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Abstract
BACKGROUND Patients and their relatives often expect to be actively involved in decisions of treatment. Even during resuscitation and acute medical care, patients may want to have their relatives nearby, and relatives may want to be present if offered the possibility. The principle of family presence during resuscitation (FPDR) is a triangular relationship where the intervention of family presence affects the healthcare professionals, the relatives present, and the care of the patient involved. All needs and well-being must be balanced in the context of FPDR as the actions involving all three groups can impact the others. OBJECTIVES The primary aim of this review was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of post-traumatic stress disorder (PTSD)-related symptoms in the relatives. The secondary aim was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of other psychological outcomes in the relatives and what effect family presence compared to no family presence during resuscitation of patients has on patient morbidity and mortality. We also wanted to investigate the effect of FPDR on medical treatment and care during resuscitation. Furthermore, we wanted to investigate and report the personal stress seen in healthcare professionals and if possible describe their attitudes toward the FPDR initiative. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL from inception to 22 March 2022 without any language limits. We also checked references and citations of eligible studies using Scopus, and searched for relevant systematic reviews using Epistomonikos. Furthermore, we searched ClinicalTrials.gov, WHO ICTRP, and ISRCTN registry for ongoing trials; OpenGrey for grey literature; and Google Scholar for additional trials (all on 22 March 2022). SELECTION CRITERIA We included randomized controlled trials of adults who have witnessed a resuscitation attempt of a patient (who was their relative) at the emergency department or in the pre-hospital emergency medical service. The participants of this review included relatives, patients, and healthcare professionals during resuscitation. We included relatives aged 18 years or older who have witnessed a resuscitation attempt of a patient (who is their relative) in the emergency department or pre-hospital. We defined relatives as siblings, parents, spouses, children, or close friends of the patient, or any other descriptions used by the study authors. There were no limitations on adult age or gender. We defined patient as a patient with cardiac arrest in need of cardiopulmonary resuscitation (CPR), a patient with a critical medical or traumatic life-threatening condition, an unconscious patient, or a patient in any other way at risk of sudden death. We included all types of healthcare professionals as described in the included studies. There were no limitations on age or gender. DATA COLLECTION AND ANALYSIS We checked titles and abstracts of studies identified by the search, and obtained the full reports of those studies deemed potentially relevant. Two review authors independently extracted data. As it was not possible to conduct meta-analyses, we synthesized data narratively. MAIN RESULTS The electronic searches yielded a total of 7292 records after deduplication. We included 2 trials (3 papers) involving a total of 595 participants: a cluster-randomized trial from 2013 involving pre-hospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice, and its 1-year assessment; and a small pilot study from 1998 of FPDR in an emergency department in the UK. Participants were 19 to 78 years old, and between 56% and 64% were women. PTSD was measured with the Impact of Event Scale, and the median score ranged from 0 to 21 (range 0 to 75; higher scores correspond to more severe disease). In the trial that accounted for most of the included participants (570/595), the frequency of PTSD-related symptoms was significantly higher in the control group after 3 and 12 months, and in the per-protocol analyses a significant statistical difference was found in favor of FPDR when looking at PTSD, anxiety and depression, and complicated grief after 1 year. One of the included studies also measured duration of patient resuscitation and personal stress in healthcare professionals during FPDR and found no difference between groups. Both studies had high risk of bias, and the evidence for all outcomes except one was assessed as very low certainty. AUTHORS' CONCLUSIONS There was insufficient evidence to draw any firm conclusions on the effects of FPDR on relatives' psychological outcomes. Sufficiently powered and well-designed randomized controlled trials may change the conclusions of the review in future.
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Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
| | | | - Suzanne Forsyth Herling
- The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU (Service d'Aide Médicale Urgente) de Paris, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Cochrane Pre-hospital and Emergency Care Field, Paris, France
- Université Paris Cité, Paris Cardiovascular Research Centre (PARCC), INSERM, Integrative Epidemiology of Cardiovascular Diseases Team, Paris, France
| | - Ann Merete Møller
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
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Quasi-causal associations between chronotype and post-traumatic stress disorder symptoms: A twin study. Sleep Health 2023; 9:218-227. [PMID: 36775751 DOI: 10.1016/j.sleh.2023.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE The evening ("night owl") chronotype is associated with greater severity and lifetime prevalence of post-traumatic stress disorder (PTSD) symptoms compared to morning or intermediate chronotypes. This twin study investigated the gene-environment relationships between chronotype, recent PTSD symptoms, and lifetime intrusive symptoms. METHODS We used the reduced Horne-Östberg Morningness-Eveningness Questionnaire (rMEQ) to assess chronotype in a sample of 3777 same-sex adult twin pairs raised together (70.4% monozygotic, 29.6% dizygotic) in the community-based Washington State Twin Registry. PTSD symptoms were reported on the Impact of Events Scale (IES) and a single item for lifetime experience of intrusive symptoms after a stressful or traumatic event. RESULTS Genetic influences accounted for 50% of chronotype variance, 30% of IES score variance, and 14% of lifetime intrusive symptom variance. Bivariate twin models showed a phenotypic association (bp) between evening chronotype and more severe PTSD symptoms (bp = -0.16, SE = 0.02, p < .001) that remained significant even after adjusting for shared genetic and environmental influences (bp = -0.10, SE = 0.04, p = .009), as well as age, sex, and self-reported sleep duration (bp = -0.11, SE = 0.04, p = .004). An association was found between evening chronotype and lifetime intrusive symptoms (bp = -0.11, SE = 0.03, p < .001) that was no longer significant after adjusting for shared genetic and environmental influences (bp = 0.04, SE = 0.06, p = .558). CONCLUSIONS Our results suggest a "quasi-causal" relationship between evening chronotype and PTSD symptoms that is not purely attributable to genetic or shared environmental factors. Evening chronotype may increase vulnerability to pathologic stress responses in the setting of circadian misalignment, providing potential avenues of prevention and treatment using chronobiological strategies.
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Craparo G, La Rosa VL, Commodari E, Marino G, Vezzoli M, Faraci P, Vicario CM, Cinà GS, Colombi M, Arcoleo G, Severino M, Costanzo G, Gori A, Mangiapane E. What Is the Role of Psychological Factors in Long COVID Syndrome? Latent Class Analysis in a Sample of Patients Recovered from COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010494. [PMID: 36612816 PMCID: PMC9819212 DOI: 10.3390/ijerph20010494] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 05/24/2023]
Abstract
Background: This study aimed to identify clusters of long COVID-19 symptoms using latent class analysis and investigate the psychological factors involved in the onset of this syndrome. Method: Five hundred and six subjects recovering from COVID-19 completed a series of standardized questionnaires to evaluate the personality traits, alexithymia, and post-traumatic stress. Results: Five classes were identified: Brain fog (31.82%), No symptoms (20.95%), Sensory disorders (18.77%), Breath impairment (17.59%), and Multiple disorders (10.87%). Women reported post-COVID-19 respiratory symptoms and multiple disorders to a greater extent than men. Hospitalized subjects were more likely to report persistent symptoms after COVID-19 than asymptomatic or home-treated subjects. Antagonism, hyperarousal, and difficulty identifying emotions significantly predicted post COVID-19 symptoms. Conclusions: These findings open new questions for research on long COVID-19 and how states of emotional dysregulation can alter the physiological processes of the body and contribute to the onset of organic pathologies.
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Affiliation(s)
- Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy
| | | | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Graziella Marino
- IRCCS—Referral Cancer Center of Basilicata (CROB), 85028 Rionero in Vulture, Italy
| | - Michela Vezzoli
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Palmira Faraci
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, 98122 Messina, Italy
| | - Gabriella Serena Cinà
- Department of Psychology, U.O.C., Azienda Sanitaria Provinciale Trapani, 91100 Trapani, Italy
| | | | | | | | - Giulia Costanzo
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy
| | - Alessio Gori
- Department of Health Sciences, University of Florence, 50121 Florence, Italy
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Kothari A, Bruxner G, Dulhunty JM, Ballard E, Callaway L. Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes. BMC Pregnancy Childbirth 2022; 22:956. [PMID: 36550457 PMCID: PMC9773585 DOI: 10.1186/s12884-022-05288-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes. METHODS A prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose male partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event. RESULTS Data for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%). CONCLUSION Our study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.
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Affiliation(s)
- A. Kothari
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - G. Bruxner
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - J. M. Dulhunty
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - E. Ballard
- grid.1049.c0000 0001 2294 1395QIMR Berghofer Medical Research Institute, Brisbane, Queensland Australia
| | - L. Callaway
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia ,grid.416100.20000 0001 0688 4634The Royal Brisbane and Women’s Hospital, Brisbane, Queensland Australia
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Armand S, Wagner MK, Ozenne B, Verbunt J, Sep SJS, Berg SK, Knudsen GM, Stenbæk DS. Acute Traumatic Stress Screening Can Identify Patients and Their Partners at Risk for Posttraumatic Stress Disorder Symptoms After a Cardiac Arrest: A Multicenter Prospective Cohort Study. J Cardiovasc Nurs 2022; 37:394-401. [PMID: 37707973 DOI: 10.1097/jcn.0000000000000829] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is prevalent in patients who have had a cardiac arrest and their partners. Accordingly, acute traumatic stress screening is recommended, but its association with later PTSD symptoms has never been addressed in postresuscitation settings. OBJECTIVE The aim of this study was to examine whether acute traumatic stress is associated with PTSD symptoms in patients who have had a cardiac arrest and their partners. METHODS This multicenter longitudinal study of 141 patients and 97 partners measures acute traumatic stress at 3 weeks and PTSD symptoms at 3 months and 1 year after resuscitation, using the Impact of Event Scale. Linear regression models were used to evaluate the association between severity of acute traumatic stress and PTSD symptoms and post hoc to explore effects of group (patients/partners), age, and sex on acute traumatic stress severity. We categorized Impact of Event Scale scores higher than 26 at 3 months and 1 year as clinical severe PTSD symptoms . RESULTS Higher acute traumatic stress severity is significantly positively associated with higher PTSD symptom severity at 3 months (patients and partners: P < .001) and 1 year (patients and partners: P < .001) postresuscitation, with the strongest association for women compared with men ( P = .03). Acute traumatic stress was higher in women compared with men across groups ( P = .02). Clinical severe PTSD symptoms were present in 26% to 28% of patients and 45% to 48% of partners. CONCLUSION Experiencing a cardiac arrest may elicit clinical severe PTSD symptoms in patients, but particularly in their partners. Screening patients and partners for acute traumatic stress postresuscitation is warranted to identify those at increased risk of long-term PTSD symptoms.
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Paechter M, Phan-Lesti H, Ertl B, Macher D, Malkoc S, Papousek I. Learning in Adverse Circumstances: Impaired by Learning With Anxiety, Maladaptive Cognitions, and Emotions, but Supported by Self-Concept and Motivation. Front Psychol 2022; 13:850578. [PMID: 35496215 PMCID: PMC9046842 DOI: 10.3389/fpsyg.2022.850578] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/11/2022] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 summer semester 2020 posed many challenges and uncertainties, quite unexpectedly and suddenly. In a sample of 314 psychology students, it was investigated how they experienced learning and preparing for an end-of-semester exam, which emotions and strain they experienced, how academic performance was affected, and how personal antecedents of learning as important facets of a learner’s identity could support or prevent overcoming adverse circumstances of learning. The participants of the study filled in a questionnaire about their achievement emotions and strain they experienced during learning and exam preparation as well as academic self-concept, motivation, gender, proneness to anxiety. Points achieved in the exam were also recorded. The interaction between the variables was investigated by a structural equation model. It showed that the investigated variables can be distinguished into two groups, variables that contribute mainly negatively to performance and variables with a positive contribution. Strain experienced during the COVID-19 pandemic and unpleasant emotions “belong together” in the sense that they inhibit academic performance directly or indirectly. Proneness to anxiety in academic situations was related with higher levels of mental, emotional, and physical disturbances due to the COVID-19 situation. In contrast, motivation and a high academic self-concept acted as support for learning and performance. Both contribute to pleasant achievement emotions in the learning situation; moreover, motivation had a direct relationship to academic performance. The results from the present study do not only provide insight into important students’ personal dispositions and their role for learning in adverse circumstances but also give advice how to strengthen students for successful learning.
