Spielberger State-Trait Anxiety Inventory Scores Research Articles

Impact of Student Pharmacist State Anxiety on Vasopressor Calculation Accuracy in Advanced Cardiac Life Support Simulations

ObjectiveTo assess the impact of student pharmacist state anxiety on vasopressor calculation accuracy in advanced cardiac life support (ACLS) simulations. MethodsThird-year professional students participated in 2 ACLS-related simulation laboratory sessions. In week 1, students completed 3 calculations at their workstation with no stressors. Students were then randomized into teams for a bedside simulation where they independently completed 3 additional calculations either with or without stressors. Team assignments were maintained for week 2 where all participants completed a high-fidelity ACLS simulation that included a team vasopressor calculation. At both encounters, calculation accuracy was assessed as well as pre- and post-state anxiety using the Spielberger State-Trait Anxiety Inventory (STAI) survey tool. ResultsStudents’ (N = 145) trait anxiety aligned with normative data for similarly aged professional students. Post-simulation state anxiety in week 1 was found to be higher for those completing the activity with stressors than without (STAI score 44.7 vs 36.9) paired with lower bedside calculation accuracy, despite similar initial workstation calculation accuracy. In week 2, pre-simulation state anxiety score and calculation accuracy were not significantly different between the 2 groups. However, the state anxiety score significantly increased post-simulation for those exposed to stress in the previous week. ConclusionStress negatively impacted student pharmacist vasopressor calculation accuracy. However, the repeated exposure to a stressed simulation did not result in a significant difference in pre- or post-simulation state anxiety score or calculation accuracy when compared to a non-stressed control. Consideration should be made whether to include more “real-life” simulations in student pharmacist education.

Medical graphics to improve patient understanding and anxiety in elderly and cognitively impaired patients scheduled for transcatheter aortic valve implantation (TAVI).

Anxiety and limited patient comprehension may pose significant barriers when informing elderly patients about complex procedures such as transcatheter aortic valve implantation (TAVI). We aimed to evaluate the utility of medical graphics to improve the patient informed consent (IC) before TAVI. In this prospective, randomized dual center study, 301 patients were assigned to a patient brochure containing medical graphics (Comic group, n = 153) or sham information (Control group, n = 148) on top of usual IC. Primary outcomes were patient understanding of central IC-related aspects and periprocedural anxiety assessed by the validated Spielberger State Trait Anxiety Inventory (STAI), both analyzed by cognitive status according to the Montreal Cognitive Assessment (MoCA). Patient understanding was significantly higher in the Comic group [mean number of correct answers 12.8 (SD 1.2) vs. 11.3 (1.8); mean difference 1.5 (95% CI 1.2-1.8); p < 0.001]. This effect was more pronounced in the presence of cognitive dysfunction (MoCA < 26) [12.6 (1.2) in the Comic vs. 10.9 (1.6) in the Control group; mean difference 1.8 (1.4-2.2), p < 0.001]. Mean STAI score declined by 5.7 (95% CI 5.1-6.3; p < 0.001) in the Comic and 0.8 points (0.2-1.4; p = 0.015) in the Control group. Finally, mean STAI score decreased in the Comic group by 4.7 (3.8-5.6) in cognitively impaired patients and by 6.6 (95% CI 5.8 to 7.5) in patients with normal cognitive function (p < 0.001 each). Our results prove beneficial effects for using medical graphics to inform elderly patients about TAVI by improving patient understanding and reducing periprocedural anxiety (DRKS00021661; 23/Oct/2020). Medical graphics entailed significant beneficial effects on the primary endpoints, patient understanding and periprocedural anxiety, compared to the usual patient informed consent (IC) procedure. Patient understanding of IC-related aspects was significantly higher in the Comic group, with a more pronounced benefit in patients with cognitive impairment (p for IC method and cognitive status < 0.001, respectively; p for IC method x MoCA category interaction = 0.017). There further was a significant decline of periprocedural anxiety in patients with and without cognitive impairment (p for IC method x measuring time point < 0.001; p for IC method x MoCA category x measuring time point interaction = 0.018).

