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Oliva FM, Tarasconi M, Malovini A, Zappa M, Visca D, Zampogna E. Evaluation of physical activity before and after respiratory rehabilitation in normal weight individuals with asthma: a feasibility study. Front Sports Act Living 2024; 6:1372048. [PMID: 38783863 PMCID: PMC11111960 DOI: 10.3389/fspor.2024.1372048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024] Open
Abstract
Background Individuals with asthma spend less time engaging in physical activity compared to the general population. Increasing physical activity has become a patient-centered goal for the treatment of treatable traits of individuals with asthma. There are data showing the possible effects of a pulmonary rehabilitation program on physical activity in obese individuals with asthma but not in normal-weight asthmatics. The objective of this feasibility study is to estimate the number of daily steps and time spent on activity in normal-weight individuals with asthma, measured before and after a pulmonary rehabilitation program. Methods Normal-weight individuals with moderate to severe asthma were evaluated. The individuals measured their daily steps with an accelerometer for 5 days before and after a pulmonary rehabilitation program. The study was registered on ClinicalTrials.gov: NCT05486689. Results In total, 17 participants were enrolled; one dropout and data on the time in activity of two individuals are missing due to a software error during the download. Data from 16 patients were analyzed. The median number of steps/day at baseline was 5,578 (25th, 75th percentiles = 4,874, 9,685) while the median activity time was 214 min (25th, 75th percentiles = 165, 239). After the rehabilitation program, the number of daily steps increased by a median value of 472 (p-value = 0.561) and the time in activity reduced by 17 min (p-value = 0.357). We also found a significant difference in quality of life, muscle strength, and exercise capacity. Conclusions The results of this study make it possible to calculate the sample size of future studies whose main outcome is daily steps in normal-weight individuals with asthma. The difficulties encountered in downloading time in activity data do not allow the same for this outcome. Clinical Trial Registration ClinicalTrials.gov, identifier NCT05486689.
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Affiliation(s)
- Federico Mattia Oliva
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Tarasconi
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Martina Zappa
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
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Norouzkhani N, Faramarzi M, Bahari A, Shokri Shirvani J, Shirvani YE, Eslami S, Tabesh H. Effect of a gamified mobile-based self-management application on disease activity index, quality of life, and mental health in adults with inflammatory bowel disease: A protocol of a randomized controlled trial study. Health Sci Rep 2024; 7:e2109. [PMID: 38779219 PMCID: PMC11109478 DOI: 10.1002/hsr2.2109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/26/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Background and Aims Inflammatory bowel disease (IBD) is a chronic inflammatory gastrointestinal tract disease subdivided into Crohn's disease (CD) and ulcerative colitis (UC). There is currently no cure for IBD, and individuals with IBD frequently experience a lower health-related quality of life (HRQOL) than the general population. Gamification has become an increasingly popular topic in recent years. Adapting game design concepts to nongaming contexts represents a novel and potential approach to changing user engagement. This study will be conducted with the aim of evaluating the effect of a gamified mobile-based self-management application on disease activity index, quality of life, and mental health in adults with IBD. Methods A multicenter, parallel, two-arm, exploratory randomized controlled trial with a 6-month follow-up per patient will be designed to compare the impact of the gamified mobile-based tele-management system on primary and secondary health outcomes and outpatient visits in 210 patients with all types of IBD which are divided equally into a control group with standard care and an intervention group which will use the developed mobile application named MY IBD BUDDY. All patients will attend study visits at baseline, 12 and 24 weeks, and routine IBD clinic visits or telephone consultations based on randomization group assignment. Disease activity or disease activity index, mental health (anxiety and depression) symptoms, quality of life, self-efficacy, and IBD-specific knowledge will be measured at baseline with two follow-ups at 12 and 24 weeks. Conclusions In sum, the outcomes of our trial will demonstrate the impact of the gamified mobile-based self-management system on disease activity, quality of life, and anxiety and depression by means of interactive care and patient empowerment. Trial Registration IRCT: IRCT20200613047757N1. Registered November 16, 2021. Prospectively registered and visible at OSF (https://doi.org/10.17605/OSF.IO/AWFY9).
