State Subscale Research Articles

Predictor of depressive disorders in patients with antineutrophil cytoplasmic antibody-associated vasculitis.

We investigated the frequency of depressive disorders and determined the predictors of depressive disorders in Korean patients with antineutrophil cytoplasmic antibody-associated vasculitis. Sixty-one patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) were enrolled in this study. We assessed the Birmingham vasculitis activity score (BVAS), vasculitis damage index (VDI) and the Korean version of the short form 36-item Health Survey (SF-36). SF-36 consists of the mental component score (MCS) and physical component score (PCS). Depression disorder was identified based on the Korean version of the Center for Epidemiologic Studies Depression Scale-Revised (K-CESD-R) ≥ 16. Mood states including depression were assessed by the Korean edition of the Profile of Mood States (K-POMS) subscales. The mean age was 62.2years (19 men). Twenty-eight AAV patients (45.9%) had depressive disorders based on K-CESD-R ≥ 16. Both SF-36 MCS and SF-36 PCS were negatively correlated with K-CESD-R (r = - 0.687 and r = - 0.594) and K-POMS depression (r = - 0.604 and r= - 0.480), respectively. The optimal cut-offs of SF-36 MCS and SF-36 PCS for depressive disorders based on K-CESD-R ≥ 16 were obtained as 48.07 and 55.63. Patients with SF-36 MCS ≤ 48.07 exhibited a significantly high RR for depressive disorders, compared with those without (RR 42.667). Also, patients with SF-36 PCS ≤ 55.63 showed a significantly high RR depressive disorder, compared with those without (RR 13.619). We demonstrated that SF-36 could help to estimate the current depressive disorders. We also suggest a method to obtain the optimal cut-offs of SF-36 to predict depressive disorders.Key points• Both SF-36 MCS and SF-36 PCS were negatively correlated with K-CESD-R and K-POMS depression.• Patients with SF-36 MCS ≤ 48.07 exhibited a significantly high relative risk (RR) for depressive disorders, compared with those without (RR 42.667).• Patients with SF-36 PCS ≤ 55.63 showed a significantly high RR depressive disorder, compared with those without (RR 13.619).

Faces Anxiety Scale as a screening measure of preoperative anxiety: Validation and diagnostic accuracy study.

The aim of the study was to examine validity and diagnostic accuracy of the single-item Faces Anxiety Scale for the purposes of preoperative anxiety screening. Anxiety is common in most patients expecting surgery interfering with patients' recovery. Valid and reliable measures for situations with limited time for assessment are needed. A descriptive cross-sectional design was used to collect the data from both self-report and rating instruments. We enrolled 90 consecutive patients admitted for surgery in a university-affiliated hospital from January 2013 to June 2013. Patients were administered the anxiety state subscale of the Spielberger State-Trait Anxiety Inventory and the anxiety subscale of the Hospital Anxiety and Depression Scale, and they were presented the Faces Anxiety Scale. At the same time, patients' anxiety was rated by a nurse. The correlations among scores of self-report instruments, rating scale, and the Faces Anxiety Scale were high and statistically significant. Of the Faces Anxiety Scale cut-off scores tested, the cut-off score>2 has an optimal combination of sensitivity and specificity. The Faces Anxiety Scale is valid and easy to administer. The scale is useful in settings where fast and precise screening is necessary.

State Anxiety and Worry Responses to a Single Sprint Before and After Sprint Interval Training