Effect of Auriculotherapy on the Anxiety of Women After Cesarean Section: A Clinical Trial

Introduction: Anxiety after cesarean section can delay the recovery process of mothers after delivery. Auriculotherapy as a complementary medicine may be beneficial in reducing maternal anxiety. Objective: This study assesses auriculotherapy’s effect on women’s anxiety after cesarean section. Materials and Methods: This randomized controlled clinical trial was conducted on 68 women after cesarean section in a teaching hospital in Rasht City, Iran. The mothers were assigned into intervention groups (n=34) and control (n=34). In the intervention group, auriculotherapy was performed by Vaccaria seeds on 1 point in the left ear and 5 points in the right ear. The mothers’ anxiety was measured by the Spielberger state-trait anxiety inventory (STAI) before, 3, and 10 days after the intervention. The collected data were analyzed by using the independent t-test, Fisher exact test, and repeated measures ANOVA. Analysis of covariance (ANCOVA) was also used to compare the STAI score between the two groups after the intervention. The significance level was set at 0.05. Results: The Mean±SD age of the participants was 31.8±7.2 years. In the intervention group, no significant difference was found in the state and trait anxiety scores from baseline to day 3 after the intervention. However, their mean scores were significantly reduced on the 10th day after the intervention compared to the scores at baseline and day 3 (P=0.001). In the control group, the mean state anxiety score on the third day was significantly higher than at baseline and day 10 (P=0.001, η2=0.249). At the same time, there was no significant difference in trait anxiety scores from the baseline to the third day. However, these values increased on day 10 (P=0.001). According to the ANCOVA results, the adjusted means of state and trait anxiety in the intervention group were lower than in the control group on the 3rd and 10th days; these values decreased more from the third to the tenth day (P=0.001, η2=0.829). Conclusion: Auriculotherapy effectively reduces mothers’ anxiety after cesarean section. Therefore, health service providers, especially midwives, can use this complementary medicine to reduce mothers’ anxiety.

Investigating associations between maternal stress, smoking and adverse birth outcomes: evidence from the All Our Families cohort

BackgroundIndependently, active maternal and environmental tobacco smoke exposure and maternal stress have been linked to an increased risk of preterm birth and low birth weight. An understudied relationship is the potential for interactive effects between these risk factors.MethodsData was obtained from the All Our Families cohort, a study of 3,388 pregnant women < 25 weeks gestation recruited from those receiving prenatal care in Calgary, Canada between May 2008 and December 2010. We investigated the joint effects of active maternal smoking, total smoke exposure (active maternal smoking plus environmental tobacco smoke) and prenatal stress (Perceived Stress Scale, Spielberger State-Trait Anxiety Inventory), measured at two time points (< 25 weeks and 34–36 weeks gestation), on preterm birth and low birth weight.ResultsA marginally significant association was observed with the interaction active maternal smoking and Spielberger State-Trait Anxiety Inventory scores in relation to low birth weight, after imputation (aOR = 1.02, 95%CI: 1.00-1.03, p = 0.06). No significant joint effects of maternal stress and either active maternal smoking or total smoke exposure with preterm birth were observed. Active maternal smoking, total smoke exposure, Perceived Stress Scores, and Spielberger State-Trait Anxiety Inventory scores were independently associated with preterm birth and/or low birth weight.ConclusionsFindings indicate the role of independent effects of smoking and stress in terms of preterm birth and low birthweight. However, the etiology of preterm birth and low birth weight is complex and multifactorial. Further investigations of potential interactive effects may be useful in helping to identify women experiencing vulnerability and inform the development of targeted interventions.

A88 EVALUATING THE ACCEPTABILITY AND EFFICACY OF CYTOSPONGE FOR BARRETT'S ESOPHAGUS: A SINGLE CENTRE CROSS-SECTIONAL STUDY