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Affiliation(s)
- Narges Norouzkhani
- Department of Medical Informatics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mahbobeh Faramarzi
- Population, Family and Spiritual Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| | - Ali Bahari
- Department of Internal Medicine, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | | | - Saeid Eslami
- Department of Medical Informatics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- Pharmaceutical Research CenterMashhad University of Medical SciencesMashhadIran
| | - Hamed Tabesh
- Department of Medical Informatics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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Caeiro L, Jaramillo Quiroz S, Hegarty JS, Grewe E, Garcia JM, Anderson LJ. Clinical Relevance of Physical Function Outcomes in Cancer Cachexia. Cancers (Basel) 2024; 16:1395. [PMID: 38611073 PMCID: PMC11010860 DOI: 10.3390/cancers16071395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors.
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Affiliation(s)
- Lucas Caeiro
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA; (L.C.); (S.J.Q.); (J.S.H.); (E.G.); (J.M.G.)
- Division of Gerontology and Geriatric Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Sofia Jaramillo Quiroz
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA; (L.C.); (S.J.Q.); (J.S.H.); (E.G.); (J.M.G.)
- Division of Gerontology and Geriatric Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Jenna S. Hegarty
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA; (L.C.); (S.J.Q.); (J.S.H.); (E.G.); (J.M.G.)
| | - Ellen Grewe
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA; (L.C.); (S.J.Q.); (J.S.H.); (E.G.); (J.M.G.)
| | - Jose M. Garcia
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA; (L.C.); (S.J.Q.); (J.S.H.); (E.G.); (J.M.G.)
- Division of Gerontology and Geriatric Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Lindsey J. Anderson
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA; (L.C.); (S.J.Q.); (J.S.H.); (E.G.); (J.M.G.)
- Division of Gerontology and Geriatric Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
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Nikolovski A, Gamgoum L, Deol A, Quilichini S, Kazemir E, Rhodenizer J, Oliveira A, Brooks D, Alsubheen S. Psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in individuals with stable chronic obstructive pulmonary disease (COPD): a systematic review. Disabil Rehabil 2024; 46:1230-1238. [PMID: 36861817 DOI: 10.1080/09638288.2023.2182918] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE The Hospital Anxiety and Depression Scale (HADS) is used to assess anxiety and depression in individuals with chronic obstructive pulmonary disease (COPD); however, its measurement properties lack critical appraisal. We aimed to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in COPD. MATERIALS AND METHODS Five electronic databases were searched. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines were used to assess the methodological and evidence quality in the selected studies. RESULTS Twelve studies assessed the psychometric properties of the HADS-Total and its subscales HADS-Anxiety and HADS-Depression in COPD. High-quality evidence supported the structural and criterion validity of the HADS-A, the internal consistency of the HADS-T, HADS-A, and HADS-D with Cronbach's alpha values of 0.73-0.87, and before-after treatment responsiveness of HADS-T and its subscales (minimal clinically important difference = 1.4-2; effect size = 0.45-1.40). Moderate-quality evidence supported the test-retest reliability of the HADS-A and HADS-D with excellent coefficient values of 0.86-0.90. CONCLUSIONS The HADS-A is recommended for use in individuals with stable COPD. The lack of high-quality evidence on the validity of the HADS-D and HADS-T prevented drawing robust conclusions about their clinical utility in COPD.
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Affiliation(s)
| | - Lara Gamgoum
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Arshpreet Deol
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Shea Quilichini
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Ethan Kazemir
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | | | - Ana Oliveira
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- West Park Healthcare Centre, Toronto, Canada
- School of Health Sciences, Lab 3R Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), IBMED, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, Canada
| | - Sanaa Alsubheen
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
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de Filippis R, Mercurio M, Segura-Garcia C, De Fazio P, Gasparini G, Galasso O. Defining the minimum clinically important difference (MCID) in the hospital anxiety and depression scale (HADS) in patients undergoing total hip and knee arthroplasty. Orthop Traumatol Surg Res 2024; 110:103689. [PMID: 37741440 DOI: 10.1016/j.otsr.2023.103689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/02/2023] [Accepted: 08/30/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION Total hip (THA) and knee (TKA) arthroplasty are effective procedures, but whose success depends on various factors, including patients' genetics, sociocultural environments, and psychological factors. Patient-reported outcome measures (PROMs) provide objective health status outcomes measurements, whose lowest significant variation is detected by the minimum clinically important difference (MCID). HYPOTHESIS We aimed to find the MCID scores for the Hospital Anxiety and Depression Scale (HADS), HADS-A, and HADS-D in a cohort of individuals undergoing THA or TKA. PATIENTS AND METHODS We enrolled 88 patients suffering from osteoarthritis (43 undergoing THA, and 45 TKA) by administering HADS, SF-12 and WOMAC at baseline and then with a 12-month prospective follow-up. The MCID for HADS, HADS-A, and HADS-D was calculated using the distribution-based approach, according to various techniques (0.5 standard deviation [0.5 SD]), the standard error of measurement (SEM), the effect size (ES), and the minimum detectable change (MDC). RESULTS The analysis of HADS, HADS-A, and HADS-D scores revealed clinically significant improvements in symptoms in patients who underwent THA and TKA. The MCID range values were determined to be between 2.7-8.5 for the HADS, 1.4-4.4 for the HADS-A, and 1.5-4.8 for the HADS-D in the group of patients undergoing THA, and 2.1-6.7 for the HADS, 1.2-3.8 for the HADS-A, and 1.1-3.6 for the HADS-D in the TKA group. DISCUSSION The study determined significant improvement in all scores applying MCID analysis, which can aid physicians in interpreting anxiety and depression scores and developing both preoperative and postoperative procedures to enhance outcomes for patients undergoing THA and TKA. LEVEL OF EVIDENCE I; well-designed cohort study.
