 (9.2). In the experimental group, the mean (SD) depression score decreased from 32.6 (4.4) in the pre-test to 23.2 (5.1) in the post-test, and 22.1 (5.2) follow-up (P<0.001) and the mean (SD) anxiety score decreased from 33.6 (4.9) in the pre-test to 22.6 (4.2) in the post-test and 22.6 (5.1) in follow-up (P<0.001) and the mean (SD) of physical symptoms decreased from 41.5 (3.2) in the pre-test to 33.7 (3.1) in the post-test and 31.8 (3.3) follow-up stages (P<0.001). In the control group, the scores in the three stages of pre-test, post-test and follow-up were not different. Conclusion: Acceptance and commitment therapy was effective in reducing anxiety, depression and physical symptoms in patients with chronic pain.

The Efficacy of Web and Mobile-Based Interventions to Alleviate Physical Symptoms in People with Advanced Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (GP750)

• Describe how web and mobile-based symptom management interventions may alleviate physical symptoms in patients with advanced, life limiting illness.• Describe the inclusion criteria, search strategy and analysis used in a meta-analysis of web and mobile-based symptom management interventions of physical symptoms in patients with advanced, life limiting illness. Web and mobile-based interventions are promising modalities in which patients with advanced, life-limiting diagnoses can attain symptom-focused care as part of comprehensive palliative care. Systematically review and meta-analyze studies to summarize evidence on the effectiveness of web or mobile-based interventions impacting physical symptoms in patients with advanced, life-limiting diagnoses. Titles and abstracts published from 2004-2019 were identified using PubMed, PsycINFO, and CINAHL. RCTs involving adults with advanced, life-limiting diagnoses using a web or mobile-based intervention to manage their disease or symptoms were included. Interventions must have reported physical symptom outcomes. Risk of bias was assessed using the ROBINS-I tool. Studies that reported mean scores for physical symptoms using validated tools for the intervention and control groups were analyzed. These scores were pooled using a random effects model, and standardized mean difference (SMD) and 95% confidence intervals were reported. Heterogeneity was assessed using the I2 statistic. Eleven of the 1177 screened studies met the inclusion criteria. Interventions focused on five diagnoses (Cancer n=7, COPD n=3, Parkinson’s Disease n=1, Multiple Sclerosis n=1, Post-Polio Syndrome n=1). Intervention components included: general information, messaging a provider, tracking/monitoring, and feedback/tailored information. Eight studies evaluated physical symptoms using a multi-symptom tool and three evaluated specific symptoms (e.g. pain or fatigue). Web or mobile-based interventions significantly improved physical symptoms (SMD -0.34, -0.64 to -0.03, I2=88%). A subgroup analysis including studies using a multi-symptom tool observed a similar trend in improvement of physical symptoms (SMD -0.48, -0.86 to -0.09, I2=91%). This meta-analysis demonstrated that web and mobile-based symptom management interventions are effective modalities to alleviate physical symptoms in adults living with advanced, life-limiting diagnoses. Significant heterogeneity was noted among included studies.

Alexithymia, empathy, negative affect and physical symptoms in patients with asthma.

Although alexithymia has been found to be associated with physical symptoms in psychosomatic disorders such as asthma, mechanisms linking this association are unknown. However, affective alexithymic features may be associated with physical symptoms in the presence of deficits in affective characteristics such as low empathy and high negative affect. This study aimed to assess direct effects of alexithymic traits on physical symptoms and indirect effects of these subscales through empathy and negative affect (e.g. depressive, anxious and stress symptoms) by controlling for asthma severity in patients with asthma. Three hundred patients with asthma completed the Toronto Alexithymia Scale-20 (TAS-20), the Basic Empathy Scale (BES), the Depression Anxiety Stress Scales-21 (DASS-21) and the Physical Symptoms Inventory (PSI). After controlling for asthma severity, the results showed that alexithymia subscales of the TAS-20 had no direct effects on physical symptoms, but the difficulty in identifying feelings (DIF) subscale of the TAS-20 was associated with affective empathy and negative affect. Affective empathy was significantly related to negative affect. Affective empathy and negative affect were associated with physical symptoms. The affective subscale of alexithymia on the TAS-20, that is DIF, indirectly affected physical symptoms through affective empathy and negative affect. Findings suggest that patients with asthma who have high levels of DIF may show high physical symptoms in the presence of low affective empathy and high negative affect.