Abstract Background Barrett's Esophagus (BE) is a pre-malignant condition defined by the presence of metaplastic columnar epithelial cells above the gastroesophageal junction. Currently, diagnoses is made by endoscopy. Once metaplasia is present, there is 0.5% annual risk of progression to dysplasia and ultimately adenocarcinoma. Cytosponge is a new device and technique to diagnose BE. Furthermore, this test has a strong safety profile. Research has suggested increased patient tolerance for the Cytosponge compared to endoscopy; this has not been demonstrated in a Canadian healthcare setting. Before Cytosponge test can be integrated in Canada, ideally, patient acceptability of this device should be evaluated. Purpose To assess patient acceptability, tolerability and integration of Cytosponge in the diagnosis of Barrett's Esophagus in a Canadian healthcare setting. We also assessed the ease of use and familiarity with Cytosponge. Method A single-centre, prospective cross-sectional study was conducted to evaluate the acceptability and comfort of patients undergoing Cytosponge procedure. Outpatients referred for EGD for Barrett's Esophagus at St. Paul’s Hospital between 03/21-07/22 were included. 36 patients with BE have been enrolled in this project. Acceptability was evaluated through Visual Analogue Scale (VAS), Spielberger State Trait Anxiety Inventory (STAI), and Impact of Events Scale (IOES) on the day of procedure, day 7 post procedure and day 90 post procedure. Data from health care providers administering the Cytosponge were collected using the System Usability Scale (SUS). One-way ANOVA and Tukey’s Honestly Significant Difference tests were completed to assess score differences between follow up. Result(s) A total of 36 patients met the inclusion criteria and consented to participate. Of these patients 81.6% were successful in swallowing Cytosponge, 18.4% were unsucessful. ANOVA test revealed statistically significant difference in VAS scores, F(3, 140) = 12.59, p &amp;lt; 0.0000005. There were significant differences in VAS between Day 0 and Day 7, p=0.0032. This was also seen in VAS between Day 0 vs Day 90, p=0.0017. There were no statistically significant difference in mean STAI scores between different time points, F(3, 140) = 12.59, p=0.44. ANOVA test also showed statistical difference in IOES scores, F(2, 111) = 8.76, p&amp;lt;0.0005. There was statistical difference between day 0 compared to day 7 and between day 0 and day 90, p=0.0045, and p=0.00045 respectively. Conclusion(s) Our results demonstrate that Cytosponge is a well tolerated in a Canadian healthcare setting. Follow up scores of VAS and IOES were lower compared to day 0 suggesting that patients found Cytosponge acceptable. A score of 68 and above is considered to be above average on the SUS which measures usability of Cytosponge. The average SUS score in this sample was 65.3, this may suggest that there is a learning curve for health care providers to become familiar with Cytosponge. There were no complications with Cytosponge in this sample. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; Gastroenterology Institute of Research Institute Disclosure of Interest None Declared

ALTERATIONS IN FUNCTIONAL CONNECTIVITY: BEING WATCHED AS AN INDICATOR OF STATE ANXIETY

Anxiety increases self-focused attention and rumination. Individuals with anxiety are sensitive to being watched by others, as being watched provokes self-referential processing and induces thoughts regarding others perceptions of oneself. However, whether the neural sensitivity to being watched depends on the level of anxiety remains unclear.We investigated the relationship between anxiety and the neural sensitivity to being watched by others.The anxiety of 25 healthy participants (mean age standard deviation, 23.08 1.71 years; 12 men and 13 women) was evaluated using the Spielberger StateTrait Anxiety Inventory. Resting state electroencephalography data was collected under the alone condition and the condition of being watched by another person. By subtracting the phase lag value between the two conditions, we determined the alterations in participants functional networks when they were being watched. We then found the correlation between the Spielberger StateTrait Anxiety Inventory scores and reactivity of functional connectivity when being watched.The score of state anxiety was significantly correlated with increased phase lag values in the left precuneus, bilateral caudal anterior cingulate cortex, and right rostral middle frontal cortex in the beta band (p&lt; 0.05). We found no significant correlation between the trait anxiety scores and altered phase lag values.Functional connectivity may be involved in the default mode network relevant to self-referential processing and the dorsal attentional network. Our results suggest that self-focused mental processing and sensitivity to being watched by others could be common in people with anxiety, thus expanding the current understanding of the cognitive mechanisms behind anxiety.

