Short Form Research Articles

Impact and Mechanisms of Cognitive Behavioural Therapy for Insomnia on Fatigue among Cancer Survivors: A Secondary Analysis of a Randomized Controlled Trial.

Cancer-related fatigue is one of the most common symptoms in cancer survivors. Cognitive behavioural therapy for insomnia (CBT-I) can improve fatigue, but mechanisms are unclear. This secondary analysis of a randomized controlled trial evaluated whether CBT-I led to a significant improvement in fatigue, accounting for change in comorbid symptoms of insomnia, perceived cognitive impairment (PCI), anxiety, and depression. The parent study evaluated the impacts of CBT-I on PCI and insomnia. Cancer survivors with insomnia and PCI were randomized to CBT-I or a sleep-self monitoring waitlist control. Fatigue was measured using the Multidimensional Fatigue Symptom Inventory - Short Form at pre-, mid-, and post-treatment. Significant improvement in fatigue was defined as a reduction >10.79 points. Insomnia, PCI, anxiety and depression symptoms were assessed. A linear mixed model evaluated whether CBT-I improved fatigue after adjusting for comorbidities. Mediation analyses examined whether change in comorbidities accounted for the effect of CBT-I on fatigue. The sample consisted of 132 cancer survivors (77% female, Mage=60.12 years, 41% breast cancer). There was a significant group-by-time interaction on fatigue, p<.001, with the CBT-I group experiencing a 20.6-point reduction in fatigue compared to 3.7-points in the control. Improvements in fatigue were fully accounted for by improvements in the comorbidities with change in insomnia accounting for 45.3% of the effect observed in fatigue. CBT-I resulted in significant improvement in fatigue, and these effects were largely accounted for by change in insomnia. CBT-I is a robust intervention with efficacy for improving fatigue among cancer survivors.

Quality of life, pain, depression, fatigue and sleep in patients with remission or mild fibromyalgia: a comparison with remission or low disease activity rheumatoid arthritis and healthy controls

BackgroundFibromyalgia is a chronic condition marked by widespread pain and various accompanying symptoms. Compared to healthy individuals and other rheumatic disease patients, it leads to more severe symptoms and a lower quality of life. Whether fibromyalgia patients in a mild activity or remission stage still experience core symptoms remains unclear.ObjectiveTo compare the severity of clinical symptoms and quality of life (QOL) in patients with remission or mild fibromyalgia (RFM) and remission or low disease activity in rheumatoid arthritis (RRA) patients and healthy controls (HCs) to investigate whether fibromyalgia in a stable stage can be disease-free.MethodsThis cross-sectional study evaluated a total of 266 RFM and 252 RRA patients and 50 HCs using Revised Fibromyalgia Impact Questionnaire (FIQR), Widespread Pain Index (WPI), Pain Visual Analogue Scale (VAS), Numerical Rating Scale, Multidimensional Fatigue Inventory (MFI-20), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI), and Short Form-36 Health Status Questionnaire (SF-36).ResultsThe FIQR total score and pain VAS, MFI, and PSQI scores were higher in RFM and RRA patients compared to HCs (P < 0.001). RFM patients had higher BDI and WPI scores than RRA patients (P < 0.001). The majority of RFM patients (97.4%) had more than two pain sites, with moderate-to-severe pain (78.2%), sleep disorders (85.0%), and depression (53.4%), all of which were significantly higher than those in RRA patients (P < 0.001). RFM patients also had lower scores in SF-36 physical and mental component summaries and subscores for role physical, pain index, general health perception, vitality, and mental health index, but a higher social functioning score than RRA patients (P < 0.001).ConclusionDespite being in a mild activity or remission stage, RFM patients experience more severe symptoms and poorer QOL than RRA patients. Therefore, individualized evaluation and intensive management are required.Trial registrationClinicalTrials.gov Identifier: NCT02449395, registered on May 20, 2015.

Self-Compassion and Psychosocial Well-Being After Traumatic Births: Caring for the Midwife.