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Affiliation(s)
- Manuela Paechter
- Educational Psychology Unit, Department of Psychology, University of Graz, Graz, Austria
| | - Hellen Phan-Lesti
- Department of Education, Ludwig Maximilian University of Munich, Munich, Germany
| | - Bernhard Ertl
- Department of Education, Universität der Bundeswehr München, Neubiberg, Germany
| | - Daniel Macher
- Educational Psychology Unit, Department of Psychology, University of Graz, Graz, Austria
| | - Smirna Malkoc
- Educational Psychology Unit, Department of Psychology, University of Graz, Graz, Austria.,Institute for Practical Education and Action Research, University College of Teacher Education Styria, Graz, Austria
| | - Ilona Papousek
- Biological Psychology Unit, Department of Psychology, University of Graz, Graz, Austria
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Kerns J, Cheeks M, Cassidy A, Pearlson G, Mengesha B. Abortion Stigma and Its Relationship with Grief, Post-traumatic Stress, and Mental Health-Related Quality of Life After Abortion for Fetal Anomalies. WOMEN'S HEALTH REPORTS 2022; 3:385-394. [PMID: 35415714 PMCID: PMC8994429 DOI: 10.1089/whr.2021.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/13/2022]
Abstract
Background: Materials and Methods: Results: Discussion: Implications for Practice and/or Policy:
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Affiliation(s)
- Jennifer Kerns
- Division of Zuckerberg San Francisco General, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA
| | - Morgan Cheeks
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Arianna Cassidy
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA
| | - Geffan Pearlson
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Biftu Mengesha
- Division of Zuckerberg San Francisco General, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA
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Méndez-Chacón E. Gender Differences in Perceived Stress and Its Relationship to Telomere Length in Costa Rican Adults. Front Psychol 2022; 13:712660. [PMID: 35282254 PMCID: PMC8915848 DOI: 10.3389/fpsyg.2022.712660] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Stress is associated with disease and reduced leukocyte telomere length (LTL). The objective of this research is to determine if self-perceived stress is associated with telomere length in Costa Rican adults and the gender differences in this association. Findings may help explain how some populations in apparent socioeconomic disadvantage and with limited access to specialized medical services have a remarkably high life expectancy. Methodology Data come from the pre-retirement cohort of the Costa Rican Longevity and Healthy Aging Study (CRELES), a population based survey conducted in the households to 2,327 adults aged 53 to 66 years. The DNA to measure LTL was extracted from blood cells in laboratories of the University of Costa Rica whereas the Blackburn laboratory at the University of California performed the telomere length measurement applying the quantitative polymerase chain reaction (Q-PCR). The relationship between telomere length and perceived stress was measured using least-squares multiple regression. Perceived stress was measured by a set of questions about family, job, finances and, health reasons to be stressed. Models included the control variables: (1) age and sex of the participant, (2) whether he or she resides in the Nicoya area, a “blue zone” known for its high longevity, and (3) the aforementioned sociodemographic, health and lifestyles characteristics. Results Stress perception and LTL are significantly different by sex. Women perceived higher stress levels than men in almost all aspects studied, except work. Women have significantly longer telomeres. Shorter telomeres are significantly associated with caregiving stress in men and with parental health concerns in women. Counter-intuitive telomere lengthenings were observed among women who feel stressed about caring for family members; and among men who feel stressed due to their family relationships as well as concerns about their own health. Discussion Results confirm that people with self-perceived stress due to caregiving or health issues have shorter telomeres. The relationship between stress and telomere length differs between men and women. Gender relations exert a strong modifier effect on the relationship between stress and LTL: gender is related to perceived stress, telomere length, and apparently also to the way stress and LTL are related.
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Craparo G, La Rosa VL, Marino G, Vezzoli M, Cinà GS, Colombi M, Arcoleo G, Severino M, Costanzo G, Mangiapane E. Risk of post-traumatic stress symptoms in hospitalized and non-hospitalized COVID-19 recovered patients. A cross-sectional study. Psychiatry Res 2022; 308:114353. [PMID: 34968807 PMCID: PMC8688161 DOI: 10.1016/j.psychres.2021.114353] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/31/2022]
Abstract
High rates of post-traumatic stress disorder (PTSD) symptoms have been found among patients with more severe COVID-19-related symptoms, and hospitalization is generally recognized as a risk factor for developing PTSD. Furthermore, other personality characteristics may increase the risk of developing post-traumatic stress symptoms following a COVID-19 infection. This study aimed to assess personality traits, alexithymia, dissociation, anxiety, and depression in patients who have recovered from COVID-19 and the impact of these variables on the presence of post-traumatic stress symptoms. Five hundred and six participants completed a battery of standardized questionnaires. All the scales used in this study are valid and reliable measures of their respective constructs. Results showed that high levels of alexithymia, dissociation, anxiety, and depression statistically significantly predicted the three main clusters of PTSD symptoms (avoidance, intrusion, and hyperarousal) in individuals who have recovered from COVID-19. Furthermore, negative affectivity and psychoticism significantly predicted PTSD symptoms in our sample. Finally, individuals hospitalized by COVID-19 are more at risk of developing intrusion and hyperarousal symptoms than those who never needed hospital care. Our findings are a valuable contribution in identifying the main risk factors of psychological distress related to COVID-19 to address the long-term mental health needs of people who have experienced the disease.
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Affiliation(s)
- Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, Cittadella Universitaria, Enna 94100, Italy.
| | | | - Graziella Marino
- IRCCS – Referral Cancer Center of Basilicata (CROB), Rionero in Vulture, Potenza, Italy
| | - Michela Vezzoli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Gabriella Serena Cinà
- Department of Psychology, U.O.C., Azienda Sanitaria Provinciale Trapani, Trapani, Italy
| | | | | | | | - Giulia Costanzo
- Faculty of Human and Social Sciences, Kore University of Enna, Cittadella Universitaria, Enna 94100, Italy
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Shepherd J, Waller A, Sanson-Fisher R, Clark K. Nurses' perceptions, experiences and involvement in the provision of end-of-life care in acute hospitals: A mapping review of research output, quality and effectiveness. Int J Nurs Stud 2021; 122:104007. [PMID: 34298319 DOI: 10.1016/j.ijnurstu.2021.104007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/10/2021] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Safe and high-quality end of life care is not always achieved in acute care hospitals. Nurses represent a key source of information about current practice, and active participants in interventions to improve end of life care in these settings. Examining the volume, type and quality of publications in this field can help to determine whether research is following a natural scientific progression to inform best-practice end of life care. AIMS To systematically review: (i) whether the volume and type of publications (i.e. measurement, descriptive or interventions studies) examining nurses' perceptions of, and involvement in, end-of-life care delivered in acute hospitals changed over time (i.e. since 2000); (ii) the proportion of intervention studies involving nurses that meet Risk of Bias research design criteria; and (iii) the effectiveness of intervention studies that met minimum Risk of Bias criteria. METHODS MEDLINE, Embase, CINAHL, and PsychInfo were searched for data-based papers published in English between Jan 2000 and Dec 2020. Studies were included if they focused on nurses' perceptions of, or role in, the provision of end-of-life care in hospitals. Eligible papers were classified as descriptive, measurement or intervention studies. Intervention studies were assessed against the Risk of Bias methodological criteria for research design, and their effectiveness examined. RESULTS A total of 131 papers met eligibility criteria for inclusion in the review. The number increased by 31% in each time period (p < 0.0001). Most studies were descriptive (n = 70; 53%), 11 were measurement studies (8%), and the remainder were intervention studies (n = 50; 38%). Thirteen intervention studies (26%) met eligibility criteria. Methodological quality of the eligible intervention studies was variable. Randomisation and blinding of outcome assessors were the domains of greatest concern. Results were variable, with larger, system-wide interventions that incorporated the expertise of the multidisciplinary healthcare team showing the most promise. CONCLUSION There is an increasing number of studies examining nurses' perceptions of, and involvement in, end-of-life care delivered in acute hospitals. The difficulties of conducting intervention research in this field mean that many studies are descriptive in nature. Given the importance of intervention research in establishing causal relationships, larger-scale intervention studies are essential to improving the quality of end-of-life care provided to patients dying in hospital.
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Affiliation(s)
- Jan Shepherd
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Amy Waller
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Rob Sanson-Fisher
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Katherine Clark
- Northern Sydney Local Health District, Royal North Shore Hospital Campus, Reserve Road, St Leonards, NSW 2065, Australia; Northern Clinical School, The University of Sydney, Royal North Shore Hospital Campus, Reserve Road, St Leonards, NSW 2065, Australia
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Variation in self-identified most stressful life event by outcome of previous pregnancy in a population-based sample interviewed 6-36 months following delivery. Soc Sci Med 2021; 282:114138. [PMID: 34153818 DOI: 10.1016/j.socscimed.2021.114138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/21/2022]
Abstract
The majority of health research uses a deductive approach to measure stressful life events, despite evidence that perception of what is stressful varies. The goal of this project was to 1) describe the distribution of self-identified most stressful life events in a cohort of women who experienced a perinatal loss (stillbirth or neonatal death) or live birth in the previous three years and 2) test how childhood adversity influences participant selection of their most stressful life event. We used data from 987 women (282 with stillbirth, 657 without loss, and 48 with a neonatal death in the first 28 days) in the Stillbirth Collaborative Research Network - OASIS (Outcomes after Study Index Stillbirth) follow-up study, a population-based sample set in five U.S. states in 2009. We applied an inductive coding process to open-ended responses to a question about the most stressful event or major crisis that participants had ever experienced, resulting in a set of 15 categories. We compare psychologic wellbeing across self-identified most stressful life event, accounting for sampling and loss-to-follow-up weights. Overall, stillbirth was most commonly identified as the most stressful event (18.3% [95% CI: 15.6, 21.5]), followed by loss by death of someone other than a child (17.25% [95% CI: 13.9, 20.3]). For participants who experienced a perinatal loss, we fit multivariable logistic regression models to quantify the association between report of childhood maltreatment and identifying the perinatal loss as the most stressful life event, calculating risk ratios (RRs). Reporting any moderate or severe childhood maltreatment was associated with 24% lower risk of identifying the perinatal loss as the most stressful life event (adjusted RR: 0.76 [95% CI: 0.58, 1.01]), after adjusting for race/ethnicity, age, and education. These results demonstrate the value of combining standardized measures with open-ended, inductive approaches to measuring stress in large, population-based studies.
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Traumatic Distress, Alexithymia, Dissociation, and Risk of Addiction During the First Wave of COVID-19 in Italy: Results from a Cross-sectional Online Survey on a Non-clinical Adult Sample. Int J Ment Health Addict 2021; 20:3128-3144. [PMID: 34131416 PMCID: PMC8191437 DOI: 10.1007/s11469-021-00569-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 12/20/2022] Open
Abstract
This study aimed to explore the prevalence of post-traumatic distress, alexithymia, dissociation, and addictive behaviors during the stressful situation of the COVID-19 pandemic. It also aimed to determine whether trauma, alexithymia, and dissociation can effectively predict the risk of addiction in non-clinical subjects during the COVID-19 pandemic. Two hundred nineteen subjects completed a web survey during the first COVID-19 lockdown in Italy, including the Impact of Event Scale-Revised (IES-R), the Dissociative Experience Scale-II (DES-II), and the Addictive Behavior Questionnaire (ABQ). Females reported higher levels of COVID-19-related traumatic stress than males (p = 0.009). A greater fear of getting COVID-19 was associated with significantly high IES-R scores (p < 0.0005). IES-R total score was significantly lower in the "not internet-addicted" group than that in the "internet-addicted" group (p < 0.0005). Furthermore, DES-II total score was significantly higher in the "internet-addicted" group than that in the "non internet-addicted" group (p < 0.0005). No statistically significant score differences were highlighted in the "alcohol" group. Future research with longitudinal studies and larger samples will have to clarify whether trauma, alexithymia, and dissociation can effectively predict the risk of addiction in non-clinical subjects during the COVID-19 pandemic.