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Affiliation(s)
- Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Mercurio
- Department of Orthopaedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V. le Europa, 88100 Catanzaro, Italy.
| | - Cristina Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Giorgio Gasparini
- Department of Orthopaedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V. le Europa, 88100 Catanzaro, Italy
| | - Olimpio Galasso
- Department of Orthopaedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, V. le Europa, 88100 Catanzaro, Italy
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Zhang Y, Han Z, Dai Y, Liu Y, Wang Q, Cheng L, Xiong C, Hou C, Yang X, Ye Y, Zhao Q, Nie N, Ma X, Tang H, Zhang A, Hu Z, Cao G, Jones P, Jiang J, Zeng L, He Y, Li L. Symptom Burden among Older COVID-19 Survivors Two Years after Hospital Discharge. Aging Dis 2023; 14:2238-2248. [PMID: 37199576 PMCID: PMC10676794 DOI: 10.14336/ad.2023.0304] [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: 11/07/2022] [Accepted: 03/04/2023] [Indexed: 05/19/2023] Open
Abstract
To study the long-term symptom burden among older COVID-19 survivors 2 years after hospital discharge and identify associated risk factors. The current cohort study included COVID-19 survivors aged 60 years and above, who were discharged between February 12 and April 10, 2020, from two designated hospitals in Wuhan, China. All patients were contacted via telephone and completed a standardized questionnaire assessing self-reported symptoms, the Checklist Individual Strength (CIS)-fatigue subscale, and two subscales of the Hospital Anxiety and Depression Scale (HADS). Of the 1,212 patients surveyed, the median (IQR) age was 68.0 (64.0-72.0), and 586 (48.3%) were male. At the two-year follow-up, 259 patients (21.4%) still reported at least one symptom. The most frequently self-reported symptoms were fatigue, anxiety, and dyspnea. Fatigue or myalgia, which was the most common symptom cluster (11.8%; 143/1212), often co-occurred with anxiety and chest symptoms. A total of 89 patients (7.7%) had CIS-fatigue scores ≥ 27, with older age (odds ratio [OR], 1.08; 95% CI: 1.05-1.11, P < 0.001) and oxygen therapy (OR, 2.19; 95% CI: 1.06-4.50, P= 0.03) being risk factors. A total of 43 patients (3.8%) had HADS-Anxiety scores ≥ 8, and 130 patients (11.5%) had HADS-Depression scores ≥ 8. For the 59 patients (5.2%) who had HADS total scores ≥ 16, older age, serious illness during hospitalization and coexisting cerebrovascular diseases were risk factors. Cooccurring fatigue, anxiety, and chest symptoms, as well as depression, were mainly responsible for long-term symptom burden among older COVID-19 survivors 2 years after discharge.
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Affiliation(s)
- Ying Zhang
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Zhaojie Han
- Department of Thoracic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Yang Dai
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Yuhui Liu
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
- Wuhan Huoshenshan Hospital, Wuhan, China.
| | - Qinghua Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
- Wuhan Huoshenshan Hospital, Wuhan, China.
| | - Lixia Cheng
- Department of Medical and Research Management, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
- Taikang Tongji Hospital, Wuhan, China.
| | - Chuyue Xiong
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Chao Hou
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Xinyue Yang
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Yidan Ye
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Qian Zhao
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Naifu Nie
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Xiangyu Ma
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Huan Tang
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Anqiang Zhang
- Department of Trauma Medical Center, Daping Hospital, State Key laboratory of Trauma, Burns, and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Zhenhong Hu
- Departmemt of Respiratory Medicine, Chinese PLA General Hospital of Central Theater Command, Wuhan, China.
| | - Guoqiang Cao
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
- Wuhan Huoshenshan Hospital, Wuhan, China.
| | - Paul Jones
- Institute of Infection and Immunology, University of London, London, UK.