Midwives report high rates of exposure to traumatic births that can negatively affect their psychosocial well-being. Self-compassion can be considered as a tool to promote psychosocial well-being. The aim of this study was to assess the prevalence of midwives' exposure to traumatic births and explore midwives' self-compassion and its correlation to their psychosocial well-being in relation to experiences of traumatic births. In a cross-sectional correlational study, data were collected using an electronic questionnaire by way of social networks and the website of the Israel Midwives Association. Inclusion criteria were certified Israeli midwives working in a hospital delivery room and able to read and write Hebrew. The questionnaire was composed of 4 parts: a demographic section, a traumatic events in perinatal care list, a self-compassion scale-short form, and a psychosocial health and well-being tool (short form of Copenhagen Psychosocial Questionnaire). The most common traumatic event reported was death. Self-compassion and psychosocial health and well-being were found to be at a medium-high level (mean [SD], 40.66 [6.5]; 38.33 [13.03]), and correlated significantly (r = 0.339; P <.001). There was a significant interaction effect between low self-compassion (mean, ≤3.17) and exposure to traumatic birth in the last year on psychosocial well-being compared with those who were not exposed to traumatic birth in the last year (F2,103 = 3.25; P =.043). No significant effect was found in those women with medium (mean, 3.18-3.67) or high (mean, ≥3.68) self-compassion. Self-compassion is related to the psychosocial health and well-being of midwives exposed to traumatic birth. Self-compassion can be learned and should be considered for inclusion in midwives' basic and continuing education.

The effect of psychiatric clerkship, educational phase, contact with mental illness and gender on stigma and mental health help-seeking attitude in medical students in Jordan

Background and aimsStigma is considered a significant barrier to help-seeking and it is more prominent in medical students. Studies exploring stigma and its impact on Attitude Towards Seeking Professional Psychiatric Help (ATSPPH) among medical students in Jordanian universities are scarce. In this paper, we aim to assess the level of stigma among Jordanian medical students and its relationship with help-seeking and other secondary factors.MethodsA cross-sectional study conducted through an online questionnaire on medical students in Jordan, the survey included validated psychometric tools Mental Health Clinicians Attitude 2 (MICA-2) and Attitude Towards Seeking Professional Psychiatric Help Short Form (ATSPPH-SF) in addition to sociodemographics. Stigma was analysed as a correlate of help-seeking using Spearman’s rank besides the non-parametric analysis of secondary factors.ResultsA total of 390 responses were analysed, 224 were females and 201 had experience with mental illness. There is an inverse relationship between stigma and ATSPPH p-value < .001. Jordanian medical students show relatively higher stigma compared to students from other nations. Females showed significantly less stigmatizing attitude p-value < .001 and more positive ATSPPH p-value < .001 compared to males. Individuals who encountered mental illness had significantly less stigma and more positive help-seeking behaviour compared to the opposite group. (p-value = .002 and p-value < .001) respectively. Completing a psychiatric clerkship had no impact on help-seeking.ConclusionMedical students in Jordan show a highly stigmatizing attitude compared with students from other nations. In parallel with the literature, females and students who experienced mental illness show less stigmatizing attitudes and more positive help-seeking behaviour.

Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study

BackgroundUrinary incontinence (UI) is a common and debilitating condition among people with multiple sclerosis (MS) and is more prevalent among women. Over the past decade, numerous studies have investigated the effects of pelvic floor muscle training (PFMT) as a treatment for UI in people with MS. MS negatively impacts pulmonary function even in the early stages of the disease and people with MS may experience respiratory muscle weakness. Considering the synergy between the pelvic floor muscle (PFM) and respiratory muscles, this trial will evaluate the effects of PFMT and breathing exercises on PFM activity and strength, diaphragm activity, and urinary symptoms in women with MS who experience UI.MethodsFifty women with MS and UI will participate in this parallel randomized controlled trial, comprising 32 treatment sessions. The intervention group consists of PFMT and breathing exercises, and the control group includes PFMT. The severity of UI symptoms, PFM activity, diaphragm activity, and PFM strength will be evaluated using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, ultrasound imaging, and modified Oxford grading scale, respectively before and after the intervention.DiscussionThe current trial is designed to examine the effects of a combined exercise program for UI in women with MS. It is hypothesized that using breathing exercises in conjunction with PFM exercises will improve patient symptoms compared to PFMT alone.Trial registrationThe trial was registered in the Iranian Registry of Clinical Trials with code IRCT20180916041051N3 and was approved on 23 May 2024.Graphical

Health-related quality of life at diagnosis and follow-up in Faroese and Danish patients with inflammatory bowel disease – a Faroese IBD cohort study