There has been continued interest in the anxiolytic effects of diverse and non-traditional exercise modes. However, the acute and chronic effects of sprint interval training (SIT) on anxiety and worry are not well known, and the degree to which chronic SIT changes the acute response to a single sprint is untested. PURPOSE: This study quantified state anxiety and worry responses to a single sprint (Wingate), state anxiety and worry responses to three weeks of SIT, and, the extent to which chronic SIT changed acute responses to a single sprint. METHODS: Eighteen healthy young adult males (25.2±3.6 y) completed a single 30s Wingate at 7.5% body mass before and after a 3-wk SIT intervention comprised of nine sessions of 4-6 sprints. Acute and chronic effects of SIT on state anxiety, worry, and worry engagement were assessed with the State subscale of the State-Trait Anxiety Inventory and the Penn State Worry Questionnaire, respectively. Paired t-tests quantified pre-training acute responses and training responses (i.e., baseline to post-SIT); magnitude of change was quantified with standardized mean difference (d). RM-ANOVA examined differences between pre-training and post-training acute responses. The magnitude of change in acute responses was quantified with Hedges’ d effect sizes. RESULTS: At pre-training, state anxiety was significantly increased (t17=-2.34, p≤0.032) and worry engagement was significantly decreased (t17=3.14, p≤0.006) following a single sprint. Small-to-moderate magnitude reductions were found for worry engagement (d=0.37) and worry (d=0.18), and a small-to-moderate magnitude increase was found for state anxiety (d=-0.36). No statistically significant changes were found for state anxiety, worry, or worry engagement following SIT (all p>0.23); however, small magnitude reductions were found for state anxiety (d=0.11), worry (d=0.26), and worry engagement (d=0.21). Following SIT, a statistically non-significant small magnitude attenuation (d=0.14) of state anxiety response to a single sprint was found. CONCLUSION: Findings provide proof of principle that even a single high-intensity sprint can acutely perturb state anxiety and improve worry. Short-term SIT may elicit improved resting levels of anxiety and worry and response to a single high-intensity sprint in healthy young men.

Effects of a Soccer Tournament on the Psychohormonal States of Collegiate Female Players.

Broodryk, A, Pienaar, C, Edwards, D, and Sparks, M. Effects of a soccer tournament on the psychohormonal states of collegiate female players. J Strength Cond Res 35(7): 1873-1884, 2021-A gap exists in the literature concerning the connection between soccer players' hormonal and psychological responses when playing a tournament, or even a match, and its outcome (victory or defeat). This study evaluates the effects of a week-long tournament on the psychohormonal states of collegiate female soccer players. Eight players' cortisol (saliva sample), mood states (Incredibly Short Profile of Mood States [ISP]), and state-anxiety (state subscale of the State-Trait Anxiety Inventory) were assessed 1 hour before and 15 minutes after every game. Cortisol increased significantly after most matches, with intramatch differences observed (p < 0.05, d > 1.2). Match intensity influenced cortisol secretion, with greater secretion as intensity increased. The ISP demonstrated intramatch differences for the subscales' fatigue, depression, tension, and vigor (p < 0.05). Matches lost produced a higher total mood disturbance (TMD) index compared with matches won (p = 0.001, d = 1.4). Cortisol correlated with the TMD and various mood subscales before a winning outcome, with the ISP correlating at all times with the anxiety scores (p < 0.05). In conclusion, these results indicate that physiological and psychological variables combine to contribute to the stress response during a tournament. Focusing on high-intensity activities and minimizing fatigue are important, as both are associated with raised cortisol and negative mood states. Finally, implementing a mood questionnaire over a tournament can be beneficial, as sensitive information on players' hormonal and perceived anxiety states, which subsequently affect physical performance, can be obtained.

Natural Course of Posttraumatic Symptoms in Late-Adolescent Maritime Disaster Survivors: Results of A 12-Month Follow-Up Study.

ObjectiveThis study is a prospective observational study on 75 late-adolescent survivors of a large passenger ship accident from immediately after the accident to one year later. MethodsAssessments of student survivors were conducted on day 2 and at months 1, 6, and 12. The PTSD Checklist (PCL), Patient Health Questionnaire-9 (PHQ-9), State subscale of the State and Trait Anxiety Inventory (STAI-S), Athens Insomnia Scale (AIS), and Brief Resilience Scale (BRS) were administered. ResultsWhen the assessments for day 2 and month 12 were compared, all the scales, except the PCL-avoidance subscale, showed a significant improvement in symptoms among males. However, among females, all the scales, except the PCL-re-experience subscale and the STAI-S, failed to show a significant improvement. All the symptoms for both males and females showed a pattern that decreased to the lowest level at month 1 (camp-based controlled intervention period), then increased at months 6 and 12 (voluntary individual treatment after returning to school). ConclusionThe rapid deterioration of psychological symptoms was found during the chronic phase, when students returned to their daily routines and received voluntary individual therapy. There is a need to screen high-risk adolescents and be more attentive to them during this period.

Effects of Visual Stimulation with Bonsai Trees on Adult Male Patients with Spinal Cord Injury.