Metal mixtures are associated with increased anxiety during pregnancy

BackgroundExposure to low-dose toxic metals in the environment is ubiquitous. Several murine studies have shown metals induce anxiety-like behaviors, and mechanistic research supports that metals disrupt neurotransmitter signaling systems implicated in the pathophysiology of anxiety. In this study, we extend prior research by examining joint exposure to six metals in relation to maternal anxiety symptoms during pregnancy. MethodsThe sample includes 380 participants enrolled in the PRogramming of Intergenerational Stress Mechanisms (PRISM) pregnancy cohort. Spot urine was collected during pregnancy (mean ± standard deviation: 31.1 ± 6.1 weeks), and concentrations of six metals (barium [Ba], cadmium [Cd], chromium [Cr], cesium [Cs], lead [Pb], antimony [Sb]) were measured by Inductively Coupled Plasma – Mass Spectrometry. Trait anxiety symptoms were measured during pregnancy using a short version of the Spielberger State Trait Anxiety Inventory (STAI-T) and information on covariates was collected by questionnaire. We used weighted quantile sum (WQS) regression as the primary modeling approach to examine metals, treated as a mixture, in relation to higher (≥20) vs. lower anxiety symptoms while adjusting for urinary creatinine and key sociodemographic variables. ResultsThe sample is socioeconomically and racially/ethnically diverse. Urinary metal concentrations were log-normally distributed and 25% of the sample had an STAI-T score ≥20. Joint exposure to metals was associated with elevated anxiety symptoms (ORWQS = 1.56, 95% CI: 1.24, 1.96); Cd (61.8%), Cr (14.7%), and Cs (12.7%) contributed the greatest weight to the mixture effect. ConclusionExposure to metals in the environment may be associated with anxiety symptoms during pregnancy. This is a public health concern, as anxiety disorders are highly prevalent and associated with significant co-morbidities, especially during pregnancy when both the mother and developing fetus are susceptible to adverse health outcomes.

Anxiety levels in parents of asymptomatic neonates and young infants referred for echocardiography

ABSTRACT Introduction Previous studies in children with innocent murmurs have shown that parental concern is common. Methods We assessed the anxiety levels among parents of asymptomatic neonates or infants up-to 6 weeks referred for cardiologic consultation because of a heart murmur. A six-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI) was completed by the parents before and after consultation. Results The average STAI score decreased from 14.42 ± 4.54 on arrival to 9.69 ± 4.26 after the consultation (p < 0.001). Overall, the parents felt more calm, less tense, less upset, more relaxed, more content and less worried after the consultation (p < 0.001). Multivariable linear regression analysis showed that the STAI score prior to consultation was related to infants age (coefficient β = – 0.172; P = 0.046) and STAI score post consultation was related to the final diagnosis (β = 0.312; P < 0.001). Conclusion In conclusion, parents of asymptomatic neonates and young infants with a murmur exhibit moderate levels of anxiety which can be ameliorated after consultation. Parental education in the field is of paramount importance and the role of both paediatric cardiologists as well as primary care physicians is crucial and decisive.

Additive effects of acupuncture in alleviating anxiety: A double-blind, three-arm, randomized clinical trial

BackgroundIn this trial, additive effects of acupuncture to selective serotonin reuptake inhibitors (SSRIs) treatment for reducing anxiety, were investigated. Methods112 patients with anxiety disorder were randomly divided into three groups including SSRIs alone (drug group), SSRIs with sham acupuncture (control group) and SSRI with acupuncture (acupuncture group), and treated for 4 weeks. At the beginning of the study and on day 28, Spielberger State-Trait Anxiety Inventory (STAI) questionnaire was completed and serum levels of cortisol were measured. Results105 patients completed the treatment period. STAI score showed significant differences among the three groups at the end of the study; importantly, changes in STAI score in the acupuncture group were significantly larger than the other groups. A decrease in cortisol levels was observed in all groups; though statistically non-significant, this decrease in the acupuncture group was larger. ConclusionAcupuncture combined with SSRIs can significantly improve anxiety state compared to anti-anxiety therapy using SSRIs alone.

Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: a randomized controlled study

BackgroundHospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery.MethodsIn this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. The children were randomly divided into 2 groups (n = 50 for each), Group A: using a self-produced audio-visual animation introduction; Group C: controlled group without audio-visual animation introduction. Children’s preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) at different time points: the night before surgery(T1), at pre-anesthetic holding room(T2), and just before anesthesia induction(T3). The Spielberger State-Trait Anxiety Inventory (STAI) was used to record the anxiety of parents at T1,T2 and T3. The incidence and the degree of emergence agitation were recorded.ResultsThe mYPAS scores at T2 and T3 were higher than T1(p < 0.05) in both groups. The average score of mYPAS in Group A was significantly lower than in Group C at T2 and T3(p < 0.05). The STAI scores in Group A at T2 and T3 were significantly lower than in Group C(p < 0.05). The incidence of agitation in Group A was lower than that in Group C(p < 0.05).ConclusionsBased on the findings, viewing a self-produced audio-visual animation can effectively alleviate the preoperative anxiety for both children and their parents in pediatric strabismus surgery, and it was effective for reducing emergence agitation as well.Trial registrationThe trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1900025116, Date: 08/12/2019).

Maternal psychiatric status and infant wheezing: The role of maternal hormones and cord blood cytokines.

Maternal psychosocial stress might be associated with development of allergic diseases in the offspring. To evaluate the association of maternal depression and anxiety with ever wheezing and recurrent wheezing among infants and to assess the role of maternal hypothalamo-pituatary-adrenal axis changes and fetal immune response in this association. This study encompasses two designs; cohort design was developed to evaluate the association of prenatal depression with development of wheezing in infants while nested case-control design was used to assess the role of maternal cortisol and tetranectin and cord blood interleukin 13and interferon γ. We enrolled 697 pregnant women. Elementary school graduate mother (odds ratio [OR] = 1.5, p = .06), maternal smoking during pregnancy (OR = 3.4, p = .001), familial history of asthma (OR = 2.7, p < .001) increased the risk of ever wheezing. Elementary school graduate mother (OR = 2.6, p = .002), maternal smoking during pregnancy (OR = 4.8, p < .001) and familial history of asthma (OR = 1.7, p = .01) increased the risk of recurrent wheezing. Maternal previous psychiatric disease, or Edinburgh Postnatal Depression Scale or Spielberger State-Trait Anxiety Inventory scores were not associated with wheezing. Maternal tetranectin levels were significantly higher among never wheezers compared to the ever wheezers (264.3 ± 274.8 vs. 201.6 ± 299.7, p = .04). In conclusion, the major risk factors for ever wheezing and recurrent wheezing were maternal smoking, level of education and family history of asthma. However, maternal depression and anxiety were not determined as risk factors for wheezing. Maternal tetranectin carries potential as a biomarker for wheezing in the infant.

The evaluation of perceived sources of stress and stress levels among Turkish dental students

The purpose of this study was to identify sources of stress and to evaluate stress levels among Turkish dental students and also to investigate the role of year of study and gender on perceived stressors. This study included 308 dental students. Dental Environment Stress (DES) questionnaire, Beck Depression Inventory (BDI) and Spielberger State Trait Anxiety Inventory (STAI) were used to collect data. Also, some factors considered to be effective on stress levels of dental students were questioned. Data were statistically analysed with Kruskal Wallis and Mann Whitney U tests. The most stress provoking factors were fear of failing the year, completion of clinical requirements and amount of assigned work. Statistically significant differences were found between years of study and gender for many stressors. There was statistically significant difference between years of study and gender for mean DES scores but no statistically significant differences were found between years of study for mean BDI, STAI scores. There was statistically significant difference between genders for STAI-1. Choice rank of dental school has affected stress levels of dental students. This study showed that perceived sources of stress of clinical students were very similar and stress levels of these students were lower than preclinical students, also gender was effective on stressors and stress levels.

Influence of COVID-19 pandemic on the psychological status of infertile couples

Objective(s)to evaluate the impact of the COVID-19 pandemic on infertile couples’ emotions, anxiety and future plans. Study designAn observational study was perfomed by Italian ART centers and online forums. In this study, infertile couples candidate to ART and whose treatment was blocked due to the COVID-19 lockdown were enrolled through an online survey. The psychological impact of COVID-19 was measured by Impact of Event Scale-Revised (IES-R) and by a short form of the Spielberger State-Trait Anxiety Inventory (STAI); Self-perceived anxiety related either to pregnancy safety and to economic crisis measured by VAS scale. Results627 patients completed the survey. The COVID-19 lock-down had a moderate/severe psychological impact on infertile patients (mean IES-R score 36.4 ± 16.6). The mean STAI score was 49.8 ± 15.3, with an overall incidence of STAI > 36 of 71 %. The mean VAS scale for anxiety perception was 45.3 ± 15.3. Women were more emotionally distressed, anxious and depressed than men (36.8 ± 16.4 vs 31.0 ± 18.4 for IES-R, respectively; p = 0.03). Notwithstanding the uncertainty about pregnancy safety, 64.6 % of respondents chose to maintain their reproductive programme. Economic crisis induced 11.5 % of the surveyed patients to give up their ART program. Respondents who had at least one relative affected by COVID-19 had a significantly higher IES-R score and anxiety VAS, but not higher STAI scores, than patients belonging to unaffected families. Conclusion(s)COVID-19 pandemic itself and the recommendation to stop ART program generated higher distress levels in infertile couples. The psychological impact of COVID-19 pandemic in infertility patients should not be underestimated, and a specific psychological support should be planned.