- GlaxoSmithKline, Brentford, UK
| | - Jianxin Jiang
- Department of Trauma Medical Center, Daping Hospital, State Key laboratory of Trauma, Burns, and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Ling Zeng
- Department of Trauma Medical Center, Daping Hospital, State Key laboratory of Trauma, Burns, and Combined Injury, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Yong He
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Li Li
- Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
- Wuhan Huoshenshan Hospital, Wuhan, China.
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Fabregat-Cid G, Cedeño DL, Harutyunyan A, Rodríguez-López R, Monsalve-Dolz V, Mínguez-Martí A, Hernández-Cádiz MJ, Escrivá-Matoses N, Villanueva-Pérez V, Asensio Samper JM, De Andrés J, Vallejo R. Effect of Conventional Spinal Cord Stimulation on Serum Protein Profile in Patients With Persistent Spinal Pain Syndrome: A Case-Control Study. Neuromodulation 2023; 26:1441-1449. [PMID: 37516956 DOI: 10.1016/j.neurom.2023.05.004] [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: 03/12/2023] [Revised: 04/30/2023] [Accepted: 05/30/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Spinal cord stimulation (SCS) provides pain relief for most patients with persistent spinal pain syndrome type 2 (PSPS 2). Evidence is mounting on molecular changes induced by SCS as one of the mechanisms to explain pain improvement. We report the SCS effect on serum protein expression in vivo in patients with PSPS 2. MATERIALS AND METHODS Serum proteins were identified and quantified using mass spectrometry. Proteins with significantly different expression among patients with PSPS 2 relative to controls, responders, and nonresponders to SCS, or significantly modulated by SCS relative to baseline, were identified. Those most correlated with the presence and time course of pain were selected using multivariate discriminant analysis. Bioinformatic tools were used to identify related biological processes. RESULTS Thirty patients with PSPS 2, of whom 23 responded to SCS, were evaluated, together with 14 controls with no pain who also had undergone lumbar spinal surgery. A significant improvement in pain intensity, disability, and quality of life was recorded among responders. Five proteins differed significantly at baseline between patients with PSPS 2 and controls, with three proteins, mostly involved in immune processes and inflammation, being downregulated and two, mostly involved in vitamin metabolism, synaptic transmission, and restorative processes, being upregulated. In addition, four proteins, mostly related to immune processes and inflammation, decreased significantly, and three, mostly related to iron metabolism and containment of synaptic sprouting, increased significantly during SCS. CONCLUSION This study identifies various biological processes that may underlie PSPS 2 pain and SCS therapeutic effects, including the modulation of neuroimmune response and inflammation, synaptic sprouting, vitamin and iron metabolism, and restorative processes.
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Affiliation(s)
- Gustavo Fabregat-Cid
- Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain; Surgery Department, Medical School, University of Valencia, Valencia, Spain.
| | | | - Anushik Harutyunyan
- Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain
| | | | - Vicente Monsalve-Dolz
- Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain
| | - Ana Mínguez-Martí
- Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain
| | | | | | | | - Juan Marcos Asensio Samper
- Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain; Surgery Department, Medical School, University of Valencia, Valencia, Spain
| | - José De Andrés
- Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain; Surgery Department, Medical School, University of Valencia, Valencia, Spain
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Man W, Chaplin E, Daynes E, Drummond A, Evans RA, Greening NJ, Nolan C, Pavitt MJ, Roberts NJ, Vogiatzis I, Singh SJ. British Thoracic Society Clinical Statement on pulmonary rehabilitation. Thorax 2023; 78:s2-s15. [PMID: 37770084 DOI: 10.1136/thorax-2023-220439] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- William Man
- Royal Brompton & Harefield Hospitals, Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | - Emma Chaplin
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Enya Daynes
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
| | - Alistair Drummond
- Royal Brompton & Harefield Hospitals, Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | - Rachael A Evans
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
| | - Neil J Greening
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
| | - Claire Nolan
- Royal Brompton & Harefield Hospitals, Guy's and St.Thomas' NHS Foundation Trust, London, UK
- Department of Health Sciences, College of Health Medicine and Life Sciences, Brunel University London, London, UK
| | - Matthew J Pavitt
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| | - Nicola J Roberts
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, School of Health and Life Sciences, Northumberland University Newcastle, Newcastle Upon Tyne, UK
| | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
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9