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Bonichini S, Tremolada M. Quality of Life and Symptoms of PTSD during the COVID-19 Lockdown in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084385. [PMID: 33924236 PMCID: PMC8074764 DOI: 10.3390/ijerph18084385] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/30/2021] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has led to a complete lockdown in many countries and Italy was the first country interested in Europe, as the cases spread very quickly with a high rate of mortality. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, it can have a significative impact on mental health on the population involved, that is still not well known and must be explored. The objective of the present research is to investigate the Quality of Life (QoL) and Symptoms of PTSD (PTSS) encountered during the quarantine period (April 2020) due to the spread of COVID-19 in Italy. Participants (N = 1839; 1430 females and 409 males), who were volunteers and anonymous, adults (18-73 years), were drawn from a convenience sample of the general population and asked to fill out an online questionnaire, after giving an informed written consent. The General Health Questionnaire (GH12), used to assess health related QoL, identified 24.5% of respondents as problematic, and the Impact of Event Scale-Revised (IES-R), used to assess PTSS, identified the 23.5% with clinical scores. Results showed that married people/cohabitants, non-workers, and those with a lower level of education perceived a better QoL and less PTSS. The most frequent emotions felt during the first month of quarantine and referred to by participants were sadness (72%), boredom (54.5%), impotence (52%), and anxiety (50%). The COVID-19 pandemic represents one of the most stressful events in recent times worldwide and poses a major challenge for social, economic, and, above all, psychological resources of the population that must be assessed and supported if insufficient.
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Hulbert-Williams NJ, Hulbert-Williams L, Flynn RJ, Pendrous R, MacDonald-Smith C, Mullard A, Swash B, Evans G, Price A. Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial). AMRC OPEN RESEARCH 2021; 3:12. [PMID: 38708072 PMCID: PMC11064984 DOI: 10.12688/amrcopenres.12971.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 05/07/2024]
Abstract
Background Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety ( p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient-driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors. Trial registration ClinicalTrials.gov, NCT03553784 (registered 14 June 2018).
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Affiliation(s)
| | - Lee Hulbert-Williams
- Centre for Contextual Behavioural Science, School of Psychology, University of Chester, Chester, CH1 4BJ, UK
| | - Ryan James Flynn
- Centre for Contextual Behavioural Science, School of Psychology, University of Chester, Chester, CH1 4BJ, UK
| | - Rosina Pendrous
- Centre for Contextual Behavioural Science, School of Psychology, University of Chester, Chester, CH1 4BJ, UK
| | - Carey MacDonald-Smith
- North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Bodelwyddan, Rhyl, LL18 5UJ, UK
| | | | - Brooke Swash
- School of Psychology, University of Chester, Chester, CH1 4BJ, UK
| | - Gemma Evans
- School of Psychology, University of Chester, Chester, CH1 4BJ, UK
| | - Annabel Price
- Department of Psychological Medicine, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, UK
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Ritchie LA, Long MA. Psychosocial impacts of post-disaster compensation processes: Community-wide avoidance behaviors. Soc Sci Med 2021; 270:113640. [PMID: 33434716 DOI: 10.1016/j.socscimed.2020.113640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/18/2020] [Accepted: 12/19/2020] [Indexed: 11/30/2022]
Abstract
RATIONALE There is a small but growing body of literature on litigation- and compensation-related stress after disasters. Results of these studies are consistent and unsurprising: compensation processes are a source of stress to plaintiffs and their families. "Litigation Response Syndrome"-anxiety, stress, and depression-is common among those exposed to the pressures of litigation (Lees-Haley 1988). However, little is known about how compensation processes-claims, litigation, and settlements-affect communities at large. OBJECTIVE Building on prior research, we examine adverse impacts of compensation processes in Roane County, Tennessee five years following the Tennessee Valley Authority coal ash spill. We investigate whether compensation-related stress occurs at a community level, as well as avoidance behaviors as measured by the Impact of Event Scale. METHOD Based on data from a 2014 household mail survey of a random sample of 716 residents of Roane County, we examine the relationship between compensation processes and event-related avoidance behaviors. RESULTS We found that compensation-related stress is not limited to those directly involved with compensation processes. Respondents view these processes as adversely impacting the community at large. The strongest contributors to event-related avoidance behaviors are beliefs about adverse compensation impacts and the effectiveness of cleanup and restoration activities, socioeconomic status, and economic resource loss. Therefore, it appears that Litigation Response Syndrome can extend to some members of the community who were not directly involved in litigation and compensation processes.
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Affiliation(s)
- Liesel A Ritchie
- Department of Sociology, 431 Murray Hall, Oklahoma State University, Stillwater, OK, 74078, USA.
| | - Michael A Long
- Department of Sociology, 431 Murray Hall, Oklahoma State University, Stillwater, OK, 74078, USA.
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Sharif Nia H, Kaur H, Fomani FK, Rahmatpour P, Kaveh O, Pahlevan Sharif S, Venugopal AV, Hosseini L. Psychometric Properties of the Impact of Events Scale-Revised (IES-R) Among General Iranian Population During the COVID-19 Pandemic. Front Psychiatry 2021; 12:692498. [PMID: 34408679 PMCID: PMC8365034 DOI: 10.3389/fpsyt.2021.692498] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/21/2021] [Indexed: 01/07/2023] Open
Abstract
Objective: The aim of this study was to translate and evaluate the validity and reliability of the Impact of Events Scale-Revised (IES-R) among the Iranian general population during the coronavirus disease 2019 (COVID-19) pandemic. Method: This study was methodological cross-sectional. It was conducted on an Iranian public population from April to July 2020 which was during the COVID-19 pandemic. Construct validity was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a total of 500 adults recruited via online data gathering. Reliability was checked through the average inter-item correlation (AIC), Cronbach's alpha, and McDonald's omega. Convergent and divergent validity was determined using Fornell and Larcker's approach. Results: The results showed that the Persian version of IES-R had three factors, including intrusion (six items), avoidance (seven items), and hyperarousal (five items), that explained 59.22% of the total variance of the IES-R. The CFA findings indicated that all goodness-of-fit indices confirmed the model fit. The Cronbach's alpha, McDonald's omega, composite reliability (CR), and maximal reliability were excellent, and the three factors have good convergent validity. Conclusion: The findings of this study indicated that the Persian version of the IES-R scale is efficient and useful to assess post-traumatic stress disorder among Iran general population in the COVID-19 outbreak.
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Affiliation(s)
- Hamid Sharif Nia
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Harpaljit Kaur
- Faculty of Business and Law, Taylor's University, Subang Jaya, Malaysia
| | | | - Pardis Rahmatpour
- Department of Nursing, School of Nursing, Alborz University of Medical Sciences, Karaj, Iran
| | - Omolhoda Kaveh
- School of Nursing and Midwifery, Mazandaran University of Medical Science, Sari, Iran
| | - Saeed Pahlevan Sharif
- Faculty of Business and Law, Taylor's University, Subang Jaya, Malaysia.,Faculty of Business and Law, Taylor's University, Subang Jaya, Malaysia
| | | | - Lida Hosseini
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Abstract
Trauma nurses are exposed to suffering, death and dying, and vicarious trauma, which may result in nurses experiencing posttraumatic stress disorder (PTSD). This study aims to investigate the extent of PTSD and the effect of the frequency of traumatic events, coping strategies, and social support on PTSD in South Korean trauma nurses. A cross-sectional study was conducted. Participants were 145 trauma nurses recruited from 6 regional trauma centers in Korea. The data were collected through convenience sampling using self-administered questionnaires, including the Korean version of Impact of Event Scale-Revised (IES-R-K), the frequency of traumatic events, coping strategies, and social support. The data were analyzed with descriptive statistics, t test, analysis of variance, Pearson's correlation coefficients, and multiple linear regression. The prevalence of IES-R-K score of 25 or more (indicating a high risk of PTSD) was detected in 57.2% of the trauma nurses. The frequency of traumatic events, work at traumatic emergency units, dysfunctional coping, emotion-focused coping, and social support were found to be significantly associated with PTSD. Therefore, it is necessary to develop PTSD management programs in order to provide effective coping strategies and social support for relieving PTSD symptoms. At the same time, efforts to improve the working environment are needed.
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18
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Baenziger J, Roser K, Mader L, Harju E, Ansari M, Waespe N, Scheinemann K, Michel G. Post-traumatic stress in parents of long-term childhood cancer survivors compared to parents of the Swiss general population. JOURNAL OF PSYCHOSOCIAL ONCOLOGY RESEARCH AND PRACTICE 2020; 2:e024. [PMID: 32832904 PMCID: PMC7411524 DOI: 10.1097/or9.0000000000000024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/27/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND We describe post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in parents of long-term childhood cancer survivors (CCS-parents) and compare them to parents of similar-aged children (comparison-parents) of the Swiss general population (SGP). We compare type of reported stressful event, prevalence of PTSS and PTSD, and psychosocial and cancer-related characteristics associated with PTSS. We further describe the respective normative data for the SGP. METHODS We conducted a nationwide cross-sectional questionnaire survey in a population-based sample of long-term CCS-parents (survivors aged ≤16 years at diagnosis, ≥20 years at study, >5 years post-diagnosis) and in the SGP. Using the Impact of Event Scale-Revised, we measured PTSS regarding the most stressful event experienced, and computed probable cases of PTSD. RESULTS Participants included 663 CCS-parents (39.4% fathers) and 1035 individuals of the SGP (40.0% male), of which we identified 391 comparison-parents (41.2% fathers). Illness was most often indicated as stressful event (CCS-parents: 49.5%, comparison-parents: 27.6%, SGP: 25.3%). Prevalence of PTSS and PTSD (CCS-parents: 4.8%, comparison-parents: 6.7%, SGP: 5.6%) did not significantly differ. Lower education was associated with higher intrusion, avoidance, and hyperarousal in all samples (all P ≤ .003). Parents of children with a chronic illness reported higher intrusion (all P ≤ .004). We found no associations with cancer-related characteristics. CONCLUSIONS No increased risk for PTSS or PTSD was found among CCS-parents. Individuals with lower education and those with a chronically ill child might benefit from additional support to help manage and resolve the stress symptoms in the long term.