Nature therapy has been demonstrated to induce physiological relaxation. The psychophysiological effects of nature therapy (stimulation with bonsai trees) on adult male patients with spinal cord injury (SCI) were examined. Oxyhemoglobin concentration changes in the prefrontal cortex were measured using near-infrared spectroscopy, and heart rate variability was analyzed. Psychological responses were evaluated using the modified semantic differential method and Profile of Mood States (POMS) subscale scores. Visual stimulation of adult male patients with SCI elicited significantly decreased left prefrontal cortex activity, increased parasympathetic nervous activity, decreased sympathetic nervous activity, increased positive feelings, and resulted in lower negative POMS subscale scores. Nature therapy can lead to a state of physiological and psychological relaxation in patients with SCI.

A Program Aimed at Reducing Anxiety in Pregnant Women Diagnosed With a Small-for-Gestational-Age Fetus: Evaluative Findings From a Spanish Study.

The objective of this study was to evaluate the effect of anxiety-reducing techniques including music therapy, sophrology, and creative visualization in pregnant women with a fetus diagnosed as small for gestational age and improved fetal and neonatal weight. This was a quasi-experimental study with a nonrandomized clinical trial design. We compared 2 groups of pregnant women with a fetus diagnosed as small for gestational age with no abnormalities on Doppler studies. The control group (n = 93) received standard care, and the intervention group (n = 65), in addition to standard care, underwent a program of 6 sessions led by a midwife or nurse who taught anxiety-reduction techniques. The State-Trait Anxiety Inventory (STAI) including trait and state subscales were completed by both groups at the start of the study, and only the STAI-State subscale was completed again at the end of the study. Comparisons between the 2 groups regarding fetal weight and centile and maternal STAI scores were performed using the t test and the χ test. There were no significant differences in the STAI-Trait scores between the 2 groups. There were statistically significant differences in the intervention group's STAI-State score percentiles between the start and the end of the study, being lower at the end of the study (P < .001). There were significant differences between the 2 groups in fetal weight trajectory on the basis of fetal weight: the intervention group had a larger weight gain (P < .005). The program designed to reduce anxiety in pregnant women was effective at reducing anxiety in the women in the intervention group, leading to a favorable fetal weight trajectory in this group.

Psychometric Properties of the Kessler 10 Scale in Chinese Parents of Children With Cancer.

The Kessler Psychological Distress Scale (K10) has been widely used in rating psychological distress in general and clinical populations. However, whether it can be used in parents of children with cancer is unknown. Still lacking is the evidence on its reliability and validity in culturally diverse groups. The aim of this study was to translate the K10 into Mandarin Chinese and test its psychometric properties (especially the factor structure) of the Chinese version (C-K10) in parents of children with cancer. By convenience sampling, 2 samples of parents of children with cancer (sample I, n = 206, and sample II, n = 103) were surveyed in Guangzhou, China. Sample I completed the C-K10, and the internal consistency reliability and exploratory factor analysis of the C-K10 were estimated. Sample II completed the C-K10, the State Subscale of State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale; confirmatory factor analysis and concurrent validity estimates were completed. The C-K10 demonstrated strong internal consistency reliability (Cronbach's α = .93). Both exploratory and confirmatory factor analyses supported a 2-factor structure (ie, anxiety and depression). The concurrent validity was moderate with Pearson correlations greater than 0.50 (P < .001). The C-K10 demonstrated very acceptable reliability and validity in screening psychological distress in Chinese parents of children with cancer. This study provides evidence that the C-K10 is a valid tool that can be used in clinical settings to screen for psychological distress in Chinese parents of children with cancer.

Noise sensitivity, rather than noise level, predicts the non-auditory effects of noise in community samples: a population-based survey