Family intensive care unit syndrome: An integrative review

Background:Hospitalization in the Intensive Care Unit (ICU) brings about psychological and physical symptoms in patients' family members. Family Intensive Care Unit Syndrome (FICUS) is a term used to explain the psychological symptoms of the family of a patient in response to the patient's admission to the ICU. The purpose of this study was to define FICUS along with its symptoms and predictors.Materials and Methods:The Web of Science, PubMed, Scopus, Google Scholar, and SID databases were searched for literature published in 2005–2018 with the keywords “FICUS,” “intensive care unit,” “family,” “caregivers,” “anxiety,” “depression,” and “post-traumatic stress disorder” in their title and abstract. The strategy for conducting an integrative review provided by Whittemore and Knafl (2005) was used in this study.Results:Twenty articles were included in the final data analysis. Following the patient's admission to the ICU, family members experience multiple psychological symptoms such as FICUS. The most commonly reported symptoms were anxiety, depression, post-traumatic stress disorder (PTSD), complicated grief, sleep disorder, stress, and fatigue. The low education level, having a critically-ill spouse, adequate support, financial stability, preference for decision-making, understanding of the disease process, anxiety, depression, or previous acute stress were predictors of FICUS.Conclusions:On the basis of the results, families also experience physical symptoms, so the FICUS is not limited to the occurrence of psychological symptoms. This study found that there is no universal definition for the term “FICUS” in the research literature. Thus, further research is needed to explore FICUS in the health field.

Surgical impact on anxiety of patients with breast cancer: 12-month follow-up prospective longitudinal study.

PurposeBreast cancer diagnosis and treatment often produce stress in patients. Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment.MethodsThis is prospective cohort study. Between July 2010 and July 2011, we recruited patients with nonmetastatic breast cancer who were expected to receive adjuvant chemotherapy (n = 411) from 2 cancer hospitals in Seoul, Korea. Anxiety was measured using the Hospital Anxiety and Depression Scale.ResultsThe mean age of the participants was 46.4 ± 7.9 years. Preoperatively, 44.5% (183 of 411) of the patients showed abnormal anxiety. The proportion of the abnormal anxiety group significantly decreased after surgery (P < 0.01) and this phenomenon continued until the 12-month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative months 6 and 12.ConclusionSurgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient's physical symptoms is important.

The Presence of Physical Symptoms in Patients With Tinnitus: International Web-Based Survey.

BackgroundTinnitus, or ringing in the ears, is a phantom perception of sound in the absence of overt acoustic stimulation. Many patients indicate that the perception of their tinnitus is not constant and can vary from moment to moment. This tinnitus fluctuation is one of the diagnostic criteria for somatosensory tinnitus (ST), a tinnitus subtype that is influenced by cervical spine or temporomandibular dysfunctions, although various factors have been reported to cause fluctuations in tinnitus, such as stress, anxiety, and physical activity.ObjectiveThe aim of this study was twofold: (1) to investigate the presence of physical symptoms in a large group of participants with tinnitus and (2) to investigate if these physical symptoms are more frequently present in a subgroup of participants with ST.MethodsA Web-based survey, questioning the presence of physical symptoms in a convenience sample of participants with tinnitus, was launched on the online forum, Tinnitus Talk, managed by Tinnitus Hub. After a general analysis of the physical symptoms present in our survey population, we further analyzed the group of participants who were diagnosed by a physician (n=1262). This subgroup was divided into 2 groups, one group diagnosed with ST and another group diagnosed with other types of tinnitus.ResultsIn total, 6115 participants with a mean age of 54.08 years (SD 13.8) completed the survey. Physical symptoms were frequently present in our sample of participants with tinnitus: 4221 participants (69.02%) reported some form of neck pain, 429 (7.01%) were diagnosed with temporomandibular disorders, 2730 (44.64%) indicated they have bruxism, and between 858 and 1419 (14.03%-23.20%) participants were able to modulate their tinnitus by voluntary movements. ST was diagnosed in 154 out of 1262 (12.20%) participants whose tinnitus cause was diagnosed by a physician. Symptoms referring to the known diagnostic criteria were evidently more present in the ST group than in the non-ST group. Additionally, participants with ST more often indicated a negative effect of a bad night’s sleep (P=.01) and light intensity exercise (P=.01).ConclusionsPhysical activity and movement (disorders) frequently affect tinnitus severity. Head-neck related symptoms are more frequently reported in the ST group, as is the ability to modulate the tinnitus by head or jaw movements. Additionally, participants with ST more often report fluctuations of their tinnitus and reaction to sleeping difficulties and low intensity exercise.

Effects of Mindfulness-Based Stress Reduction on Depression, Anxiety, and Pain in Patients With Postherpetic Neuralgia.

The aim of this study was to explore the effects of mindfulness-based stress reduction (MBSR) on reducing the psychological and physical symptoms in patients with postherpetic neuralgia (PHN). A total of 50 patients with PHN from January 2017 to September 2018 were selected into the intervention group and the control group. Both groups received routine care, whereas the intervention group also was given an 8-week of MBSR. Psychological (depression and anxiety) and physical (pain) symptoms were assessed before and after the intervention. The study demonstrated evidence of MBSR effectiveness in reducing depression (p < 0.01), anxiety (p < 0.01), and pain (p < 0.01) scores after intervention for herpetic patients with neuralgia. MBSR can effectively alleviate depression, anxiety, and pain in patients with PHN. Our results provide clinical effectiveness evidence that MBSR works to improve the psychological and physical symptoms with the greatest improvement occurring during the 8-week program.