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Affiliation(s)
- Julia Baenziger
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Luzius Mader
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Erika Harju
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marc Ansari
- Division of Pediatrics, Onco-Hematology Unit, Geneva University Hospitals, Geneva, Switzerland
- CANSEARCH research laboratory, Geneva University Medical School, Geneva, Switzerland
| | - Nicolas Waespe
- CANSEARCH research laboratory, Geneva University Medical School, Geneva, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Katrin Scheinemann
- Division of Hematology/Oncology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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19
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Resick JM, Arnold RM, Sudore RL, Farrell D, Belin S, Althouse AD, Ferrell B, Hammes BJ, Chu E, White DB, Rak KJ, Schenker Y. Patient-centered and efficacious advance care planning in cancer: Protocol and key design considerations for the PEACe-compare trial. Contemp Clin Trials 2020; 96:106071. [PMID: 32739493 PMCID: PMC7510772 DOI: 10.1016/j.cct.2020.106071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/05/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Failure to deliver care near the end of life that reflects the needs, values and preferences of patients with advanced cancer remains a major shortcoming of our cancer care delivery system. METHODS A mixed-methods comparative effectiveness trial of in-person advance care planning (ACP) discussions versus web-based ACP is currently underway at oncology practices in Western Pennsylvania. Patients with advanced cancer and their caregivers are invited to enroll. Participants are randomized to either (1) in-person ACP discussions via face-to-face visits with a nurse facilitator following the Respecting Choices® Conversation Guide or (2) web-based ACP using the PREPARE for your care™ web-based ACP tool. The trial compares the effect of these two interventions on patient and family caregiver outcomes (engagement in ACP, primary outcome; ACP discussions; advance directive (AD) completion; quality of end-of-life (EOL) care; EOL goal attainment; caregiver psychological symptoms; healthcare utilization at EOL) and assesses implementation costs. Factors influencing ACP effectiveness are assessed via in-depth interviews with patients, caregivers and clinicians. DISCUSSION This trial will provide new and much-needed empirical evidence about two patient-facing ACP approaches that successfully overcome limitations of traditional written advance directives but entail very different investments of time and resources. It is innovative in using mixed methods to evaluate not only the comparative effectiveness of these approaches, but also the contexts and mechanisms influencing effectiveness. Data from this study will inform clinicians, payers and health systems seeking to adopt and scale the most effective and efficient ACP strategy in real-world oncology settings.
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Affiliation(s)
- Judith M Resick
- Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Pittsburgh, PA, 15213, USA.
| | - Robert M Arnold
- Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Pittsburgh, PA, 15213, USA.
| | - Rebecca L Sudore
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, USA; San Francisco Veterans Affairs Health Care System, SFVAMC 4150 Clement Street, #151R, San Francisco, CA 94121, USA.
| | - David Farrell
- People Designs, Inc., 1304 Broad Street, Durham, NC 27705, USA.
| | - Shane Belin
- Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Pittsburgh, PA, 15213, USA.
| | - Andrew D Althouse
- Center for Research on Health Care Data Center, University of Pittsburgh School of Medicine, 200 Meyran Avenue, Suite 300, Pittsburgh, PA 15213, USA.
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Medical Center, 1500 Duarte Road, Duarte, CA 91010, USA.
| | - Bernard J Hammes
- Respecting Choices, A Division of C-TAC Innovations, PO Box 258, Oregon, WI 53575-0258, USA.
| | - Edward Chu
- Department of Medicine, Division of Hematology-Oncology and Cancer Therapeutics Program, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Douglas B White
- University of Pittsburgh, School of Medicine, Department of Critical Care Medicine, Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Program on Ethics and Decision Making, 600 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15213, USA.
| | - Kimberly J Rak
- University of Pittsburgh, School of Medicine, Department of Critical Care Medicine, Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Program on Ethics and Decision Making, 3520 Fifth Ave, Suite100, Pittsburgh, PA 15213, USA.
| | - Yael Schenker
- Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Pittsburgh, PA, 15213, USA.
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20
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McCall CA, Turkheimer E, Tsang S, Avery A, Duncan GE, Watson NF. Sleep duration and post-traumatic stress disorder symptoms: a twin study. Sleep 2020; 42:5549607. [PMID: 31408518 DOI: 10.1093/sleep/zsz179] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/18/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Long and short sleep duration are associated with greater risk of developing post-traumatic stress disorder (PTSD); however, it is unknown how genetic and environmental influences affect this relationship. Thus, we investigated the association between sleep duration and PTSD symptoms using twin models. METHODS Data were obtained from 1865 monozygotic and 758 dizygotic twin pairs enrolled in the community-based Washington State Twin Registry. PTSD symptoms were assessed using the Impact of Events Scale (IES). A classical twin model decomposed the variances of sleep duration and IES score into additive genetic, shared environmental, and unique environmental components. We used correlated factor models to examine the moderation of variance components of sleep duration and IES. RESULTS Shorter and longer sleep duration were associated with higher IES scores with a quadratic association (p < 0.001). The heritability of sleep duration was 36%, and IES 31%. Variance in sleep duration attributable to shared (b1C1 = 2.91, 95% CI = 1.40 to 4.43; p < 0.001) and unique (b1E1 = 0.18, 95% CI = 0.10 to 0.27; p < 0.001) environment was moderated by IES score. Similarly, but to a lesser extent, variance in IES attributable to additive genetics (b1A2 = -0.23, 95% CI = -0.45 to 0.00; p = 0.048) was moderated by sleep duration. CONCLUSIONS Greater PTSD symptom severity was associated with short and long sleep duration. Increasing PTSD symptoms increased variability in sleep duration primarily via shared environmental factors, whereas decreasing sleep duration increased variability in PTSD symptoms primarily via additive genetic factors. This suggests childhood experiences affect variability of sleep duration and genetic factors affect the variability of PTSD symptoms in trauma-exposed individuals.
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Affiliation(s)
- Catherine A McCall
- Department of Pulmonary, Critical Care, and Sleep Medicine, VA Puget Sound Health Care System, Seattle.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and University of Washington Sleep Medicine Center, Seattle
| | - Eric Turkheimer
- Department of Psychology, University of Virginia, Charlottesville
| | - Siny Tsang
- Washington State Twin Registry, Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Ally Avery
- Washington State Twin Registry, Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Glen E Duncan
- Washington State Twin Registry, Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Nathaniel F Watson
- Department of Neurology, University of Washington School of Medicine and University of Washington Sleep Medicine Center, Seattle
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21
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Amass TH, Villa G, OMahony S, Badger JM, McFadden R, Walsh T, Caine T, McGuirl D, Palmisciano A, Yeow ME, De Gaudio R, Curtis JR, Levy MM. Family Care Rituals in the ICU to Reduce Symptoms of Post-Traumatic Stress Disorder in Family Members-A Multicenter, Multinational, Before-and-After Intervention Trial. Crit Care Med 2020; 48:176-184. [PMID: 31939785 PMCID: PMC7147959 DOI: 10.1097/ccm.0000000000004113] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the feasibility and efficacy of implementing "Family Care Rituals" as a means of engaging family members in the care of patients admitted to the ICU with a high risk of ICU mortality on outcomes including stress-related symptoms in family members. DESIGN Prospective, before-and-after intervention evaluation. SETTING Two U.S. academic medical ICU's, and one Italian academic medical/surgical ICU. SUBJECTS Family members of patients who had an attending predicted ICU mortality of greater than 30% within the first 24 hours of admission. INTERVENTIONS A novel intervention titled "Family Care Rituals" during which, following a baseline observation period, family members enrolled in the intervention phase were given an informational booklet outlining opportunities for engagement in care of the patient during their ICU stay. MEASUREMENTS AND MAIN RESULTS Primary outcome was symptoms of post-traumatic stress disorder in family members 90 days after patient death or ICU discharge. Secondary outcomes included symptoms of depression, anxiety, and family satisfaction. At 90-day follow-up, 131 of 226 family members (58.0%) responded preintervention and 129 of 226 family members (57.1%) responded postintervention. Symptoms of post-traumatic stress disorder were significantly higher preintervention than postintervention (39.2% vs 27.1%; unadjusted odds ratio, 0.58; p = 0.046). There was no significant difference in symptoms of depression (26.5% vs 25.2%; unadjusted odds ratio, 0.93; p = 0.818), anxiety (41.0% vs 45.5%; unadjusted odds ratio, 1.20; p = 0.234), or mean satisfaction scores (85.1 vs 89.0; unadjusted odds ratio, 3.85; p = 0.052) preintervention versus postintervention 90 days after patient death or ICU discharge. CONCLUSIONS Offering opportunities such as family care rituals for family members to be involved with providing care for family members in the ICU was associated with reduced symptoms of post-traumatic stress disorder. This intervention may lessen the burden of stress-related symptoms in family members of ICU patients.
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Affiliation(s)
- Timothy H Amass
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Brown University, Providence RI, USA
| | - Gianluca Villa
- Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Sean OMahony
- Department of Internal Medicine, Palliative Medicine Section, Rush University Medical Center, Chicago, IL, USA
| | - James M. Badger
- Department of Psychiatry, Brown University, Providence RI, USA
| | - Rory McFadden
- Department of Internal Medicine, Palliative Medicine Section, Rush University Medical Center, Chicago, IL, USA
| | - Thomas Walsh
- Rhode Island Hospital, Research Division of Pulmonary, Critical Care & Sleep, Providence RI, USA
| | - Tanis Caine
- Rhode Island Hospital, Research Division of Pulmonary, Critical Care & Sleep, Providence RI, USA
| | - Don McGuirl
- Rhode Island Hospital, Research Division of Pulmonary, Critical Care & Sleep, Providence RI, USA
| | - Amy Palmisciano
- Rhode Island Hospital, Research Division of Pulmonary, Critical Care & Sleep, Providence RI, USA
| | - Mei-Ean Yeow
- Center for Palliative Care, Mayo Clinic, Rochester, NY, USA
| | - Raffaele De Gaudio
- Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - J. Randall Curtis
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - Mitchell M. Levy
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Brown University, Providence RI, USA
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Lučić L. Parents of Children with Developmental Difficulties and Parents of Typically Developed Children: What Happens in a Year? Behav Sci (Basel) 2019; 10:E4. [PMID: 31861464 PMCID: PMC7016978 DOI: 10.3390/bs10010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/03/2022] Open
Abstract
Parents of children with developmental difficulties (DD) face many challenges on an everyday basis and, compared to a parent of a typically developed child (TD), are at risk to experience lower well-being. Earlier, as a part of the CRO-WELL project, we explored differences in the well-being of parents of children with DD and a matching group of parents of TD children. Results showed that both groups of parents were equally happy and satisfied with their lives in general, with only a difference in satisfaction with free time. The aim of the current study was to explore what happened in one-year's time. Out of the initial sample of 41 parents by group, the second wave was completed by 19 parents of DD children and 27 parents of TD children. Results showed that parents of children with DD were less satisfied with life in general, as well as less happy and less satisfied with health, family, friends, and safety compared to parents of TD children. They also experienced three times more negative events than parents of TD children. Having a child with developmental difficulties reflects on many life domains and these results could serve as a guidepost in the design of support for families of children with developmental difficulties. All authors have read and agreed to the published version of the manuscript.
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Affiliation(s)
- Lana Lučić
- Ivo Pilar Institute of Social Sciences, Zagreb 10000, Croatia
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Bakker LP, Eriksen S, Reichelt JG, Grov EK. The experiences of dealing with consequences of an avalanche - surviving soldiers' perspectives. Int J Qual Stud Health Well-being 2019; 14:1689066. [PMID: 31713468 PMCID: PMC6853213 DOI: 10.1080/17482631.2019.1689066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2019] [Indexed: 12/01/2022] Open
Abstract
Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago.Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster.Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies.Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events.
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Affiliation(s)
- Lars-Petter Bakker
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Oslo, Norway
| | - Siren Eriksen
- Faculty of Health Studies, Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway, and VID Specialized university, Oslo, Norway
| | - Jon Gerhard Reichelt
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Abstract
In the United States, the iconic groundfish fishery for Gulf of Maine cod has endured several dramatic reductions in annual catch limits and been federally declared an economic disaster. Using a repeated cross-sectional survey of fishing captains to assess potential social impacts of the fishery failure, we found that psychological distress and social disruption were pervasive throughout New England fishing communities. For instance, our results indicate that 62% of captains self-reported severe or moderate psychological distress 1 y after the crisis began, and these patterns have persisted for 5 y. Using classification tree analyses, we found that low levels of trust in fisheries management was the most powerful predictor of both initial and chronic psychological distress. Distress was most severe among individuals without income diversity and those with dependents in the household. Compared to other aspects of fisheries, measuring and managing for noneconomic social outcomes and human well-being has lagged behind, even though it is a necessary component of mitigating the adverse impacts of fisheries disruptions.