FARKLI KUŞAKLARDAKİ KADINLARIN JİNEKOLOJİK MUAYENEYE İLİŞKİN UTANGAÇLIK VE ANKSİYETE DURUMLARININ BELİRLENMESİ

Aim: To determine the shyness and anxiety states of women of different generations regarding gynecological examination. Methods: This study was conducted in an Obstetric Education and Research Hospital in Istanbul city from 10 April to 15 July 2018. The universe of the study, all women receiving health care from the gynecology outpatient clinic of this hospital,The sample was composed of 254 women who agreed with the research criteria and agreed to participate in the study (254 women). Research data “Introducing Information Form”, “Spielberger State-Trait Anxiety Inventory (STAI-I) subscale” and “Shyness Scale” were collected. In evaluating the data; Chi-square, Mann-Whitney U test, Kruskal-Wallis and Independent Sample t test were used. The results were interpreted at p <0.05 significance level. Results: The difference between the years of birth and shyness of women, gender preference of gynecologic examination was significant (p<0.05); the generation born after 1980, and they have more concerns than the other generations (55.9), more women doctors of their choice (21.7%) were more than they felt a sense of shame. STAI-I score averages and generation differences, educational status, normal life anxiety status (p <0.05) and the difference was statistically significant (p <0.05) between the mean of UO scores and education status and gender preference of gynecologic examination. Conclusions: Women born in 1980 and later had more anxiety and shame than the other generations; the individual characteristics of the women and the preferences of the physician should be taken into consideration in order to alleviate the feeling of anxiety and shame about the examination.

Associations between midlife chronic conditions and medication use with anxiety and depression: A cross-sectional analysis of the PREVENT Dementia study.

Background:Multimorbidity including physical and mental illness is increasing in prevalence. We aimed to investigate the associations between physical conditions and medication use with anxiety and depression in midlife.Methods:We conducted an observational cross-sectional study of volunteers in the PREVENT Dementia study. Using logistic and linear regression, we investigated the association between increasing numbers of self-reported chronic physical conditions and medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest.Results:Of the 210 participants, 148 (71%) were women and 188 (90%) Caucasian. The mean age was 52 (standard deviation (SD) = 5.5) years. The mean number of physical conditions was 2.2 (SD = 1.9) and medications 1.7 (SD = 2.2). Each additional physical condition was associated with increased odds of self-reported depression (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.11–1.80; p = 0.004, adjusted for age and gender) and anxiety disorder (OR 1.70, 95% CI 1.30–2.37; p < 0.001). Increasing medication use was associated with self-reported depression (adjusted OR per additional medication 1.35, 95% CI 1.08–1.71; p = 0.008) but not anxiety disorder. For each additional condition, CES-D scores increased by 0.72 (95% CI 0.11–1.33; p = 0.020) and for each extra medication, by 0.88 (95% CI 0.32–1.44; p = 0.002). There was no significant association between increasing conditions and medications with STAI scores. In models accounting for antidepressant use, all associations were attenuated.Conclusions:Having more physical conditions is associated with anxiety and depression in midlife, and taking more medications is associated with depression but not anxiety.

Effect of family presence during teaching rounds on patient's anxiety and satisfaction in cardiac intensive care unit: A double-blind randomized controlled trial.