Background and aims Patients with inflammatory bowel disease (IBD) have lower health-related quality of life (HRQoL) than the general population. The highest incidence and prevalence rates of IBD in the world are found in the Faroe Islands, however, the HRQoL of Faroese patients is unknown. This study aimed to determine their HRQoL at diagnosis and two years of follow-up in comparison with Danish patients. Methods All patients (15 years or older) were invited to answer the Short Form 12 questionnaire (SF-12) and Short Inflammatory Bowel Disease Questionnaire (SIBDQ) at diagnosis and follow-up. Faroese patients were included from 2010 to 2022, and Danish patients in 2010. Results 160 Faroese patients and 160 Danish patients completed questionnaires twice. For Faroese patients with IBD, the physical and mental component summary scores (SF-12) significantly improved from 46.6 and 44.0 to 49.4 and 47.7, respectively. Total SIBDQ scores also improved from 46.6 to 53.9. However, Faroese patients had significantly lower scores at diagnosis of social functioning, mental health, and mental component summary (SF-12) as well as lower emotional scores (SIBDQ) compared with Danish patients. Conclusions Faroese patients with IBD improved their HRQoL from diagnosis to follow-up, although greater improvements were observed for Danish patients. Increased awareness of the HRQoL of this patient group is warranted as Faroese patients had lower mental and emotional scores than Danish patients at diagnosis.

Takeaway food consumption and depressive symptoms in Chinese university students: mediating effects of physical activity

BackgroundThe consumption of takeaways is becoming increasingly prevalent. Despite this, the relationship between takeaway food consumption and depressive symptoms in Chinese populations has not been clarified. Furthermore, the factors that mediate the association between takeaway frequency and depressive symptoms are unknown.MethodsQuestionnaires were employed to collect data from 6,417 new students at Chongqing Medical University in the autumn of 2023, including sociodemographic information, takeaway frequency, physical activity levels (measured by the International Physical Activity Questionnaire Short Form), and depressive symptoms (measured by the Patient Health Questionnaire-9). Multiple linear regression and mediation analysis were performed. Multiple imputations were used to fill in missing data through sensitivity analyses.ResultsAmong 6417 participants, 2,606 (40.6%) students ordered takeaway at least once a week, with 235 (3.7%) of them ordering takeaway food every day. Takeaway frequency was significantly associated with depressive symptoms (β=0.034, P=0.006), and physical activity partially mediated this relationship (95% bootstrap confidence interval=0.0024, 0.0371).ConclusionsThe study highlights the negative relationship between takeaway frequency and emotional well-being, emphasizing the need to focus on the emotional health of frequent takeaway food consumers. Moreover, our study suggests that increased physical activity may alleviate takeaway-induced mood-related outcomes.

Assessing the relationship between the distress levels in patients with irreversible terminal delirium and the good quality of death from the perspective of bereaved family

BackgroundResearch on achieving a good death for terminally delirious patients is scarce, with limited knowledge about the level of good death and influencing factors. This study investigates the level of good death among delirium patients, factors influencing it, and the correlation between distress, end-of-life care needs, and achieving a good death by surveying bereaved family members of deceased patients in Chinese hospitals.MethodsThis cross-sectional study from January 2022 to January 2024 was conducted among bereaved family members of patients using an online questionnaire. The questionnaires consisted of (1) participants’ demographic and disease-related questionnaires; (2) the Good Death Inventory (GDI) China version; (3) Terminal Delirium-Related Distress Scale (TTDS) China version; (4) the Care Evaluation Scale - short form (CES) China version. All data were analyzed using descriptive statistics, and the associated factors influencing good death were analyzed by multiple linear regression analyses.ResultA total of 263 subjects were enrolled. More males (63.5%) participated than females (36.5%), the mean age was 75.35 ± 13.90 years. Good quality of death was significantly and negatively related to the distress in patients with irreversible terminal delirium (r = -0.458, P<0.01).The multiple linear regression model indicates that TDDS score, CES score, types of diseases, smoking history, nutritional deficiency are important factor affecting the good quality of death.ConclusionsThe good quality of death from the perspective of bereaved family, a negative correlation was found between the distress in patients with irreversible terminal delirium and good death. Medical staff should be more aware of good quality of death in patients, future research should expand sample sizes to include more demographic data, and explore the concept of a good death across different cultural contexts.