BackgroundExcessive noise affects human health and interferes with daily activities. Although environmental noise may not directly cause mental illness, it may accelerate and intensify the development of latent mental disorders. Noise sensitivity (NS) is considered a moderator of non-auditory noise effects. In the present study, we aimed to assess whether NS is associated with non-auditory effects.MethodsWe recruited a community sample of 1836 residents residing in Ulsan and Seoul, South Korea. From July to November 2015, participants were interviewed regarding their demographic characteristics, socioeconomic status, medical history, and NS. The non-auditory effects of noise were assessed using the Center of Epidemiologic Studies Depression, Insomnia Severity index, State Trait Anxiety Inventory state subscale, and Stress Response Inventory-Modified Form. Individual noise levels were recorded from noise maps. A three-model multivariate logistic regression analysis was performed to identify factors that might affect psychiatric illnesses.ResultsParticipants ranged in age from 19 to 91 years (mean: 47.0 ± 16.1 years), and 37.9% (n = 696) were male. Participants with high NS were more likely to have been diagnosed with diabetes and hyperlipidemia and to use psychiatric medication. The multivariable analysis indicated that even after adjusting for noise-related variables, sociodemographic factors, medical illness, and duration of residence, subjects in the high NS group were more than 2 times more likely to experience depression and insomnia and 1.9 times more likely to have anxiety, compared with those in the low NS group. Noise exposure level was not identified as an explanatory value.ConclusionsNS increases the susceptibility and hence moderates there actions of individuals to noise. NS, rather than noise itself, is associated with an elevated susceptibility to non-auditory effects.

Yatarak tedavi gören alkol kullanım bozukluğu hastaları örnekleminde TSSB semptomlarının şiddeti ve alkolle ilişkili sorunlarla ilişkisi

Objective: The aim of the present study was to evaluate the effect of post-traumatic stress disorder (PTSD) symptoms measured with the PTSD Checklist Civilian (PCL-C) version on the severity of alcohol-related problems while controlling for the effects of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). Method: Participants (n=190) were evaluated with the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory State Subscale (STAI-S), the PTSD Checklist Civilian (PCL-C) Version and the Michigan Alcohol Screening Test (MAST). Results: Although severity of the state of anxiety predicted the severity of alcohol-related problems in the first and depression in the second step of a linear regression model, when severity of PTSD symptoms was included in the analysis, it was the only independent variable that predicted the severity of alcohol-related problems while the state of anxiety and depression were no longer predictors. Conclusion: These findings suggest that the severity of PTSD symptoms is related to the severity of alcohol-related problems, independent from severity of state anxiety and depression among inpatients with AUD.

Trajectories of Perinatal Depressive and Anxiety Symptoms in a Community Cohort.

The evidence on trajectories of perinatal depression is mostly based on studies composed of women at high risk for poor mental health. Research on maternal anxiety trajectories is also scarce. Using a large community cohort, the All Our Babies study, in Alberta, Canada, we examined trajectories of perinatal depressive and anxiety symptoms and compared characteristics of women across trajectories. Anxiety and depressive symptoms were measured at the second and third trimesters and at 4 and 12 months postpartum among 1,445 women recruited between May 2008 and December 2010. The state subscale of the Spielberger State-Trait Anxiety Inventory was used to measure anxiety symptoms, and depressive symptoms were measured with the Edinburgh Postnatal Depression Scale. Semiparametric group-based mixed modeling was performed to identify the optimal trajectory shape, number of groups, and proportion of the sample belonging to each trajectory. Model fit was evaluated using the Bayesian information criterion. Multinomial logistic regression analysis was conducted to compare characteristics across the trajectories. Five distinct trajectory groups with constant and variable patterns were identified for both depressive and anxiety symptoms: minimal, mild, antepartum, postpartum, and chronic. Common risk factors of depression and anxiety across groups with elevated symptoms were history of mental health issues (odds ratios [ORs] varied from 1.83 to 7.64), history of abuse/neglect (ORs varied from 1.67 to 8.97), and low social support (ORs varied from 1.64 to 11.37). The magnitude of the influence of the psychosocial risk factors was greater in the chronic group compared to others, suggesting a dose-related relationship. Heterogeneity of anxiety and depressive symptoms highlights the importance of multiple mental health assessments during the perinatal period. The patterns and intensity of postpartum depression differed between community and high-risk samples, underlining the significance of defining suitable cutoffs. Research to examine the impact of these trajectories on child outcomes is needed.