INTRODUCTION:The family members’ presence during teaching rounds is introduced as a challenging issue. The outcomes of family presence during teaching rounds in adult care settings is an under investigate issue. The propose of this study was to determining the effect of family presence at teaching rounds on patient's anxiety and satisfaction in cardiac intensive care unit (CICU).MATERIALS AND METHODS:In this double-blind randomized controlled trial, 60 patients who were hospitalized in CICU were selected based on inclusion criteria and then assigned into 2 groups (with and without family members presence during teaching round), equally by the random minimization method. The patient's anxiety score was measured before and after rounds on the Spielberger State-Trait Anxiety Inventory (STAI). Furthermore, the patient's satisfaction about various clinical aspects of round was measured by a self-reported questionnaire. The data were analyzed by SPSS software using Kolmogorov–Smirnov test, Chi-square test, independent sample and paired sample t-test, at the significance level of 0.05.RESULTS:The study groups were similar in terms of demographic variables. In the family members presence group, the STAI score significantly decreased after intervention (P = 0.001). Furthermore, in this group, the after-intervention STAI score was significantly lower than family absence group (P = 0.011). The mean changes of patient's satisfaction about quality of round score in family member presence group were significantly higher than family absence group (P = 0.001).CONCLUSIONS:Family presence during teaching rounds led to patient's lower anxiety and higher satisfaction score.

ASSOCIATIONS BETWEEN CHRONIC PHYSICAL CONDITIONS, MEDICATIONS AND MENTAL HEALTH IN AN AGING COHORT

Older people increasingly live with multiple chronic conditions and medications. We explored their interactions with mental health in the PREVENT Dementia study participants. Using logistic and linear regression, we investigated the association between increasing self-reported chronic physical conditions and current medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest. Among 210 participants, each additional condition was associated with increased odds of depression (adjusted OR, 95% CI: 1.41, 1.11-1.80; P=0.005) and anxiety (1.71, 1.35-2.21; P<0.001). Each additional medication was associated with depression (1.36, 1.07-1.73; P=0.010) but not anxiety. For each additional condition, CES-D scores increased by 0.62 (0.04-1.20, P=0.035) and for each medication, by 0.66 (0.12-1.21, P=0.017). There was no significant association between conditions or medications and STAI scores. These findings provide crucial information on the future brain health of these individuals.

Communicating the External Beam Radiation Experience (CEBRE): Perceived Benefits of a Graphic Narrative Patient Education Tool

PurposeCurrent radiation oncology patient education materials exceed national readability recommendations. A graphic narrative educational tool, the Communicating the External Beam Radiation Experience (CEBRE) discussion guide, was developed to facilitate patient–provider communication. A pilot study evaluated perceived benefits of CEBRE for patients and physicians. Methods and MaterialsCEBRE was designed through a collaboration between physicians and designers. Designers interviewed patients, family members, and the clinical team. Interviews were coded for themes, leading to the design principles that drove the design of CEBRE, including a graphic narrative component. CEBRE explains the radiation therapy care path. Readability was measured using the Flesch-Kincaid test. Patients receiving radiation therapy or in follow-up and practicing radiation oncologists reviewed CEBRE and completed independent surveys. Each survey included modified versions of the Systems Usability Score (SUS) and Spielberger State-Trait Anxiety Inventory (STAI) short form, along with questions unique to CEBRE. Likert-type scores are reported as median (interquartile range). ResultsCEBRE scores at a 5.4 Flesch-Kincaid grade level. Thirty-four patients and 15 radiation oncologists completed surveys. Patients had completed a high school/general equivalency degree (18%), a 2-year degree or some college (50%), or at least 4 years of college (32%). Patient and physician responses were concordant. On a scale of 1 to 5 for modified SUS and 1 to 4 for modified STAI (“strongly disagree” to “strongly agree”) the SUS scores were 4 (4-5) and 4 (4-5) and STAI scores were 3 (3-4) and 3 (3-3.5) for patients and providers, respectively. This indicates CEBRE is usable and would decrease anxiety. Compared with text, the graphic narrative component of CEBRE was rated as “quite helpful” (4 [4-5]). ConclusionsCEBRE, a graphic narrative education tool developed through a novel collaboration between designers and radiation therapy stakeholders, is accessible for patients and practical to facilitate patient–provider discussion. Perceived benefits demonstrating high usability and the potential to decrease patient anxiety warrant further prospective investigation of CEBRE in the clinical setting.