Robotically Assisted vs. Manual Total Hip Arthroplasty in Developmental Hip Dysplasia: A Comparative Analysis of Radiological and Functional Outcomes

Background/Objectives: Developmental dysplasia of the hip (DDH), defined by the malalignment of the femoral head and acetabulum, is a major precursor to coxarthrosis, posing substantial challenges during total hip arthroplasty (THA). Patients with coxarthrosis secondary to DDH often exhibit acetabular bone insufficiency, which makes challenging surgical reconstruction difficult. This study aimed to compare the radiologic and functional outcomes of robotically assisted and conventional manual THA techniques in patients with coxarthrosis secondary to Crowe type III–IV DDH. Methods: This prospective study included 40 patients divided into robotically assisted (n = 20) and conventional manual (n = 20) THA groups. Evaluations encompassed hip pain (Visual Analogue Scale, VAS), function (Harris hip score and University of California, Los Angeles, activity scale), quality of life (Short Form-12), and prosthesis sensation (Forgotten Joint Score-12). Radiologic outcomes included acetabular inclination and anteversion angles. Femoral shortening, operative duration, and follow-up times were also analyzed. Results: Demographic characteristics did not differ between groups (p &gt; 0.05). Robotically assisted THA exhibited a significantly longer operative time (171.40 ± 11.96 vs. 150.30 ± 14.67 min; p = 0.001) but a shorter follow-up (29.3 ± 8.51 vs. 52.95 ± 18.96 months; p = 0.001), without a difference in the amount of femoral shortening (p = 0.947). Despite the extended surgical duration, the two techniques achieved comparable radiologic outcomes, with no significant differences in acetabular inclination or anteversion angles (p &gt; 0.05). Functional assessments, including Harris hip scores (73.85 vs. 73.95; p = 0.978), UCLA activity scores, and VAS, indicated similar efficacy between groups. SF-12 physical and mental quality of life and Forgotten Joint Score-12 prosthesis sensation did not differ between groups (p &gt; 0.05). Conclusions: This study concludes that robotically assisted and conventional manual THA present similar radiologic and functional outcomes in patients with coxarthrosis secondary to Crowe type III–IV DDH, as displayed by comparable acetabular anteversion and inclination alignment, femoral shortening, hip function, pain, quality of life, and prosthesis sensation scores. While robotically assisted THA requires a longer operative time, its precision in implant placement may hold potential advantages for long-term outcomes, demanding further investigation in extended follow-up studies.

Burden of caregivers of older people in Sri Lanka: an overlooked concern in the health care system

BackgroundCaring for older people has become a significant public health concern in Sri Lanka due to the growing aging population. This has placed a heavy burden on family caregivers, particularly those caring for older individuals with multiple chronic conditions. Recognizing this challenge, the present study aimed to evaluate the psychometric properties of the Sinhala version of the 10-item short form of the Burden Scale for Family Caregivers (BSFC-s) and assess caregiver burden and associated factors among caregivers of older people aged over 65 years with multimorbidity.MethodsThe BSFC-s was cross-culturally adapted following standard guidelines and administered to consecutively selected 178 family caregivers involved in the long-term care of older patients (aged ≥ 65 years) who were regular attendees of medical and neurology clinics at the National Hospital Galle, Sri Lanka. The validated Sinhala version of the Short Form-36 questionnaire (SF-36) was also administered simultaneously. After two weeks, 60 caregivers were re-assessed using the BSFC-s. The psychometric properties, including reliability and validity, as well as floor and ceiling effects, were evaluated. The final version of the BSFC-s was then administered to 270 informal family caregivers in the Gampaha District, Sri Lanka.ResultsThe study revealed that the internal consistency of the Sinhala version of the BSFC-s, measured by Cronbach’s alpha, was 0.90, with item-total correlations ranging from 0.38 to 0.82. The test-retest reliability, assessed using the intra-class correlation coefficient, was 0.99 (95% CI: 0.99-1.00; p < 0.001). Principal component analysis revealed two factors explaining 65.8% of the cumulative variance. BSFC-s scores showed a strong negative correlation with SF-36 scores (r = -0.81, p < 0.001), indicating a good concurrent validity. Neither floor nor ceiling effects were observed. Among the 270 family caregivers, 78.1% reported a high level of burden, while 21.1% reported moderate burden. Caregiver burden was significantly associated with low educational level (p = 0.032), low monthly income (p = 0.041), and unemployment status (p < 0.001) of the caregiver.ConclusionThe Sinhala version of the BSFC-s demonstrated strong reliability and validity, making it a suitable tool for assessing caregiver burden in Sri Lanka. Most caregivers reported high levels of subjective burden, particularly those with lower socio-demographic status.Trial registrationNot applicable.