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Bakker LP, Småstuen MC, Reichelt JG, Gjerstad CL, Tønnessen A, Weisæth L, Herlofsen PH, Grov EK. The trajectory of symptom burden in exposed and unexposed survivors of a major avalanche disaster: a 30 year long-term follow-up study. BMC Psychiatry 2019; 19:175. [PMID: 31182052 PMCID: PMC6558916 DOI: 10.1186/s12888-019-2159-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/23/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Limited research exists concerning the long-term effects of avalanches on survivors' mental health beyond the first years after the accident. The aims of this study were to describe and evaluate possible differences in long-term mental health symptoms after a major avalanche disaster between exposed and unexposed soldiers using a longitudinal design. METHOD Present mental health symptoms were examined among avalanche exposed (n = 12) and unexposed (n = 9) soldiers by PTSS-10, IES-15 and STAI-12 in four waves (1986-1987 and 2016). RESULTS Binary logistic regression revealed that the odds to score above the cut-off were significantly lower for both groups after one year compared to baseline for PTSS-10 (p = 0.018) and significantly lower after 30 days compared to baseline for IES-15 (p = 0.005). Data did not reveal significant differences between the exposed and unexposed groups regarding adjusted PTSS-10, IES-15 or STAI-12 mean scores compared. Linear mixed model-analyses revealed significant effects of time. The adjusted mean scores declined over time for both groups: PTSS-10 (p = 0.001), IES-15 (p = 0.026) and STAI-12 (p = 0.001), and the time trajectories for PTSS-10 were significantly different between the groups (p = 0.013). Although not significant (all p > 0.05), results indicated that a larger proportion of soldiers in the exposed group experienced posttraumatic stress symptoms (5/12) (PTSS-10 score ≥ 4) and distress symptoms (6/12) (IES-15 score ≥ 26) above cut-off points, 30 years post-disaster. CONCLUSIONS The course of mental health symptoms may persist, and even increase, in selected and trained military personnel 30 years after exposure to a natural disaster. These findings may be of great importance for health authorities planning appropriate follow-up.
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Affiliation(s)
- Lars-Petter Bakker
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, PO Box 1550, Sentrum, N-0015, Oslo, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130 Oslo, Norway
| | - Jon Gerhard Reichelt
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, PO Box 1550, Sentrum, N-0015 Oslo, Norway
| | - Christer Lunde Gjerstad
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, PO Box 1550, Sentrum, N-0015 Oslo, Norway
| | - Arnfinn Tønnessen
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, PO Box 1550, Sentrum, N-0015 Oslo, Norway
| | - Lars Weisæth
- 0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, Gaustad sykehus. Bygg 4, PO Box 1039, N-0315 Oslo, Blindern Norway
| | | | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130 Oslo, Norway
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Gregory J, de Lepinau J, de Buyer A, Delanoy N, Mir O, Gaillard R. The impact of the Paris terrorist attacks on the mental health of resident physicians. BMC Psychiatry 2019; 19:79. [PMID: 30791878 PMCID: PMC6385411 DOI: 10.1186/s12888-019-2058-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 02/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND On November 13, 2015, terrorist attacks took place in Paris. One hundred and twenty-nine people were immediately killed and 302 needed emergency care. Many resident physicians were on the front line of the medical response. Our aim was to report the frequency of symptoms of post-traumatic stress disorder (PTSD), anxiety and depression among resident physicians after the Paris terrorist attacks. METHODS Anonymous questionnaires, including the Impact of Event Scale- Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS), were emailed two months after the attacks to 2413 Parisian resident physicians. Exposure to the attacks was defined as having direct clinical contact with one of the victims up to one week after the attacks, being one of the victims, or having one among close relatives. RESULTS The questionnaire was completed by 680 (28.2%) residents. Eighty-four (12.4%) reported symptoms of PTSD (IES-R ≥ 33), 76 (11.2%) reported symptoms of anxiety (HADS anxiety score > 10) and 16 (2.4%) reported symptoms of depression (HADS depression score > 10). Exposed residents had higher IES-R scores than non-exposed residents (18.8 ± 16.6 versus 14.2 ± 12.0, p = 0.001), and 40 (18.5%) of them reported symptoms of PTSD, compared to 44 (9.5%) of the non-exposed residents (p = 0.001). CONCLUSIONS There was a high frequency of symptoms of mental distress among our respondents. Dedicated screening and care strategies must be considered in the event of new attacks.
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Affiliation(s)
- Jules Gregory
- Syndicat des Internes des Hôpitaux de Paris (SIHP), 17 rue du Fer à Moulin, 75005, Paris, France.
| | - Jean de Lepinau
- 0000 0001 2175 4109grid.50550.35Syndicat des Internes des Hôpitaux de Paris (SIHP), 17 rue du Fer à Moulin, 75005 Paris, France
| | - Ariane de Buyer
- 0000 0001 2175 4109grid.50550.35Syndicat des Internes des Hôpitaux de Paris (SIHP), 17 rue du Fer à Moulin, 75005 Paris, France
| | - Nicolas Delanoy
- 0000 0001 2175 4109grid.50550.35Syndicat des Internes des Hôpitaux de Paris (SIHP), 17 rue du Fer à Moulin, 75005 Paris, France
| | - Olivier Mir
- 0000 0001 2284 9388grid.14925.3bDepartment of Cancer Medicine, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Raphaël Gaillard
- 0000 0001 2188 0914grid.10992.33Department of Psychiatry, Service Hospitalo-Universitaire, Centre Hospitalier Sainte Anne, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine Paris Descartes, Paris, France
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Raulji C, Velez MC, Prasad P, Rousseau C, Gardner RV. Impact of Hurricane Katrina on healthcare delivery for New Orleans patients, 2005-2014. Pediatr Blood Cancer 2018; 65:e27406. [PMID: 30251459 DOI: 10.1002/pbc.27406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/01/2018] [Accepted: 07/16/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Hematology/oncology patients have special health needs. To identify barriers to care, we surveyed patients/parents at Children's Hospital of New Orleans 1 year after Hurricane Katrina. We then implemented a "Hurricane Action Plan"-identification of families' evacuation plans at each hurricane season's onset; of hospital(s) and pharmacies in the intended evacuation area; updating roadmaps/treatment plans; giving information to families requiring hematology/oncology services in evacuation areas. Administration of a second survey was initiated 7 years post Katrina to assess the efficacy of the "Hurricane Action Plan." METHODS Both surveys were conducted on random patients attending Children's Hospital. Survey #1 was performed in 2006, while survey #2 was conducted in 2013-2014. RESULTS Eighty-nine percent of 124 families left New Orleans during Hurricane Katrina; only 50% had an evacuation plan. Twenty-five percent of families had difficulty physically accessing care; others (13%) could not find a hematology/oncology provider for follow-up and had difficulty reaching their primary provider or making appointments. An additional 25 percent did not have access to medical records. There was no access to mental health services. Eighty- two patients/representatives were surveyed in 2013/2014; 72% of families were evacuated during subsequent hurricane seasons with 78% of families having an evacuation plan. Thirty-six percent of patients had a roadmap/treatment plan with them; 71% had a 2-week medication supply. Ninety-two percent found information given to them by providers helpful. CONCLUSIONS Interventions instituted to allow greater access to care by our hematology/oncology patients after Hurricane Katrina resulted in better preparedness, easier acquisition of information, and possibly better continuity of care.
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Affiliation(s)
- Chittalsinh Raulji
- Department of Pediatric Hematology/Oncology, Eastern Maine Medical Center, Bangor, Maine
| | - Maria C Velez
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Louisiana State University Health Sciences Center (LSUHSC) and Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Pinki Prasad
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Louisiana State University Health Sciences Center (LSUHSC) and Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Cierra Rousseau
- Department of Pharmacology, Xavier University of Louisiana, New Orleans, Louisiana
| | - Renee V Gardner
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Louisiana State University Health Sciences Center (LSUHSC) and Children's Hospital of New Orleans, New Orleans, Louisiana
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Ohana M, Sellers SL, Mooney J, Kueh SH, Grover R, Arepalli CD, Selvakumar K, Kim U, Blanke P, Leipsic JA. Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients. J Cardiovasc Comput Tomogr 2018; 12:364-371. [DOI: 10.1016/j.jcct.2018.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/21/2018] [Accepted: 04/30/2018] [Indexed: 10/17/2022]
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Schneider A, Andrade J, Tanja-Dijkstra K, Moles DR. Mental imagery in dentistry: Phenomenology and role in dental anxiety. J Anxiety Disord 2018; 58:33-41. [PMID: 30025254 DOI: 10.1016/j.janxdis.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/16/2018] [Accepted: 06/22/2018] [Indexed: 12/26/2022]
Abstract
Dental anxiety is a prevalent problem with marked psychological, physical and public health implications. Based on cognitive theory and evidence, we hypothesized that vivid, sensory image-based cognitions play a role in dental anxiety. A quantitative online survey (N = 306) and qualitative semi-structured interviews (N = 18) found that vivid sensory images were common irrespective of dental anxiety levels, but that their content, associated distress and responses varied. Participants reporting higher anxiety experienced intense and intrusive fear-provoking dental imagery focusing on unpleasant sensations, which were associated with the intrusive recollection of negative past experiences and avoidance of dentistry. Participants with lower anxiety ratings, reported images that were less distressing and centered around reassuring aspects and positive appointment outcomes, potentially acting as protective factors against dental anxiety and facilitating appointment attendance. The inclusion of components aimed at reducing intrusive memories and dental imagery rescripting may help improve interventions for dental anxiety.
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Affiliation(s)
- Annegret Schneider
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
| | - Jackie Andrade
- School of Psychology, Cognition Institute, University of Plymouth, United Kingdom
| | - Karin Tanja-Dijkstra
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, VU Amsterdam, The Netherlands
| | - David R Moles
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, United Kingdom
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Padaki AS, Noticewala MS, Levine WN, Ahmad CS, Popkin MK, Popkin CA. Prevalence of Posttraumatic Stress Disorder Symptoms Among Young Athletes After Anterior Cruciate Ligament Rupture. Orthop J Sports Med 2018; 6:2325967118787159. [PMID: 30109239 PMCID: PMC6083780 DOI: 10.1177/2325967118787159] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: The risk of depression and the fear of reinjury were documented in recent investigations of patients after anterior cruciate ligament (ACL) ruptures. The extent of psychological trauma accompanying these injuries among young athletes, however, has never been assessed. Hypothesis: Posttraumatic stress disorder (PTSD) symptoms after ACL injury are present among young athletes with high athletic identities. Study Design Case series; Level of evidence, 4. Methods: Patients ≤21 years of age who had suffered an acute ACL rupture were consecutively recruited at a tertiary care center. Patients completed the Horowitz Impact of Event Scale - Revised (IES-R) to analyze for PTSD symptomatology, the Athletic Identity Measurement Scale, and an athlete specialization instrument created at the authors’ institution. Results: A total of 24 patients were consecutively recruited. The mean patient age was 14.5 ± 2.7 years, and 50% of patients were male. More than 87.5% of patients experienced avoidance symptoms, 83.3% acknowledged symptoms of intrusion, and 75% had symptoms of hyperarousal. Patients aged 15 to 21 years incurred a higher severity of PTSD symptoms than younger patients (P = .033). Female patients experienced greater emotional trauma than male patients (P = .017). Finally, patients with high athletic identities experienced greater emotional trauma than those with lesser athletic identities, but this finding was not statistically significant (P = .14). Conclusion: Following ACL rupture, young athletes experience significant emotional trauma, including symptoms of avoidance, intrusion, and hyperarousal. High school and college athletes, female athletes, and patients with high athletic identities may be most susceptible.
