Emotion regulation strategies mediate the associations of positive and negative affect to upper extremity physical function

Effects of Tai Chi Chuan training on the QoL and psychological well-being in female patients with breast cancer: a systematic review of randomized controlled trials

Background

Tai Chi Chuan (TCC) may have a positive impact on physical and psychological well-being in breast cancer patients, but the evidence remains limited and inconclusive. This systematic review aims to evaluate the effects of TCC on the quality of life (QoL) and psychological symptoms in women patients with breast cancer.

Methods

This review has been registered on PROSPERO (ID: CRD42019141977). Randomized controlled trials (RCTs) of TCC for breast cancer were searched from eight major English and Chinese databases. All trials included were analyzed in accordance with the Cochrane Handbook. The primary outcomes were QoL, anxiety, and depression in patients with breast cancer. Fatigue, sleep quality, cognitive function, and inflammatory cytokine were the secondary outcomes.

Results

Fifteen RCTs involving a total of 1,156 breast cancer participants were included in this review. The methodological quality of included trials was generally poor. The pooled results suggested that TCC-based exercise could significantly improve QoL [standardized mean difference (SMD)=0.35, 95%CI: 0.15-0.55, I ² = 0, model: fixed, IV], anxiety [weighted mean difference (WMD)=-4.25, 95%CI: -5.88 to -2.63, I ² = 0, model: fixed, IV], and fatigue (SMD=-0.87, 95%CI: -1.50 to -0.24, I ² = 80.9%, model: random, DL) compared other controls, with moderate to low certainty of evidence. The improvement of QoL and fatigue by TCC was also clinically meaningful. However, TCC-based exercise failed to show any between-group differences in depression, sleep quality, cognitive function, and inflammatory cytokine. Post-hoc analysis revealed that TCC-based exercise outperformed the other exercise in improving shoulder function with very low certainty of evidence.

Conclusion

Our findings manifested that TCC-based exercise is helpful for improving the QoL, anxiety, and fatigue in patients with breast cancer within the range of comparisons covered in this study. However, the results must be treated with great caution because of the methodological flaws of included trials. Larger, well-designed, and conducted randomized controlled trials with longer follow-up is warranted in the future to evaluate the important outcomes of TCC for breast cancer.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141977, identifier, CRD42019141977.

Does a Patient's Approach to Achieving Goals Influence His or Her Recovery Trajectory After Musculoskeletal Illness?

BACKGROUND

The regulatory focus theory posits that, in general, people tend to be predominantly "promotion focused" or "prevention focused", and each individual's values and motivations influence which approach he or she may use when pursuing personal goals. People who are primarily promotion focused mostly see goals as opportunities to gain or advance (that is, play to win); people who are prevention focused mostly see goals as opportunities to stay safe (that is, play not to lose). Understanding the role of regulatory focus in the recovery of patients with orthopaedic conditions could provide novel insight into how surgeons can best communicate with patients to improve how they recover from illness or injury.

QUESTION/PURPOSE

Are improvements in pain intensity and disability over 6 months associated with a patient's levels of promotion focus or prevention focus?

METHODS

In this longitudinal observational study, we enrolled 144 patients with an upper extremity orthopaedic illness at a tertiary teaching hospital and followed them for 6 months. At baseline, patients completed validated self-reported measures of regulatory focus (Regulatory Focus Questionnaire), pain (Numerical Rating Scale), disability (the QuickDASH), and demographics. Assessments were repeated 6 months later, with 76% (110 of 144) of patients completing follow-up assessments. We examined whether regulatory focus was associated with recovery outcomes (level of pain and disability at 6 months). The patient's regulatory focus was graded as two numerical scores on separate promotion-focus and prevention-focus continuums. Each individual received a score on promotion focus and one on prevention focus..

RESULTS

An individual's level of promotion (ΔR = 0.021; p = 0.03; small effect size), but not his or her level of prevention (ΔR = 0.003; p = 0.35; negligible effect size), was associated with improvement in disability over a 6-month period (R = 0.61; p < 0.001). Patients with high promotion (n = 20, b = 0.284; p = 0.001) had the greatest improvements in disability after 6 months compared with patients with moderate (n = 73, b = 0.422; p < 0.001) or low (n = 17, b = 0.561; p < 0.001) promotion. The levels of promotion (b = -0.22; p = 0.09) and prevention (b = -0.04; p = 0.65) were not associated with pain over time.

CONCLUSIONS

To support improvements in disability for patients with upper extremity orthopaedic conditions, surgeons' communication strategies, including explanations of diagnoses and recovery trajectories, should focus on increasing patients' level of promotion (for example, by emphasizing gains and promoting positive thinking), rather than prevention (for example, by providing reassurance and problem-solving what might go wrong).

LEVEL OF EVIDENCE

Level II, prognostic study.

Physical, cognitive, behavior, and negative emotion in older adults living in China: a national population-based survey

Background

Previous studies have concentrated on predictors of exceptional longevity, however, relevant studies have rarely extended to other fields of functioning. To date, little is known about what contributes to the experience of negative emotion in a very old population.

Objective

We aimed to provide a comprehensive key domain of functioning, including physical, cognitive, behavior, and negative emotion in older adults (OAs), followed by determination of predictors of negative emotion.