Abstract 140: Predictors of Patient Self-Advocacy (PSA) in Heart Failure (HF)

Objective: Patients with heart failure self-manage by communicating with various providers. Knowing what impacts patient communication must inform how providers relate to these chronically ill patients. Patients are becoming more assertive. Providers and organizations are asking them to be more assertive. The American Heart Association literature, “Heart-to-heart: Talking to Your Doctor [Healthcare Provider]” (AHA, n.d.) stresses direct communication.and asking questions which is a form of self-advocacy (AHA, n.d.). Self-advocating, or speaking-up, involves gaining and using knowledge to assertively communicate and make decisions (Brashers, 1999). Investigating what influences PSA in patients with heart failure, who access providers and the system frequently, can help us better understand this evolving behavior. Without PSA interventions cannot be individualized or targeted in ways that patients feel are important and are therefore willing to adhere to. The purpose of this study was to examine the direct and indirect effects of PSA and its predictors of trust in nurses and social support on psychological distress and physical symptoms in patients with chronic heart failure. Seven hypotheses were tested relating to the indirect and direct relationships between variables. Design: A cross-sectional, path analysis design was used to test two models. The distal outcomes of psychological distress and physical symptoms were separated into two models. IRB approval was obtained. Surveys were collected from a convenience sample of 80 HF clinic out-patients. (This is the quantitative strand of a mixed methods study. The qualitative strand analysis will be complete at time of conference). Population Studied: Eighty adults from one out-patient clinic with a diagnosis of HF for 3+ months who have had at least two visits at the out-patient care clinic participated. Findings: Neither of the two models tested fit the study data as hypothesized. A respecified model was tested and fit the data well (chi square 9.452, df 6, p .105, RMSEA .085). Trust in nurses directly influenced PSA knowledge. Social support directly influenced PSA assertiveness. And social support directly influenced depressive symptoms. Conclusions: Nurses have a direct relational role in helping patients use knowledge to speak-up. Nurses have a role in helping patients access and take advantage of social support so that patient assertiveness can be enhanced. Implications: Trusting providers and social support is important to patient self-advocacy. Interventions designed to increase trust in provider, increase social support and social skills may have a positive impact on a patient’s level of self-advocacy. The outcomes of PSA in patients with heart failure need to be studied further.The outcomes of PSA in patients with heart failure need to be studied further.

Global and Multidimensional Symptom Assessments in Patients Presenting Abdominal Neoplasms

Objective: To evaluate symptoms among patients with abdominal cancer and associated factors. Materials and methods: A cross-sectional study with 100 patients. The prevalence of symptoms was evaluated through the Memorial Symptom Assessment Scale (MSAS) and its association with demographic and clinical variables using chi-square and ANOVA tests. Results: The most prevalent symptoms were weight loss (64.0 %), pain (56.0 %), dry mouth (50.0 %), “I do not look more myself” (48.0 %) and lack of energy (45.0 %). There was a significant difference between sex and high-frequency (PHYS-H) (p = 0.001) and low-frequency (PHYS-L) physical symptoms (p = 0.004), and for general scale (TMSAS) (p = 0.002); (p = 0.001), general range (p = 0.027) and borderline significance for the global scale (GDI) (p = 0.051); high-frequency physical symptoms (p = 0.022), low-frequency physical symptoms (p = 0.034) and the overall scale (p = 0.034). There was one major complaint regarding the severity of high-frequency physical symptoms in patients with liver cancer (p = 0.018). Conclusion: Symptoms of physical and psychological aspects in cancer patients were associated with gender, race, marital status and tumor location. There is a need for tools to assess symptoms and enable health professionals to intervene more effectively.

Medically unexplained physical symptoms in patients visiting the emergency department: an international multicentre retrospective study.

The objective of this study was to assess the incidence and characteristics of patients presenting with physical symptoms that remain medically unexplained at the emergency department (ED). A retrospective chart study was carried out in three hospitals in The Netherlands and Belgium. All patients (age > 18 years) visiting the ED in 4 selected weeks in 2013 at the Erasmus University Medical Center (Erasmus MC) in Rotterdam, The Netherlands, and 1 selected week in 2013 at the Haaglanden Medical Center, Westeinde HMC in The Hague, The Netherlands, and the University Hospital Ghent (UZG), Belgium, were included. Descriptive statistics were used for data analysis. A total of 2869 patients (Erasmus MC 1674, HMC 691, UZG 504) were included. Medically unexplained physical symptoms in the emergency department (EDMUPS) were present in 13.4% of all ED visits (Erasmus MC 12.5%, HMC 18.7%, UZG 9.1%). No EDMUPS were identified in trauma patients. When excluding trauma patients, EDMUPS were present in 18.5% (Erasmus MC 16.8%, HMC 26.5%, UZG 13.3%) of the visits. The characteristics of patients with and without EDMUPS differed significantly; patients with EDMUPS were more often younger, female, self-referred, frequent visitors, were prescribed less medication and more often had a psychiatric disease. Dutch and Belgian Hospital differed in the distribution of patients in triage categories and in the incidence of psychiatric illnesses. Physical symptoms remain unexplained in a significant number of patients at the time of ED assessment.