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Affiliation(s)
- Ajay S Padaki
- Columbia University Medical Center, New York, New York, USA
| | | | | | | | - Michael K Popkin
- Department of Psychiatry, Hennepin County Medical Center, Minneapolis, Minnesota, USA
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Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications. Contraception 2018; 97:520-523. [DOI: 10.1016/j.contraception.2018.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 02/05/2023]
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Van't Wout Hofland J, Moulaert V, van Heugten C, Verbunt J. Long-term quality of life of caregivers of cardiac arrest survivors and the impact of witnessing a cardiac event of a close relative. Resuscitation 2018; 128:198-203. [PMID: 29567463 DOI: 10.1016/j.resuscitation.2018.03.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/06/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The incidence of cardiac arrest is high, with a poor survival rate of 8-14%. Currently, only limited evidence is available about long-term consequences of cardiac arrest on quality of life of caregivers. AIMS First, to determine the level of daily functioning and quality of life in caregivers of cardiac arrest survivors two years after the cardiac arrest. Second, to study the long-term impact of witnessing the event of a cardiac arrest. METHODS A longitudinal cohort study including caregivers of cardiac arrest survivors. Participants received a questionnaire at home. Outcome variables were instrumental daily activities(FAI), emotional functioning(HADS), fatigue(FSS), caregiver strain(CSI), impact of event(IES), and quality of life(SF36). RESULTS 57 caregivers (89% female, age 56,9 ± 12 years) participated. Two years after the cardiac arrest, quality of life of caregivers equals that of the general population, although almost 30% still scored high on the Impact of Events Scale. Mean IES-, FSS-, CSI and FAI-scores were increased as compared to the general population (P < 0.001). Two years after the cardiac arrest, caregivers that witnessed the resuscitation (IES = 23.6 ± 14.9) still experienced significantly more trauma related stress than caregivers that did not witness the resuscitation (11.9 ± 12.5; p < 0.01). CONCLUSIONS Two years after the cardiac arrest, quality of life of caregivers is quite good, but almost one third of the caregivers still experience a high level of trauma-related stress, especially in those that witnessed the resuscitation. Future research will have to focus on the effectiveness of support programs for caregivers of survivors of cardiac arrest.
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Affiliation(s)
- Janine Van't Wout Hofland
- CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University, PO box 616, 6200 MD, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht University, PO box 616, 6200 MD, Maastricht, the Netherlands
| | - Veronique Moulaert
- Adelante, Centre of Expertise in Rehabilitation and Audiology, 6432 CC Hoensbroek, the Netherlands; University of Groningen, University Medical Center Groningen, Hanzeplein 1 (9713 GZ) Groningen, the Netherlands
| | - Caroline van Heugten
- Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Neuroscience, School for Mental Health and Neuroscience (MHeNS), P.O. Box 616 6200 MD, Maastricht, The Netherlands,; Maastricht University, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, P.O. Box 616 6200 MD, Maastricht, The Netherlands,; Limburg Brain Injury Center, P.O. Box 616 6200 MD, Maastricht, The Netherlands
| | - Jeanine Verbunt
- CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University, PO box 616, 6200 MD, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht University, PO box 616, 6200 MD, Maastricht, the Netherlands,.
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Heyland DK, Davidson J, Skrobik Y, des Ordons AR, Van Scoy LJ, Day AG, Vandall-Walker V, Marshall AP. Improving partnerships with family members of ICU patients: study protocol for a randomized controlled trial. Trials 2018; 19:3. [PMID: 29301555 PMCID: PMC5753514 DOI: 10.1186/s13063-017-2379-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/24/2017] [Indexed: 11/24/2022] Open
Abstract
Background Over the last decade, health care delivery has shifted to partnering with patients and their families to improve health and quality of care, and to lower costs. Partnering with family members (FMs) of critically ill patients who lack capacity is particularly important for improving experiences and outcomes for both patients and FMs. How best to apply such partnering strategies, however, is yet unknown. The IMPACT trial will evaluate two interventions that enable partnerships with families of critically ill patients, each in a distinct content area, but similar in that they empower and support FMs. Methods This multi-center, open-label, randomized, phase II clinical trial aims to randomize 150 older, long-stay ICU patients and their families into one of three groups (50 in each group): (1) The OPTimal nutrition by Informing and Capacitating FMs of best practices (OPTICs) group, a multi-faceted intervention to engage and empower FMs to advocate for, and audit, best nutritional practices for their critically ill FMs, (2) A web-based decision-support intervention called the ICU Workbook (The Canadian Researchers at the End of Life Network (CARENET) ICU Workbook; https://www.myicuguide.ca/. Accessed 3 Feb 2017.) to support families in shared decision-making process regarding goals of medical treatments, and (3) Usual care. The main outcomes for this trial include nutritional adequacy in hospital and hand-grip strength prior to hospital discharge; satisfaction with decision-making; decision conflict; and degree of shared decision-making. Discussion With the goal of improving the functional recovery of nutritionally high-risk older patients and the quality of care at the end of life for these patients and their FMs in the ICU, we have proposed two novel family capacitation strategies. We hope that the nutrition and decision-support interventions implemented and evaluated in our study will contribute to the evidentiary basis for best family partnered care pathways focused on optimizing the quality of ICU care for patients with life-threatening illness and their families. Trial registration Clinical trials.gov, ID: NCT02920086. Registered on 30 September 2016. Protocol version dated 11 October 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2379-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daren K Heyland
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada. .,Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada. .,Kingston General Hospital, Angada 4, Kingston, ON, K7L 2 V7, Canada.
| | - Judy Davidson
- EBP/Research Nurse Liaison, University of California, San Diego Health, San Diego, CA, USA
| | - Yoanna Skrobik
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Amanda Roze des Ordons
- Department of Critical Care Medicine and Division of Palliative Medicine, University of Calgary, Calgary, AB, Canada
| | - Lauren J Van Scoy
- Department of Medicine and Humanities, Division of Pulmonary, Allergy and Critical Care, Pennsylvania State University, Hershey, PA, USA
| | - Andrew G Day
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada
| | - Virginia Vandall-Walker
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.,Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Andrea P Marshall
- Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Southport, QLD, Australia
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Aho AL, Malmisuo J, Kaunonen M. The effects of peer support on post-traumatic stress reactions in bereaved parents. Scand J Caring Sci 2017; 32:326-334. [DOI: 10.1111/scs.12465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 03/05/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Liisa Aho
- School of Health Sciences; University of Tampere; Tampere Finland
| | - Jaana Malmisuo
- School of Health Sciences; University of Tampere; Tampere Finland
| | - Marja Kaunonen
- School of Health Sciences; University of Tampere; Tampere Finland
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Abstract
OBJECTIVE To assess patients' recollections of in-ICU procedural pain and its impact on post-ICU burden. DESIGN Prospective longitudinal study of patients who underwent ICU procedures. SETTING Thirty-four ICUs in France and Belgium. PATIENTS Two hundred thirty-six patients who had undergone ICU procedures. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS Patients were interviewed 3-16 months after hospitalization about: 1) recall of procedural pain intensity and pain distress (on 0-10 numeric rating scale); 2) current pain; that is, having pain in the past week that was not present before hospitalization; and 3) presence of traumatic stress (Impact of Events Scale). For patients who could rate recalled procedural pain intensity (n = 56) and pain distress (n = 43), both were significantly higher than their median (interquartile range) in ICU procedural pain scores (pain intensity: 5 [4-7] vs 3 [2.5-5], p < 0.001; pain distress: 5 [2-6] vs 2 [0-6], p = 0.003, respectively.) Current pain was reported in 14% of patients. When comparing patients with and without current pain, patients with current pain recalled even greater ICU procedural pain intensity and pain distress scores than patients without current pain: pain intensity, 8 (6-8) versus 5 (3.25-7); p = 0.002 and pain distress, 7 (5-8) versus 4 (2-6); p = 0.01, respectively. Patients with current pain also had significantly higher Impact of Events Scale scores than those without current pain (8.5 [3.5-24] vs 2 [0-10]; p < 0.001). CONCLUSION Many patients remembered ICU, with far fewer able to rate procedure-associated pain. For those able to do so, recalled pain intensity and pain distress scores were significantly greater than reported in ICU. One in seven patients was having current pain, recalling even higher ICU procedural pain scores and greater traumatic stress when compared with patients without current pain. Studies are needed to assess the impact of ICU procedural pain on post-ICU pain recall, pain status over time, and the relationship between postdischarge pain status and post-ICU burden.
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Peters EMJ, Müller Y, Snaga W, Fliege H, Reißhauer A, Schmidt-Rose T, Max H, Schweiger D, Rose M, Kruse J. Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PLoS One 2017; 12:e0175904. [PMID: 28423056 PMCID: PMC5397031 DOI: 10.1371/journal.pone.0175904] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 04/02/2017] [Indexed: 12/25/2022] Open
Abstract
Mouse models show that experimental stress mimicking prolonged life-stress exposure enhances neurogenic inflammation, induces adaptive immunity cytokine-imbalance characterized by a shift to Type 1 T-helper cell cytokines and increases apoptosis of epithelial cells. This affects hair growth in otherwise healthy animals. In this study, we investigate whether a prolonged naturalistic life-stress exposure affects cytokine balance and hair parameters in healthy humans. 33 (18 exam, 15 comparison) female medical students with comparable sociobiological status were analyzed during a stressful final examination period, at three points in time (T) 12 weeks apart. T1 was before start of the learning period, T2 between the three-day written exam and an oral examination, and T3 after a 12 week rest and recovery from the stress of the examination period. Assessments included: self-reported distress and coping strategies (Perceived Stress Questionnaire [PSQ], Trier Inventory for the Assessment of Chronic Stress [TICS]), COPE), cytokines in supernatants of stimulated peripheral blood mononucleocytes (PBMCs), and trichogram (hair cycle and pigmentation analysis). Comparison between students participating in the final medical exam at T2 and non-exam students, revealed significantly higher stress perception in exam students. Time-wise comparison revealed that stress level, TH1/TH2 cytokine balance and hair parameters changed significantly from T1 to T2 in the exam group, but not the control. However, no group differences were found for cytokine balance or hair parameters at T2. The study concludes that in humans, naturalistic stress, as perceived during participation in a major medical exam, has the potential to shift the immune response to TH1 and transiently hamper hair growth, but these changes stay within a physiological range. Findings are instructive for patients suffering from hair loss in times of high stress. Replication in larger and more diverse sample populations is required, to assess suitability of trichogram analysis as biological outcome for stress studies.
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Affiliation(s)
- Eva M. J. Peters
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
- * E-mail:
| | - Yvonne Müller
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
| | - Wenke Snaga
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
| | - Herbert Fliege
- Foreign Office, Health Service, Psychosocial Counseling, Auswärtiges Amt, Berlin, Germany
| | - Anett Reißhauer
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for Physical Medicine and Rehabilitation, Berlin, Germany
| | | | | | | | - Matthias Rose
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
| | - Johannes Kruse
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
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Abstract
Introduction Disaster and humanitarian responders are at-risk of experiencing a wide range of physical and psychological health conditions, from minor injuries to chronic mental health problems and fatalities. This article reviews the current literature on the major health outcomes of responders to various disasters and conflicts in order to better inform individuals of the risks and to inform deploying agencies of the health care needs of responders. METHODS In March 2014, an EMBASE search was conducted using pre-defined search criteria. Two reviewers screened the resultant 2,849 abstracts and the 66 full-length manuscripts which are included in the review. RESULTS The majority of research on health outcomes of responders focused on mental health (57 of 66 articles). Posttraumatic stress disorder (PTSD) and depression were the most studied diagnoses with prevalence of PTSD ranging from 0%-34% and depression from 21%-53%. Physical health outcomes were much less well-studied and included a wide range of environmental, infectious, and traumatic conditions such as heat stroke, insect bites, dermatologic, gastrointestinal, and respiratory diseases, as well as burns, fractures, falls, and other traumatic injuries. CONCLUSIONS The prevalence of mental health disorders in responders may vary more and be higher than previously suggested. Overall health outcomes of responders are likely poorly monitored and under-reported. Improved surveillance systems and risk mitigation strategies should be employed in all disaster and conflict responses to better protect individual responders. Garbern SC , Ebbeling LG , Bartels SA . A systematic review of health outcomes among disaster and humanitarian responders. Prehosp Disaster Med. 2016;31(6):635-642.