A study of Filipina migrant workers’ subjective health in Hong Kong and an assessment of eight scoring methods for the 12-Item Short Form Health Survey (SF-12)

ObjectivesThe SF-12 version 2 is a survey instrument for collecting data on subjective health. The US-based scoring method is the recommended standard for measuring subjective health with data collected with this instrument. The inadequacy of the US-based scoring method of the SF-12 version 2 instrument for non-US populations is widely documented. However, few studies systematically assessed relative performance of alternative scoring methods against the US-based method, our main objective in this paper. Through this investigation, we also intend to shed light on Filipina migrant workers’ subjective health in Hong Kong, our case study.MethodsThis study investigates the feasibility of eight such scoring methods—six latent-variable models, the raw score index, and the US-based method—for analyzing an SF-12 version 2 instrument via a range of bootstrapped samples of varying sizes and an empirical study of the original 2017 Hong Kong Domestic Workers survey data with a set of covariates associated with Filipina migrant domestic workers’ subjective mental and physical health in Hong Kong.FindingsOur analyses favor the latent-variable factor model with the normal distribution and the identity link for analyzing the SF-12 version 2 type of data. Our empirical study of the survey data provides evidence for the beneficial effects of education, social support, and positive working conditions on migrant domestic workers’ subjective physical health and especially subjective mental health, with these two types of health analyzed jointly on the same measurement scale.ConclusionFor studying non-US populations with the SF-12 version 2 instrument, we recommend using the latent confirmatory factor analysis model that assumes a normal distribution and an identity link function for analyzing the MCS and PCS dimensions simultaneously.

Dyadic effects of illness perception and maladaptive cognitive-emotional regulation strategies on the fear of cancer recurrence in breast cancer patients and spouses: an actor-partner interdependence mediation model

PurposeBreast cancer, as a stressful event, profoundly impacts the entire family, especially patients and their spouses. This study used a dyadic analysis approach to explore the dyadic effects of illness perception on the fear of cancer recurrence (FCR) and whether maladaptive cognitive-emotional regulation strategies acted as a mediator in breast cancer patient-spouse dyads.MethodsThis was a cross-sectional study, and 202 dyads of breast cancer patients and their spouses were enrolled. Illness perception, maladaptive cognitive-emotional regulation strategies, and FCR were assessed by the Brief Illness Perception Questionnaire (BIPQ), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF), respectively. Data were analyzed using the actor-partner interdependence mediation model.ResultsThis study found that, for patients and spouses, maladaptive cognitive-emotional regulation strategies mediated the actor effects of illness perception on FCR. That is, illness perception was positively related to their maladaptive cognitive-emotional regulation strategies, which increased the risk of FCR. Another important finding was that patients’ illness perception had significant direct and indirect effects on spouses’ FCR through spouses’ maladaptive cognitive-emotional regulation strategies.ConclusionsNegative illness perception perceived by patients and spouses can increase their FCR by adapting their maladaptive cognitive-emotional regulation strategies. Furthermore, illness perception perceived by patients can also increase spouses’ FCR through spouses’ maladaptive cognitive-emotional regulation strategies. Medical staff should identify vulnerable patients and spouses with higher illness perception and maladaptive cognitive-emotional regulation strategies and make focused interventions to decrease the risk of FCR of both breast cancer patients and their spouses.

Influence of kinesiophobia on activity, function, and anxiety levels in patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disorder that causes joint inflammation and affects quality of life. Appropriate physical activity can enhance joint function and lower cardiovascular disease risk. However, individuals with RA often have reduced physical activity levels, likely due to kinesiophobia, or fear of movement.AimThis study aimed to assess the prevalence of kinesiophobia among RA patients and its influence on functional impairment, physical activity, and pain-related anxiety.MethodsUsing a convenience sampling method, we surveyed 350 RA patients attending outpatient clinics in the rheumatology and immunology departments of three tertiary hospitals in Henan Province, China, from August 18 to September 1, 2023. Participants completed the Tampa Scale of Kinesiophobia (TSK), the Signals of Functional Impairment Scale (SOFI), the International Physical Activity Scale—Short Form (IPAQ-SF), and the Pain Anxiety Symptoms Scale-20 (PASS-20). The Disease Activity Score 28 (DAS28) was retrieved for each participant to assess disease activity in RA patients. Descriptive analysis, Chi-square tests, Spearman correlation, and multiple linear regression assessed factors influencing kinesiophobia, with significance set at p &amp;lt; 0.05.ResultsResults indicated that 70.86% of participants experienced kinesiophobia, which was positively correlated with functional impairment and pain-related anxiety, while inversely related to physical activity levels (p &amp;lt; 0.001). Regression analysis revealed that kinesiophobia was explained by 65.5% of the variance, with gender, education level, functional impairment, pain-related anxiety, and pain severity identified as significant predictors (p &amp;lt; 0.05).ConclusionThe findings suggest that RA patients exhibit a high prevalence of kinesiophobia, predominantly influenced by factors such as gender, lower educational attainment, increased pain levels, greater functional impairment, and pain-related anxiety. Notably, physical activity levels did not serve as a predictor of kinesiophobia in this cohort.