An investigation into the jumping-to-conclusions bias in social anxiety

'Jumping-to-Conclusions' (JTC) is a data-gathering bias characterised by hasty decision-making, and is typically seen in individuals with high levels of delusions or paranoia. JTC has also been found in people with high trait and state anxiety. The present study aimed to explore the relationship between JTC and trait social anxiety and state anxiety, given paranoia is common in both social anxiety and psychotic disorders. One-hundred-and-eighty-six undergraduate students were allocated to a manipulation or control condition, and classified as high or low socially anxious. All participants completed the 'beads task' to assess JTC, and the State-Trait Anxiety Inventory (state subscale) to assess state anxiety. Participants in the manipulation condition were given an anxiety-inducing situation. Although the manipulation was effective in inducing state anxiety, there was no significant correlation between JTC and trait or state social anxiety. High socially anxious individuals showed more conservative decision-making than controls over time, which was posited to be caused by inhibited working memory resulting from increased state anxiety.

Anxiety Modifies the Association between Fatigue and Verbal Fluency in Cognitively Normal Adults.

In the present study, we examined the association between self-reported fatigue and verbal fluency in a sample of healthy adults. Given the co-occurrence of anxiety and depressive symptoms with fatigue, we examined whether these affective dimensions would modify this association. Fifty-nine cognitively normal adults took part in the study. Fatigue symptoms were assessed using the Fatigue Severity Scale (FSS), depressive symptomatology with the Center for Epidemiologic Studies Depression Scale (CES-D), and situational anxiety using the state subscale of the State-Trait Anxiety Inventory (STAI-S).We used a composite measure of verbal fluency comprising letter fluency and semantic fluency as the outcome measure. Multiple regression analyses revealed higher fatigue was associated with better verbal fluency when STAI-S scores were high. We did not find a significant interaction between the FSS and CES-D. Greater situational anxiety levels may buffer against the negative influence of fatigue on verbal fluency in non-clinical populations, consistent with previous research showing that moderate levels of anxiety can benefit cognitive function. Whether subthreshold depressive symptoms modify the association between fatigue and verbal fluency is still unclear. Measures that assess different symptom dimensions specific to depression would help to clarify this issue.

Subjective mood and energy levels of healthy weight and overweight/obese healthy adults on high-and low-glycemic load experimental diets

Emerging evidence suggests a positive association of diet and obesity with depression. Researchers have examined several diet-mood hypotheses, including investigating the extent to which carbohydrates may impact mood. There is limited research on how glycemic load, a characteristic of carbohydrates, impacts mood in healthy adults. Eighty-two healthy weight and overweight/obese, but otherwise healthy, adults enrolled in a randomized, crossover controlled feeding study testing low-compared to high-glycemic load diets. All participants completed self-report mood and energy level questionnaires during each arm of the intervention. Diets were isocaloric and were matched by macronutrient content as a percent of total energy. Mood was assessed with the Profile of Mood States (POMS) subscales; tension-anxiety, depression-dejection, anger-hostility, vigor-activity, fatigue-inertia, and confusion-bewilderment, total mood disturbance (TMD), and negative affect (NA) in addition to the Center for Epidemiological Studies – Depression (CES-D) scale at baseline and end of both 28-day feeding periods. Linear mixed models tested the intervention effect on mood, controlling for baseline POMS and CES-D scores, diet type, diet sequence, feeding period, sex, and percent body fat classification. The consumption of the high-glycemic load diet resulted in a 38% higher score for depressive symptoms on the CES-D (P = 0.002) compared to the low-glycemic load diet as well as 55% higher score for TMD (P = 0.05), and 26% higher score for fatigue/inertia (P = 0.04). In subgroup analyses, the overweight/obese participants had 40% higher scores on the CES-D scale compared to healthy weight participants (P = 0.05). In conclusion, a high-glycemic load diet was associated with higher depression symptoms, total mood disturbance, and fatigue compared to a low-glycemic load diet especially in overweight/obese, but otherwise healthy, adults.This trial was registered at clinicaltrials.gov: NCT00622661.

Introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety in children

BackgroundThe aim of the study was to determine whether the introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety levels of children undergoing major surgery. Secondary objectives were to determine whether the level of understanding of participants and other risk factors influence STAIC-S (State–Trait Anxiety Inventory for Children'state subscale) score in children. MethodsWe performed a randomized controlled parallel-group trial comparing preoperative anxiety between two groups of children aged >6 and <17 yr. Before surgery, the intervention group received a comic information leaflet at home in addition to routine information given by the anaesthetist at least 1 day before surgery. The control group received the routine information only. The outcome measure was the difference between STAIC-S scores measured before any intervention and after the anaesthetist's visit. A multiple regression analysis was performed to explore the influence of the level of education, the anxiety of parents, and the childrens' intelligence quotient on STAIC-S scores. ResultsOne hundred and fifteen children were randomized between April 2009 and April 2013. An intention-to-treat analysis on data from 111 patients showed a significant reduction (P=0.002) in STAIC-S in the intervention group (n=54, mean=−2.2) compared with the control group (n=57, mean=0.90). The multiple regression analysis did not show any influence on STAIC-S scores of the level of education, parental anxiety, or the intelligence quotient of the children. ConclusionsA paediatric anaesthesia comic information leaflet was a cheap and effective means of reducing preoperative anxiety, measured by STAIC-S, in children. Clinical trials registrationNCT 00841022.

The suitability of the Hospital Anxiety and Depression Scale, Distress Thermometer and other instruments to screen for psychiatric disorders in both lung cancer patients and their partners

BackgroundLung cancer patients and their partners report high rates of distress. Although distress is of importance, psychiatric disorders might be more important in terms of prognostic value and additional psychological treatment. This study examined the suitability of the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Beck Depression Inventory (BDI-II) and State subscale of State Trait Anxiety Inventory (STAI-S) to screen for psychiatric disorders in lung cancer patients and partners. MethodsA consecutive sample of lung cancer patients and partners completed the screening instruments. The Structured Clinical Interview DSM-IV (SCID-I) was used to diagnose psychiatric axis I disorders. ResultsIn 144 patients, overall ability of HADS total score (HADS-T) screening for patients with psychiatric disorders was good, whereas DT appeared less suitable. In 98 partners, the performance of HADS-T was good. Although no instrument was successful in identifying psychiatric disorders, HADS-T came closest with a fair performance in patients and partners. LimitationsSeveral patients and partners declined participation because they perceived participation as too distressing. As decliners possibly have the highest rates of disorders, our findings might underestimate the prevalence of psychiatric disorders. A low prevalence negatively affects the positive predictive value and complicates efficient screening for psychiatric disorders. ConclusionThe HADS-T appears to be a suitable screening instrument for ruling out those lung cancer patients and partners without a psychiatric disorder. Regarding identifying those with a psychiatric disorder, HADS-T should be used to refer both patients and partners for further diagnostics and treatment to a psychiatrist/psychologist.

Examining the Relationship Between Family Caregivers' Emotional States and Ability to Empathize with Patients with Multiple Sclerosis: A Pilot Study.

Multiple sclerosis (MS) is the most common nontraumatic cause of disability affecting young adults in Canada. Caregivers of patients with MS are highly psychologically burdened. Empathy and helping behaviors are hallmarks of quality care, but when they are challenged, suboptimal patient care can result. We aimed to evaluate the prevalence of negative emotional states among primary caregivers of people with MS; the association between the caregiver's empathy-related behavior and the physical and cognitive impairment of the person with MS; and the association between the caregiver's emotional status and his or her empathy-related behaviors. We conducted a descriptive, cross-sectional pilot study with family caregivers of noninstitutionalized individuals living with MS. We used univariate linear regression models for each potential predictor. The Kruskal-Wallis test was conducted to compare differences in caregiver empathic responses depending on Profile of Mood States subscale scores. Thirty percent of caregivers had elevated or very elevated mood scores, and such elevated scores were associated with greater functional impact of MS on the person with MS. Patient severity of cognitive impairment was not associated with caregiver mood scores. Caregiver mood state was not associated with empathy-related behaviors. Empathy-related behaviors were less frequent when levels of anger and hostility were higher, but this association did not reach statistical significance. Given the elevated levels of fatigue, depression, and anger observed among caregivers in this study, clinicians need to be aware of the potential impact of caregiving and to assess the needs of caregivers.

The Blood Donor Anxiety Scale: a six-item state anxiety measure based on the Spielberger State-Trait Anxiety Inventory.