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Bauml JM, Troxel A, Epperson CN, Cohen RB, Schmitz K, Stricker C, Shulman LN, Bradbury A, Mao JJ, Langer CJ. Scan-associated distress in lung cancer: Quantifying the impact of "scanxiety". Lung Cancer 2016; 100:110-113. [PMID: 27597289 DOI: 10.1016/j.lungcan.2016.08.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 07/27/2016] [Accepted: 08/07/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Diagnostic imaging may be a major source of cancer-related distress, a condition known as "scanxiety". Scant scholarly work has been performed to evaluate scan-associated distress in cancer. We sought to characterize risk factors for scan-associated distress among patients with Non-Small Cell Lung Cancer (NSCLC), and to evaluate the impact of scan-associated distress on quality of life. MATERIALS AND METHODS We conducted a cross-sectional survey study of patients with recurrent/metastatic NSCLC treated at an academic medical center. Clinical and demographic variables were obtained through chart abstraction and patient self-report. We used a modified version of the Impact of Event Scale 6 (IES-6) to specifically assess distress associated with scans, and quality of life was measured using the Functional Assessment of Cancer Therapy - Lung (FACT-L). RESULTS Among 103 participants (survey response rate 76.3%), median age was 67, 61.2% were women, and 82.5% were white. At the study visit, 72.8% of subjects discussed a recent scan, and 83% reported some scan-associated distress. Scan-associated distress was not associated with whether the patient had a recent scan, progressive disease or time from diagnosis. Scan-associated distress was associated with impaired quality of life (p=0.004); each unit increase in IES-6 corresponded to an approximately one-unit decrease in FACT-L score. CONCLUSION Scan-associated distress is a common problem among patients with NSCLC, and is associated with impaired quality of life. Scan-associated distress severity was not associated with time since diagnosis or whether a recent scan was discussed at the study visit, which implies scan-associated distress may be a persistent problem.
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Affiliation(s)
- Joshua M Bauml
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
| | - Andrea Troxel
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - C Neill Epperson
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Roger B Cohen
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | | | - Carrie Stricker
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Carevive Systems, United States
| | - Lawrence N Shulman
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Angela Bradbury
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Corey J Langer
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, United States; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
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de Laage A, Allodji R, Dauchy S, Rivollet S, Fayech C, Fresneau B, Oberlin O. Screening for psychological distress in very long-term adult survivors of childhood cancer. Pediatr Hematol Oncol 2016; 33:295-313. [PMID: 27657743 DOI: 10.1080/08880018.2016.1204400] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study evaluated the prevalence of psychological distress (PD) in a cohort of 348 adult childhood cancer survivors with a very long-term follow-up and assessed the characteristics associated with this distress (cancer type, treatment, sex, age at diagnosis, self-reported late effects, social support, type of remembrance, time since the diagnosis, age at evaluation), assuming that with time since the diagnosis, the PD of survivors will approximate that of the general population. Before attending a long-term follow-up consultation, survivors were sent 3 questionnaires: the Brief Symptom Inventory-18, the Impact of Event Scale, and the Illness Worry Scale (IWS). During the visit, they were administered the Mini-International Neuropsychiatric Interview (MINI) by a psychologist. The mean age of the survivors was 38.5 years (18.1-65.8) at consultation, 7 years (0.0-18.0) at cancer diagnosis, and mean time since diagnosis was 31.5 years (8.8-56.1). Multiple regression analyses of the data collected from self-administered questionnaires confirmed that being female, living alone, and self-reported late effects were associated with the high scores for all scales. Negative remembrances and being accompanied to the clinic were associated with higher IWS scores. Unlike the initial hypothesis, the MINI showed that, compared with controls, survivors experienced a higher prevalence of anxiety and mood disorders even after a very long time since the diagnosis. These findings show that a substantial subset of survivors experiment a high prevalence of PD, higher than the general population, and should be screened for PD whatever the time since the diagnosis.
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Affiliation(s)
- Astrid de Laage
- a Department of Pediatrics , Institut Gustave-Roussy , Villejuif , France
| | - Rodrigue Allodji
- b Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health , Institut National de la Santé et de la Recherche Médicale, UMR 1018 , Villejuif , France
| | - Sarah Dauchy
- a Department of Pediatrics , Institut Gustave-Roussy , Villejuif , France
| | - Sophie Rivollet
- a Department of Pediatrics , Institut Gustave-Roussy , Villejuif , France
| | - Chiraz Fayech
- a Department of Pediatrics , Institut Gustave-Roussy , Villejuif , France
| | - Brice Fresneau
- a Department of Pediatrics , Institut Gustave-Roussy , Villejuif , France
| | - Odile Oberlin
- a Department of Pediatrics , Institut Gustave-Roussy , Villejuif , France
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Misund AR, Bråten S, Nerdrum P, Pripp AH, Diseth TH. A Norwegian prospective study of preterm mother-infant interactions at 6 and 18 months and the impact of maternal mental health problems, pregnancy and birth complications. BMJ Open 2016; 6:e009699. [PMID: 27147380 PMCID: PMC4861097 DOI: 10.1136/bmjopen-2015-009699] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Pregnancy, birth and health complications, maternal mental health problems following preterm birth and their possible impact on early mother-infant interaction at 6 and 18 months corrected age (CA) were explored. Predictors of mother-infant interaction at 18 months CA were identified. DESIGN AND METHODS This prospective longitudinal and observational study included 33 preterm mother-infant (<33 gestational age (GA)) interactions at 6 and 18 months CA from a socioeconomic low-risk, middle-class sample. The Parent-Child Early Relational Assessment (PCERA) scale was used to assess the mother-infant interaction. RESULTS 'Bleeding in pregnancy' predicted lower quality in preterm mother-infant interaction in 6 PCERA scales, while high 'maternal trait anxiety' predicted higher interactional quality in 2 PCERA scales and 'family size' predicted lower interactional quality in 1 PCERA scale at 18 months CA. Mothers with symptoms of post-traumatic stress reactions, general psychological distress and anxiety at 2 weeks postpartum (PP) showed significantly better outcome than mothers without symptoms in 6 PCERA subscales at 6 months CA and 2 PCERA subscales at 18 months CA. CONCLUSIONS Our study detected a correspondence between early pregnancy complications and lower quality of preterm mother-infant interaction, and an association between high levels of maternal mental health problems and better quality in preterm mother-infant interaction.
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Affiliation(s)
- Aud R Misund
- Faculty of Health Sciences, Department of Medicine, University College of Oslo and Akershus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stein Bråten
- Faculty of Health Sciences, Department of Medicine, University College of Oslo and Akershus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Per Nerdrum
- Faculty of Health Sciences, Department of Medicine, University College of Oslo and Akershus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Faculty of Health Sciences, Department of Medicine, University College of Oslo and Akershus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trond H Diseth
- Faculty of Health Sciences, Department of Medicine, University College of Oslo and Akershus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Wenz H, Wenz R, Maros ME, Groden C, Schmieder K, Fontana J. The neglected need for psychological intervention in patients suffering from incidentally discovered intracranial aneurysms. Clin Neurol Neurosurg 2016; 143:65-70. [DOI: 10.1016/j.clineuro.2016.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/08/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
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Miles A, McClements PL, Steele RJC, Redeker C, Sevdalis N, Wardle J. Perceived diagnostic delay and cancer-related distress: a cross-sectional study of patients with colorectal cancer. Psychooncology 2016; 26:29-36. [PMID: 26868950 DOI: 10.1002/pon.4093] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/25/2015] [Accepted: 01/15/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study aimed to examine the effect of perceived diagnostic delay on cancer-related distress and determine whether fear of cancer-recurrence and quality of life mediate this relationship. METHODS Cross-sectional study in which 311 colorectal cancer (CRC) survivors in Scotland completed a survey, which included questions on cancer-related distress (IES-R), perceived diagnostic delay, quality of life (trial outcome index of the FACT-C: FACT-C TOI) and fear of cancer recurrence. Fifteen patients withheld consent to data matching with medical records, leaving a sample size of 296. Participants were an average of 69 years old (range 56 to 81) and between 3.5 and 12 years post-diagnosis. Multiple regressions were used to test predictors of distress and regression and bootstrapping to test for mediation. RESULTS Perceived diagnostic delay was correlated with higher cancer-related distress, while objective markers of diagnostic delay (disease stage at diagnosis and treatment received) were not. Some of the relationship between perceived diagnostic delay and cancer-related distress was mediated by quality of life, but not by fear of cancer recurrence. CONCLUSIONS Perceived diagnostic delay was associated with higher cancer-related distress among CRC survivors. While poorer quality of life partly explained such associations, fear of cancer recurrence, stage at diagnosis and treatment did not. The exact features of diagnostic delay that are associated with cancer-related distress remain unclear. Future research should examine the experiences patients go through prior to diagnosis that may increase distress, in an effort to improve our understanding of the factors affecting emotional wellbeing among CRC survivors. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Paula L McClements
- Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Robert J C Steele
- Centre for Research into Cancer Prevention and Screening, Cancer Division, Medical Research Institute, Ninewells Medical School, Dundee, UK
| | - Claudia Redeker
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jane Wardle
- Health Behaviour Research Centre, Institute of Epidemiology and Public Health, University College London, London, UK
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Hogan N, Costello S, Boyle M, Williams B. Measuring workplace trauma response in Australian paramedics: an investigation into the psychometric properties of the Impact of Event Scale. Psychol Res Behav Manag 2016; 8:287-94. [PMID: 26719731 PMCID: PMC4687981 DOI: 10.2147/prbm.s96647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Investigation into the psychological effects of violence toward health care workers and its associated trauma is increasing. The Impact of Event Scale (IES) provides a measure of current, subjective, emotional distress symptomatic of a specific traumatic event. However, its validity among paramedics is largely unknown. Problem The purpose of this study was to investigate the psychometric properties and factor structure of the IES with a sample of Australian paramedics. Methods The study aimed to investigate the psychometric properties and factor structure of the 15-item IES with a sample of Australian paramedics using Exploratory Factor Analysis with model fit statistics as found in confirmatory analysis. Results Maximum Likelihood Factor Analysis with Varimax rotation supported the hypothesis that a two-factor solution would provide the best fit of the data. Procrustes rotation provided further support for this hypothesis indicating that the factors, labeled “Intrusion” and “Avoidance”, as well as the individual items of the 12-item final model, were a good fit to an ideal solution. Conclusion The revision of the scale has improved its validity for use in the general population of paramedics, improving the potential for its use in trauma-related research.