Assessment of Quality of Life and Psychological Well-Being in Italian Adult Subjects with Prader–Willi Syndrome Using the Health Survey Short Form and the Psychological General Well-Being Index Questionnaires

Background/Objectives: Prader–Willi syndrome (PWS) is a rare, genetically determined neurodevelopmental disorder. Individuals with PWS face numerous challenges that significantly impact their psychological well-being and quality of life, ultimately limiting their personal and social functioning. This study aimed to evaluate the quality of life and psychological well-being in a sample of Italian adult patients with PWS compared to an age-matched control group of normal-weight Italian individuals. Methods: Thirty patients with PWS (11 men and 19 women; mean age ± SD: 36.4 ± 10.31 years; mean Body Mass Index (BMI: 35.7 ± 8.92 kg/m2) and thirty Italian adult individuals from the general population (5 men and 25 women; mean age ± SD: 32.1 ± 6.86 years; mean Body Mass Index (BMI: 21.8 ± 2.90 kg/m2) were studied. Quality of life and well-being were assessed using the Italian versions of the 36-item Health Survey Short Form and the Psychological General Well-Being Index. Results: Normal-weight subjects scored significantly higher than PWS patients on the physical health (p &lt; 0.001) and social functioning (p = 0.047) subscales of the SF-36. Conversely, PWS patients scored higher on the vitality subscale (p &lt; 0.001). Similarly, the vitality subscale of the PGWBI was significantly higher in PWS patients than in controls (p = 0.010), whereas the Self-Control subscale of the PGWBI was higher in controls compared to PWS patients, albeit not statistically significant (p = 0.057). Discussion: Patients with PWS exhibited impairments in various aspects of quality of life and psychological well-being, including physical, behavioral, and social domains. However, the higher vitality scores observed in PWS patients suggest a preserved dimension of their psychological well-being. Conclusions: These findings enhance the understanding of the psychological condition of patients with PWS and provide valuable insights for improving multidisciplinary psychological treatment approaches for these individuals.

Mobile-based in-home telerehabilitation compared with in-hospital face-to-face rehabilitation for elderly patients after total hip arthroplasty in China's level 1 trauma center: a noninferiority randomized controlled trial

BackgroundTelerehabilitation is gaining popularity in European and American countries, but whether it can be successfully implemented in China still lacks support from clinical studies.ObjectiveThis trial aimed to determine if a home-based telerehabilitation method is clinically noninferior to standard in-hospital face-to-face rehabilitation for elderly patients with total hip arthroplasty (THA) in China.MethodsThis multicenter randomized controlled trial was conducted from January 2021 to June 2022 at The First Rehabilitation Hospital in Shanghai, Shanghai Jiao Tong University affiliated Sixth People's Hospital and Shanghai Tongji University affiliated Tenth People's Hospital. Sixty-four patients were recruited for this two-arm, single-assessor blinded, randomized controlled trial. The participants were randomly assigned to the in-home telerehabilitation group (TELE group) and the in-hospital physical therapist in-person group (PT group). The intervention consisted of a 12-week home-based rehabilitation program with video instructions and remote coaching on a mobile APP (TELE group). The PT group received a standard in-hospital rehabilitation intervention assisted by a physical therapist for one month and outpatient clinic for the next two months. Patients were evaluated at baseline, 4 weeks, and 12 weeks postoperatively employing functional tests (Timed Up &amp;amp; Go test and Berg balance test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score (HOOS) and Short Form 12 (SF-12)).ResultsThere was no significant difference between the two groups for the demographic and clinical characteristics. 61 participants were analyzed (PT group: n = 31, women: 48.4% of participants; TELE group: n = 30, 33.3% of participants) whose median age was 70 and 69 years, in PT group (IQR: 63–73) and TELE group (IQR: 66–72) respectively. At 12 weeks follow-up evaluation, the main differences between the two groups regarding the HOOS gains, adjusted for baseline values, were close to zero (P &amp;gt; 0.05). There was no significant difference in primary and secondary outcome measures between the two groups.ConclusionOur results showed the noninferiority of in-home telerehabilitation and advocated its application as a reliable alternative to in-hospital face-to-face rehabilitation for patients who underwent THA.Clinical Trial Registrationhttps://www.chictr.org.cn/, Chinese Clinical Trial Registry (Number: ChiCTR1900025825).