Research demonstrates that anxiety elevates the risk of blood donors experiencing adverse events, which in turn deters the performance of repeat blood donations. Identifying donors suffering from heightened state anxiety is important to assess the impact of evidence-based interventions. This study analyzed the appropriateness of a shortened version of the state subscale of the State-Trait Anxiety Inventory (STAI) in a blood donation context. STAI-State questionnaire data were collected from two separate samples of Australian blood donors (n = 919 and n = 824 after cleaning). Responses to demographic, donation history, and adverse reaction questions were also obtained. Identification of items and analysis was performed systematically to assess and compare internal reliability and content, construct, convergent, and criterion validity of three potential short-form state anxiety scales. Of the three short-form scales tested, STAI-State six-item scale demonstrated the best metric properties with the least number of items across both sample groups. Cronbach's alpha was acceptable (α = 0.844 and α = 0.820), correlated positively with the original measure (r = 0.927 and r = 0.931) and criterion-related variables, and maintained the two-dimension factorial structure of the original measure. The six-item short version of the STAI-State subscale presented the most reliable and valid scale for use with blood donors. A validated donor anxiety tool provides a standardized assessment and record of donor anxiety to gauge the effectiveness of ongoing efforts to enhance the donation experience.

Evaluation of Postoperative Pain Control and Quality of Recovery in Patients Using Intravenous Patient-Controlled Analgesia with Fentanyl: A Prospective Randomized Study.

Opioids are increasingly used to control postoperative pain via intravenous patient-controlled analgesia, with several advantages. The present study evaluated the effects of intravenous patient-controlled analgesia with different doses of fentanyl on postoperative pain and on the quality of physical/emotional recovery from surgery and anesthesia. We retrospectively reviewed data from 288 patients, and evaluated whether intravenous patient-controlled analgesia with fentanyl correlated with the degree of postoperative pain. We then prospectively studied 47 patients who underwent elective laparoscopic cholecystectomy. The patients were randomized into 2 groups (15 or 30 μg/mL of fentanyl), and postoperative pain control was compared using a visual analog scale score. Furthermore, the Japanese 40-item quality of recovery (QoR-40J) score (global and dimensional) and Hospital Anxiety and Depression Scale (HADS) were used to assess the quality of recovery from surgery and anesthesia. Of 288 patients, 20% complained of intolerable pain and 18% experienced postoperative nausea and vomiting. In the prospective study, the visual analog scale pain score was lower in the Fentanyl 30 group than in the Fentanyl 15 group (p<0.05) on postoperative day 1. Dimensional QoR-40J pain subscales correlated with both the emotional state subscales (postoperative day 1, p<0.05; day 2, p<0.05) and global QoR-40 scores on both postoperative days (day 1, p<0.05; day 2, p<0.05). The postoperative pain as well as the physical and emotional quality of recovery in the patients who underwent laparoscopic cholecystectomy could be alleviated by sufficient doses of opioids.

Buspirone for management of dyspnea in cancer patients receiving chemotherapy: a randomized placebo-controlled URCC CCOP study.

Cancer-related dyspnea is a common, distressing, and difficult-to-manage symptom in cancer patients, resulting in diminished quality of life and poor prognosis. Buspirone, a non-benzodiazepine anxiolytic which does not suppress respiration and has proven efficacy in the treatment of generalized anxiety disorder, has been suggested to relieve the sensation of dyspnea in patients with COPD. The main objective of our study was to evaluate whether buspirone alleviates dyspnea in cancer patients. We report on a randomized, placebo-controlled trial of 432 patients (mean age 64, female 51%, lung cancer 62%) from 16 participating Community Clinical Oncology Program (CCOP) sites with grade 2 or higher dyspnea, as assessed by the Modified Medical Research Council Dyspnea Scale. Dyspnea was assessed by the Oxygen Cost Diagram (OCD; higher scores are better) and anxiety by the state subscale of the State-Trait Anxiety Inventory (STAI-S; lower scores are better) at baseline and after the 4-week intervention (post-intervention). Mean scores from baseline to post-intervention for buspirone were OCD 8.7 to 9.0 and STAI-S 40.5 to 40.1 and for placebo were OCD 8.4 to 9.3 and STAI-S 40.9 to 38.6 with raw improvements over time on both measures being greater in the placebo group. Analysis of covariance (ANCOVA) controlling for baseline scores showed no statistically significant difference between groups for OCD (P = 0.052) or STAI-S (P = 0.062). Buspirone did not result in significant improvement in dyspnea or anxiety in cancer patients. Thus, buspirone should not be recommended as a pharmacological option for dyspnea in cancer patients.