Methods

Data were collected from a nationally representative sample of 2570 Chinese OAs (aged 60 and above) from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey. Physical function was assessed using activities of daily living (ADL) and instrumental activities of daily living (IADL) measures. Cognitive function was assessed by the Modified Mini-Mental State Examination (mMMSE). Participants' behavior included smoking, drinking, exercise, physical labor, and social activities. Negative emotion was assessed using four items on affective experiences to create an index of emotional well-being. The associations between various covariates and multiple health outcomes were examined using Pearson's correlation. Multiple linear regressions were established to verify significant variables associated with respondents' negative emotion.

Results

The mean age was 80.20 years (SD=8.60). The mean ADL total score of the sample was 17.78 (SD=0.89), mean IADL total score was 21.93 (SD=3.69), the mean mMMSE total score was 21.63 (SD=2.23), the mean negative emotion total score was 8.89 (SD=2.64). Multiple linear regression analyses revealed that negative emotion was associated with self-perceived low economic status, poor self-rated health condition, poor sleep quality, low IADL function, less regular exercising, living in rural, and being female.

Conclusion

Limited physical functioning and social resources in rural residence may restrict the outpouring of emotion in OAs. Nevertheless, further intensive studies are warranted to provide guidance for the development of better living environment for this elderly population.

The effect of willpower workshop on anxiety, depression, and the excitement components in the students of Shiraz university of medical sciences

Introduction and Aim:

The current study aimed at evaluating the effect of willpower workshop on anxiety, depression, and the Granovsky excitement components among the students of Shiraz University of Medical Sciences in the academic year 2016--2017.

Materials and Methods:

Students (140) were selected by the simple random sampling method and allocated into two equal groups of intervention (willing) and control, each of 52 individuals. Data collection instruments were the Garnefski cognitive emotion regulation scale and the Beck depression and anxiety inventories. The data were collected twice, before intervention and after the intervention (9 months after the study completion and holding the workshops). The control subjects received no intervention but were interviewed every 3 months.

Results:

The results of the current study indicated no significant differences in demographic variables and pretest scores between the groups, which indicate the homogeneity of the groups. In other words, there were no significant differences between the groups regarding demographic characteristics before the intervention (P > 0.05). In addition, to compare the intervention and control groups, the Mann--Whitney U test was used and the results showed a significant difference in posttest results between the study groups (P < 0.05). Also, there was a significant difference between the pretest and posttest results of each group (P < 0.05).

Conclusion:

Results of the current study indicated that training the stress, coping and willpower strengthening skills, based on the Granovsky excitement components, could promote psychophysical health and reduce anxiety and stress among the studied students.

The relationship between spiritual well-being, mental health, and quality of life in cancer patients receiving chemotherapy

Background and Aim:

Cancer is the second cause of death after cardiovascular diseases in the world. Each year, more than 70,000 new cases of cancer and 30,000 deaths from cancer have been recorded in Iran. Cancer also reduces quality of life (QoL) by creating negative physical and mental symptoms. The purpose of this study was to investigate the relationship between mental health, spiritual well-being and QoL among cancer patients receiving chemotherapy.

Method:

About 208 adults suffering from cancer and receiving chemotherapy in Shiraz hospitals were entered in the study and they were asked to complete the Paloutzian and Ellison Spiritual Well-being Questionnaire, and Goranowski Mental Health, Quality of Life and Excitement Questionnaire. For data analysis, descriptive statistics including mean (standard deviation) and frequency (percentages) were used in table and chart format, moreover Spearman correlation tests were also used.

Results:

The results of the study revealed that there was a positive and significant correlation between mental health and QoL (P = 0.001) in cancer patients receiving chemotherapy. The results of the study revealed that there was a positive and significant correlation between spiritual well-being and mental health (P = 0.001) and QoL (P = 0.01) in cancer patients receiving chemotherapy, but there was a negative and significant Correlation between spiritual well-being and negative emotions (P = 0.47). On the other hand, there was a negative and significant correlation between mental health (P = 0.026) and QoL (P = 0.019) and negative emotions respectively.

Conclusion:

The results of this study showed that there was a positive and significant relationship between spiritual well-being, mental health, and QoL in cancer patients.

Type D personality in patients with upper extremity musculoskeletal illness: Internal consistency, structural validity and relationship to pain interference

OBJECTIVE

Type D personality - the joint tendency toward negative affectivity (NA) and social inhibition (SI) - is associated with greater symptom perception and negative health outcomes among various patient populations. We investigated Type D personality among patients with upper extremity musculoskeletal illness.

METHOD

In cross-sectional design, we estimated the prevalence of Type D personality in this population and explored the associations of two different Type D conceptualizations (i.e., categorical and dimensional as the NA×SI interaction) and the individual NA and SI traits with pain interference as well as structural-internal validity of DS14.

RESULTS

The categorical Type D personality and greater NA and SI were associated with pain interference above and beyond descriptive variables, but the interaction term between NA and SI was not. NA explained a larger proportion of the variance in pain interference than SI. DS14 showed a two-factor structure and high internal consistency in this sample.

CONCLUSIONS

The categorical Type D allows for identifying individuals who struggle with recovery from musculoskeletal injury. Although the dimensional conceptualization didn't prove to be associated with pain interference, NA and SI appear to have individual effects on pain interference, with most variance being accounted for by NA. Implications for clinical care are discussed.