Health-related quality of life following cranioplasty: a cross-sectional cohort study – Cranio-PRO

Cranioplasty is an operation that aims to repair a defect in the skull. Indications commonly include Traumatic Brain Injury (TBI), tumours, and infections. It carries a high rate of postoperative morbidity. Due to underlying pathology and the nature of the operation patients’ Health-related Quality of life (QoL) can be severely affected. Patient reported outcomes (PROs) are poorly understood following cranioplasty. To investigate PROs following cranioplasty a cross-sectional cohort study of adults undergoing cranioplasty between 01/03/2010–30/08/2020 was conducted. If consent was provided, participants were sent five health reporting questionnaires: a study specific questionnaire, EuroQoL – 5D – 5L (EQ-5D-5L), RAND Short-Form 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), and Derriford Appearance Scale (DAS-24). 239 eligible patients were contacted and 72 (30.8%) participated. Median [Range] age was 52.5 [23 – 95] of which 59.7% (n= 43) were male. 16.9% (n = 12) were categorised with borderline and 29.0% (n = 20) with extreme depression, 15.9% (n = 11) reported borderline and 35.2% (n = 25) extreme anxiety. 69.1% (n = 47) had problems with usual activities and 71.6% (n = 49) suffered from pain/discomfort. Median (Range) EQ-5D-5L visual analogue scale score for overall health was 70.0 (5–100). 76.0% (n = 53) reported feeling conscious or having negative feelings towards their appearance. When compared to normative UK population, physical functioning, overall health, and energy/fatigue were the most affected. After cranioplasty, patients may have reduced HRQoL. Signposting and referral to well-being services could benefit patients’ care. Adequately powered longitudinal studies are required to further elucidate change in PROs following cranioplasty.

The Effect of an Individualized Informational Intervention on the Quality of Life, Adherence and Psychosocial Economic Status of Patients with COPD: A Research Protocol

Introduction: Chronic obstructive pulmonary disease (COPD) has a diverse negative impact on patients, affecting them both physically and mentally. Psychosocial factors such as anxiety, depression, social isolation, and financial stress have been found to be positively associated with more exacerbations, hospital readmissions, poor adherence to medication, and lower quality of life among patients with COPD. However, healthcare professionals, who have a crucial role in diagnosing and managing COPD, often overlook these psychosocial factors of the disease, despite growing evidence suggesting their crucial role in improving disease outcomes. Consequently, this study will evaluate the effectiveness of a personalized individualized informational intervention on the quality of life, adherence, and psychosocial economic status of patients with COPD in healthcare settings of Greece. Methods: A prospective, mixed-methods design will be used, incorporating both quantitative data through questionnaires, including the Short Form (SF-12), Clinical COPD Questionnaire (CCQ), Test of Adherence to Inhalers (TAI), Patient Health Questionnaire (PHQ-4), Multidimensional Scale of Perceived Social Support (MSPSS), and Financial Ability Scale (FAS), alongside qualitative data with questions exploring themes such as general health perception, treatment adherence, mental status, socioeconomic status, and disease management. Participants will consist of patients receiving care at primary healthcare facilities and respiratory hospital departments in Crete, Greece. The intervention will involve providing structured information on social, financial, and psychological support services, along with psychosocial counseling over a six-month period. The impact of the intervention will be measured using validated tools to assess health status, quality of life, treatment adherence, mental health, and socioeconomic status before and after the intervention. Conversely, qualitative interviews will be conducted to gain deeper insights into the impact of the intervention. Finally, when the analyses of both data types are finalized, they will be triangulated to achieve convergence. This procedure entails the creation of a figure or illustration that demonstrates the convergence or divergence of both data types. Conclusions: The findings of this study are expected to highlight the importance of integrating an individualized informational intervention into the management of COPD. Thus, this study could guide healthcare professionals and policymakers in improving COPD care and patient outcomes.

Comparing the effects of computerized versus manual methods of identifying point-specific acupuncture as an adjunct to physiotherapy in the management of knee osteoarthritis: A randomized controlled trial protocol.