Comparison the effect of trained and untrained family presence on their anxiety during invasive procedures in an emergency department: A randomized controlled trial

ObjectiveThe present study was aimed to compare the effect of the trained and untrained family presence on their anxiety during invasive procedures in an emergency department. MethodsIn this randomized controlled clinical trial, 90 patients who were candidates for receiving invasive nursing procedures were selected in an emergency department based on the inclusion criteria, and then were equally assigned into 3 groups by the random minimization method: A ("presence of the trained family member group "), B ("presence of the untrained family member group "), and C ("absence and untrained family member group"). The anxiety level was measured before and after implementation of the procedure using the Spielberger State-Trait Anxiety Inventory (STAI). The data were analyzed by SPSS software using the Kolmogorov-Smirnov test, Chi-Square test, Kruskal Wallis Independent-Samples test, Paired Samples T-test, and ANOVA at the significance level of 0.05. ResultsThe three groups were similar in terms of demographic variables. In all three groups, the SATI score significantly decreased after intervention phase (p = 0.001). The mean changes of the SATI score were not statistically different between the groups. However, The STAI score decreased significantly after intervention in the group B compared to the group A (p = 0.011) and C (p = 0.042). However, there was no significant difference between the SATI score in the group A and C (p = 0.867). ConclusionThe results of the study revealed that, the “presence of the untrained" family members caused them to experience significantly less anxiety than the other two groups. However, changes in the anxiety score were not significant between the groups.

Benefit of Watching a Live Visual Inspection of the Cervix With Acetic Acid and Lugol Iodine on Women's Anxiety: Randomized Controlled Trial of an Educational Intervention Conducted in a Low-Resource Setting.

BackgroundWomen undergoing pelvic examination for cervical cancer screening can experience periprocedural anxiety.ObjectiveThe aim of this study was to assess the anxiety level experienced by women undergoing a visual inspection with acetic acid and Lugol iodine (VIA and VILI) examination, with or without watching the procedure on a digital screen.MethodsThis prospective randomized study took place in the district of Dschang, Cameroon. A previous cervical cancer screening campaign tested women aged between 30 and 49 years for human papillomavirus (HPV). HPV-positive women were invited for the 12-month follow-up control visit, including a VIA/VILI examination. During that visit, we recruited women to participate in this study. Before the examination, participants were randomized in a 1:1 ratio to a control group (CG) and an intervention group (IG). Women in both groups underwent a pelvic examination and were verbally informed about the steps undertaken during the gynecological examination. The IG could also watch it live on a tablet screen. Women’s anxiety was assessed before and immediately after the examination, using the Spielberger State-Trait Anxiety Inventory (STAI). A paired t test was used to compare the mean STAI score for each question before and after VIA/VILI while a nonpaired, 2-sided t test was used to compare the mean differences of the STAI score between the 2 study groups.ResultsA total of 122 women were randomized in the study; 4 of them were excluded as they did not undergo the pelvic examination, did not answer to the second STAI questionnaire because of personal reasons, or the cervix could not be properly visualized. Thus, the final sample size consisted of 118 patients of whom 58 women were assigned to the CG and 60 to the IG. The mean age was 39.1 (SD 5.2) years. Before the examination, the mean (SD) STAI score was 33.6 (SD 10.9) in the CG and 36.4 (SD 11.8) in the IG (P=.17). The STAI score after pelvic examination was significantly reduced for both groups (CG: 29.3 [SD 11.2]; IG: 28.5 [SD 12.0]). Overall, the difference of the STAI scores before and after the pelvic examination was lower in the CG (4.2 [SD 9.0]) than in the IG (7.9 [SD 14.3]), although the difference was not significant (P=.10). However, the women’s emotional state, such as I feel secure and I feel strained, was improved in the IG as compared with the CG (CG: P=.01; IG: P=.007).ConclusionsWatching the VIA/VILI procedure in real time improved the women’s emotional state but did not reduce the periprocedural anxiety measured by the STAI score. Furthermore, larger studies should assess women’s satisfaction with watching their pelvic examination in real time to determine whether this tool could be included in VIA/VILI routine practice.Trial RegistrationClinicalTrials.gov NCT02945111; http://clinicaltrials.gov/ct2/show/NCT02945111