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Affiliation(s)
- Nicola Hogan
- Faculty of Education, Monash University, Clayton, VIC, Australia
| | - Shane Costello
- Faculty of Education, Monash University, Clayton, VIC, Australia
| | - Malcolm Boyle
- Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, Australia
| | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, Australia
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Ford JS, Chou JF, Sklar CA, Oeffinger KC, Novetsky Friedman D, McCabe M, Robison LL, Kleinerman RA, Li Y, Marr BP, Abramson DH, Dunkel IJ. Psychosocial Outcomes in Adult Survivors of Retinoblastoma. J Clin Oncol 2015; 33:3608-14. [PMID: 26417002 DOI: 10.1200/jco.2014.60.5733] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Survival rates for individuals diagnosed with retinoblastoma (RB) exceed 95% in the United States; however, little is known about the long-term psychosocial outcomes of these survivors. PATIENTS AND METHODS Adult RB survivors, diagnosed from 1932 to 1994 and treated in New York, completed a comprehensive questionnaire adapted from the Childhood Cancer Survivor Study (CCSS), by mail or telephone. Psychosocial outcomes included psychological distress, anxiety, depression, somatization, fear of cancer recurrence, satisfaction with facial appearance, post-traumatic growth, and post-traumatic stress symptoms; noncancer CCSS siblings served as a comparison group. RESULTS A total of 470 RB survivors (53.6% with bilateral RB; 52.1% female) and 2,820 CCSS siblings were 43.3 (standard deviation [SD], 11) years and 33.2 (SD, 8.4) years old at the time of study, respectively. After adjusting for sociodemographic factors, RB survivors did not have significantly higher rates of depression, somatization, distress, or anxiety compared with CCSS siblings. Although RB survivors were more likely to report post-traumatic stress symptoms of avoidance and/or hyperarousal (both P < .01), only five (1.1%) of 470 met criteria for post-traumatic stress disorder. Among survivors, having a chronic medical condition did not increase the likelihood of psychological problems. Bilateral RB survivors were more likely than unilateral RB survivors to experience fears of cancer recurrence (P < .01) and worry about their children being diagnosed with RB (P < .01). However, bilateral RB survivors were no more likely to report depression, anxiety, or somatic complaints than unilateral survivors. CONCLUSION Most RB survivors do not have poorer psychosocial functioning compared with a noncancer sample. In addition, bilateral and unilateral RB survivors seem similar with respect to their psychological symptoms.
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Affiliation(s)
- Jennifer S Ford
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD.
| | - Joanne F Chou
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Charles A Sklar
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Kevin C Oeffinger
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Danielle Novetsky Friedman
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Mary McCabe
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Leslie L Robison
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Ruth A Kleinerman
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Yuelin Li
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Brian P Marr
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - David H Abramson
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Ira J Dunkel
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
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Esplen MJ, Wong J, Aronson M, Butler K, Rothenmund H, Semotiuk K, Madlensky L, Way C, Dicks E, Green J, Gallinger S. Long-term psychosocial and behavioral adjustment in individuals receiving genetic test results in Lynch syndrome. Clin Genet 2015; 87:525-32. [PMID: 25297893 PMCID: PMC4391982 DOI: 10.1111/cge.12509] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 09/19/2014] [Accepted: 09/23/2014] [Indexed: 11/29/2022]
Abstract
A cross-sectional study of 155 participants who underwent genetic testing for Lynch syndrome (LS) examined long-term psychosocial and behavioral outcomes. Participants completed standardized measures of perceived risk, psychosocial functioning, knowledge, and a questionnaire of screening activities. Participants were on average 47.3 years and had undergone testing a mean of 5.5 years prior. Eighty four (54%) tested positive for a LS mutation and 71 (46%) negative. For unaffected carriers, perceived lifetime risk of colorectal cancer was 68%, and surprisingly, 40% among those testing negative. Most individuals demonstrated normative levels of psychosocial functioning. However, 25% of those testing negative had moderate depressive symptoms, as measured by the Center for Epidemiologic Studies for Depression Scale, and 31% elevated state anxiety on the State-Trait Anxiety Inventory. Being female and a stronger escape - avoidant coping style were predictive of depressive symptoms. For state anxiety, similar patterns were observed. Quality of life and social support were significantly associated with lower anxiety. Carriers maintained higher knowledge compared to those testing negative, and were more engaged in screening. In summary, most individuals adapt to genetic test results over the long term and continue to engage in screening. A subgroup, including some non-carriers, may require added psychosocial support.
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Affiliation(s)
- M J Esplen
- University Health Network, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada; de Souza Institute, Toronto, Canada
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Carrico AW, Nation A, Gómez W, Sundberg J, Dilworth SE, Johnson MO, Moskowitz JT, Rose CD. Pilot trial of an expressive writing intervention with HIV-positive methamphetamine-using men who have sex with men. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2015; 29:277-82. [PMID: 25437153 PMCID: PMC5482007 DOI: 10.1037/adb0000031] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Among men who have sex with men (MSM), the co-occurrence of trauma and stimulant use has negative implications for HIV/AIDS prevention. HIV-positive, methamphetamine-using MSM were recruited to pilot test a 7-session, multicomponent resilient affective processing (RAP) intervention that included expressive writing exercises targeting HIV-related traumatic stress. An open-phase pilot with 10 participants provided support for feasibility of intervention delivery such that 99% of the RAP sessions were completed in a 1-month period. Subsequently, 23 additional participants were enrolled in a pilot randomized controlled trial of the RAP intervention (n = 12) versus an attention-control condition that included writing exercises about neutral topics (n = 11). Acceptability was evidenced by participants randomized to RAP expressing significantly more negative emotions in their writing and reporting greater likelihood of recommending expressive writing exercises to a friend living with HIV. Over the 3-month follow-up period, attention-control participants reported significant decreases in HIV-related traumatic stress while RAP intervention participants reported no significant changes. Compared to attention-control participants, those in the RAP intervention reported significant reductions in the frequency of methamphetamine use immediately following the 1-month RAP intervention period. Thematic analyses of RAP expressive writing exercises revealed that multiple negative life events characterized by social stigma or loss contribute to the complex nature of HIV-related traumatic stress. Findings support the feasibility and acceptability of an exposure-based intervention targeting HIV-related traumatic stress. However, more intensive intervention approaches that simultaneously target trauma and stimulant use will likely be needed to optimize HIV/AIDS prevention efforts with this population. (PsycINFO Database Record
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Affiliation(s)
- Adam W. Carrico
- University of California, San Francisco School of Nursing
- University of California, San Francisco Center for AIDS Prevention Studies
| | - Austin Nation
- University of California, San Francisco School of Nursing
| | - Walter Gómez
- University of California, San Francisco School of Nursing
| | | | | | - Mallory O. Johnson
- University of California, San Francisco Center for AIDS Prevention Studies
| | - Judith T. Moskowitz
- University of California, San Francisco Osher Center for Integrative Medicine
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Giorgi G, Fiz Perez FS, Castiello D'Antonio A, Mucci N, Ferrero C, Cupelli V, Arcangeli G. Psychometric properties of the Impact of Event Scale-6 in a sample of victims of bank robbery. Psychol Res Behav Manag 2015; 8:99-104. [PMID: 25878514 PMCID: PMC4388003 DOI: 10.2147/prbm.s73901] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Bank robberies are becoming a serious problem in Italy. This study aims to evaluate the validity and the reliability of the Italian version of Impact of Event Scale (IES)-6. It is also hypothesized that a potential posttraumatic disorder, as measured by the IES-6, is associated with mental health problems and several peritraumatic variables. A database was built from data collected through a survey of victims of robbery in an Italian bank. The final sample comprised 350 employees. This study tests different models of IES, comparing the validity of IES-6 with the 22-item original version (IES-R) and the 15-item Italian version (recently adopted in a sample of flood victims). A confirmatory factor analysis supported the IES-6 three-factor solution as the best model. In addition, the internal consistency of the IES-6 and the subscales was good. Outcomes revealed a robust structure supporting the composition of the IES-6 Italian version.
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Affiliation(s)
| | | | | | - Nicola Mucci
- Occupational Medicine Unit, Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Claudia Ferrero
- Health Services Research Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Vincenzo Cupelli
- Health Services Research Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giulio Arcangeli
- Health Services Research Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Fichera GP, Fattori A, Neri L, Musti M, Coggiola M, Costa G. Post-traumatic stress disorder among bank employee victims of robbery. Occup Med (Lond) 2014; 65:283-9. [DOI: 10.1093/occmed/kqu180] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mehler K, Mainusch A, Hucklenbruch-Rother E, Hahn M, Hünseler C, Kribs A. Increased rate of parental postpartum depression and traumatization in moderate and late preterm infants is independent of the infant's motor repertoire. Early Hum Dev 2014; 90:797-801. [PMID: 25463823 DOI: 10.1016/j.earlhumdev.2014.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/16/2014] [Accepted: 09/18/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Moderately and late preterm infants represent a considerable and increasing proportion of infants cared for in neonatal departments worldwide. Parents of preterm infants are at risk of postpartal depression (PPD) and posttraumatic stress disorder (PTSD), and preterm infants are at risk of developmental impairment. AIM This study aimed to assess (1) the incidence of parental PPD and PTSD in moderate to late preterm infants in comparison to full-term infants and (2) the influence of infants' motor repertoire assessed by Prechtl's general movements and illness severity on parental PPD and PTSD. SUBJECTS We studied 60 mothers and 56 fathers of 69 preterm infants (born at 32 to 37 weeks of gestation) and 32 mothers and 29 fathers of 34 full-term infants. OUTCOME MEASURES We assessed the incidence of parental PPD, PTSD and perceived social support as well as infants' illness severity and motor repertoire at birth, term and 3 months corrected age. RESULTS Preterm mothers and fathers had significant higher depression scores after birth compared to full-term parents (p=0.033 and 0.021). Preterm fathers also had higher traumatization scores compared to full-term fathers (p=0.007). Probable or possible PPD/PTSD was not associated with infant's illness severity or quality of motor repertoire. No differences in motor development were found between preterm and full-term infants. CONCLUSION Moderate to late preterm infants' parents are at increased risk for PPD irrespective of infants' motor repertoire or illness severity.
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Affiliation(s)
- Katrin Mehler
- Department of Neonatology, University of Cologne Children's Hospital, Cologne, Germany.
| | - Annika Mainusch
- Department of Neonatology, University of Cologne Children's Hospital, Cologne, Germany
| | | | - Moritz Hahn
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Christoph Hünseler
- Department of Neonatology, University of Cologne Children's Hospital, Cologne, Germany
| | - Angela Kribs
- Department of Neonatology, University of Cologne Children's Hospital, Cologne, Germany
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Postoperative pain and subsequent PTSD-related symptoms in patients undergoing lung resection for suspected cancer. J Thorac Oncol 2014; 9:362-9. [PMID: 24496000 DOI: 10.1097/jto.0000000000000084] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Because lung cancer resection is at the crossroad between cancer and high-risk surgery, we hypothesized that the patients undergoing lung resection for cancer are exposed to develop a post-traumatic stress disorder (PTSD) syndrome-related symptoms. METHODS Forty-seven adult patients were included in the study. Patients were eligible for inclusion if they underwent lung resection for suspected cancer, if they were able to speak and read French, and if they agreed to be reached for a telephone interview. We assessed before, immediately after, and 3 months after surgery the presence of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) and PTSD-related symptoms (impact of events scale revised [IES-R]). At the 3-month assessment, an IES-R score > 22 was used as criteria for predicting the patients at risk of PTSD-related symptoms. RESULTS We identified an IES-R score higher than 22 in 24 participants (51%). Patients with a preoperatory Hospital Anxiety and Depression Scale(anxiety) score more than 7 (T0) and a maximal visual analogic scale score more than 40 during the first 24 hours after surgery were more likely to develop PTSD-related symptoms at 3-months with odd ratios at 4.61 [1.20-17.73] (p = 0.03) and 1.34 [1.05-1.75] (p = 0.02). CONCLUSION The prevalence of PTSD-related symptoms after lung cancer resection is high, showing that lung cancer patients undergoing surgical resection are at high risk of postprocedure burden. The presence of preoperative symptoms of anxiety and acute procedural pain during the early postoperative period are strong predictors for developing PTSD-related symptoms after lung cancer surgery.
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