Knee osteoarthritis (KOA) is a prevalent condition causing significant pain and functional impairment. Acupuncture has shown promise as an adjunctive therapy, but conventional manual selection of acupoints lacks standardization. The Acugraph system provides a computerized method for identifying acupoints, potentially enhancing treatment precision. This study aims to compare the effects of computerized Acugraph-guided acupuncture versus manually selected acupuncture as adjuncts to physiotherapy in managing KOA. A randomized, double-blind controlled trial will be conducted with 50 participants diagnosed with mild to moderate KOA. Participants will be randomly assigned to one of two groups: Group 1 Comp-AcuPhysio (n = 25), receiving Acugraph-guided acupuncture with physiotherapy, or Group 2 Man-AcuPhysio (n = 25), receiving manually selected acupuncture with physiotherapy. Both groups will undergo 12 weekly treatment sessions, each lasting 60 minutes. Outcome measures, including the Knee Injury and Osteoarthritis Outcome Score, active knee flexion range, Timed Up and Go test, Visual Analog Scale for pain, Short Form-36 health survey, and Personal Integrated Energetics score, will be assessed at baseline and immediately post-intervention. An intention-to-treat analysis will be applied. Changes from baseline to 12 weeks will be analyzed using repeated measures analysis of variance for both within-group and between-group comparisons. This study will provide a definitive assessment of the effectiveness of computerized Acugraph-guided acupuncture compared to manually selected acupuncture as supplementary treatments alongside KOA physiotherapeutic rehabilitation. This trial will offer insights into how incorporating technology-driven approaches, such as Acugraph, with physiotherapy can enhance the customization and effectiveness of KOA management, leading to improved clinical outcomes. These results could advocate for the integration of technological tools in acupuncture to boost treatment precision and efficacy for KOA. Australian New Zealand Clinical Trials Registry (ACTRN12624000646549p).

Musculoskeletal Pain as a Risk Factor for Poor Dizziness Outcomes: A Longitudinal Study among Patients With Persistent Vestibular Dizziness.

Musculoskeletal pain and psychological distress are prevalent comorbidities in patients with persistent dizziness. Little is known about how comorbid pain influences the outcome of persistent dizziness. This study examined the impact of pain on dizziness outcomes and the potential modifying role of psychological distress. Longitudinal study of 150 patients with persistent dizziness. Vertigo Symptom Scale short form (VSS-SF), Dizziness Handicap Inventory (DHI), number of pain sites, pain intensity, and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, 6months and 12months. Linear mixed effects model for longitudinal data was used to explore the association between musculoskeletal pain and dizziness. Interaction analysis was used to assess whether psychological distress had a modifying effect on the association between pain and dizziness. VSS-SF and DHI decreased during follow-up but not to a clinically relevant level for the patients. Patients reporting comorbid psychological distress reported higher scores on VSS-SF, DHI, more pain sites and higher pain intensity. A positive association was observed between the number of pain sites and VSS-SF and between pain intensity and VSS-SF, and these associations were stronger in patients reporting psychological distress. Similar associations were found for DHI. Patients reporting ≥4 pain sites or pain intensity of ≥4 out of 10 at baseline, still reported severe dizziness and moderate disability 12months later. Musculoskeletal pain is a risk factor for poor dizziness outcomes, especially when comorbid psychological distress is present. Clinicians should be attentive to musculoskeletal pain when the number of pain sites exceeds 4 or pain intensity exceeds 4 on a numeric rating scale. A new understanding of the impact of musculoskeletal pain on persistent dizziness could be the key to successful recovery and the prevention of prolonged issues.

The Self-Compassion Scale Short Form for Children Aged 8–12: Validation of the Italian Version

Background: Although self-compassion has been consistently linked to positive outcomes in adults and adolescents, only a few studies have explored self-compassion in children and early adolescents due to a lack of measures specifically designed for younger populations. Methods: The current study explored the psychometric properties of the Italian translation of the Self-Compassion Scale for Children (SCS-C) in a sample of 230 children (mean age = 10.52, SD = 1.33). Results: The results revealed a two-factor solution for our data, with a positive self-compassion factor and a negative self-compassion factor, which were shown to be internally consistent. The SCS-C scores correlated with the children’s mindfulness, self-esteem, and narcissistic traits in the assumed directions. Conclusions: Overall, our study preliminarily supports the reliability and validity of the Italian version of the SCS-C.