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Zhang J, Yu Z, Zhang N, Zhao W, Wei B, He R, Xue H, Zhu B, Mao Y. Does music intervention relieve depression or anxiety in people living with dementia? A systematic review and meta-analysis. Aging Ment Health 2023; 27:1864-1875. [PMID: 37243671 DOI: 10.1080/13607863.2023.2214091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/06/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND This study aimed to summarize the available evidence on music intervention alleviating depression or anxiety in dementia. METHODS A comprehensive literature search was performed to analyze the effects of music intervention on depression or anxiety. Subgroups were created to explore the effect of intervention period, duration, and frequency on efficacy. The effect size was reported as a mean standardized difference (SMD) with 95% confidence interval (CI). RESULTS The analysis included 19 articles involving 614 samples. Thirteen studies for relieving depression revealed that, with an increase in intervention period, the efficacy decreased and then increased, whereas with an increase of intervention duration, the effect became better. A weekly intervention is ideal. Seven studies verifying the impact on anxiety relief revealed that the effect of intervention within 12 wk is significant; with an increase of intervention duration, the effect became better. A weekly intervention is ideal. Collaborative analysis showed that long low-frequency interventions are more efficient than short high-frequency interventions. CONCLUSIONS Music intervention can relieve depression or anxiety in people living with dementia. Weekly short interventions of more than 45 min are effective for emotional regulation. Future research should concentrate on severe dementia and follow-up impact.
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Affiliation(s)
- Jingya Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Zeru Yu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Bincai Wei
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Hao Xue
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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10
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Nicola A, Oancea C, Barata PI, Adelina M, Mateescu T, Manolescu D, Bratosin F, Fericean RM, Pingilati RA, Paleru C. Health-Related Quality of Life and Stress-Related Disorders in Patients with Bronchiectasis after Pulmonary Resection. J Pers Med 2023; 13:1310. [PMID: 37763078 PMCID: PMC10532533 DOI: 10.3390/jpm13091310] [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: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
This multicenter, cross-sectional study investigates the potential correlation between the development of bronchiectasis after lung resection surgery and the health-related quality of life (HRQoL) of the patients. The study aims to provide new insights into the long-term outcomes of patients post-lung resection surgery. The study includes adult patients who underwent lung resection surgery for suspicious lung nodules and developed bronchiectasis within a follow-up period of six months. Bronchiectasis was confirmed by high-resolution computed tomography scans. The patient's health-related quality of life (HRQoL), anxiety, depression, and stress-related disorders were assessed using WHOQOL-BREF, SF-36, HADS, and PSS-10 questionnaires. Out of the 135 patients included in the study, 44 developed bronchiectasis after lung resection surgery. No statistically significant differences were observed between the groups in terms of demographics and medical history. Patients with bronchiectasis demonstrated a lower overall health status, increased deterioration of respiratory symptoms, lower physical activity levels, lower quality of life scores, and experienced more severe anxiety symptoms. Additionally, patients in this group also perceived higher levels of stress; although, the correlation with physical functioning was contradictory. The development of bronchiectasis post-lung resection surgery was associated with poorer quality of life, increased respiratory symptoms, higher anxiety levels, and increased perception of stress. While the correlation between bronchiectasis and HRQoL was statistically significant, the contradictory correlations with stress and physical functioning call for further research. This study underscores the importance of ongoing patient monitoring and the detailed evaluation of respiratory function following lung resection surgery for lung nodules, especially among those who develop bronchiectasis.
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Affiliation(s)
- Alin Nicola
- Department of Thoracic Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (T.M.); (F.B.); (R.M.F.)
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.O.); (P.I.B.)
| | - Paula Irina Barata
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.O.); (P.I.B.)
| | - Mavrea Adelina
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Tudor Mateescu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (T.M.); (F.B.); (R.M.F.)
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Diana Manolescu
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Felix Bratosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (T.M.); (F.B.); (R.M.F.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (T.M.); (F.B.); (R.M.F.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Raja Akshay Pingilati
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India;
| | - Cristian Paleru
- Department of Thoracic Surgery, “Carol Davila” University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucuresti, Romania;
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11
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Bates A, Golding H, Rushbrook S, Shapiro E, Pattison N, Baldwin DS, Grocott MPW, Cusack R. A randomised pilot feasibility study of eye movement desensitisation and reprocessing recent traumatic episode protocol, to improve psychological recovery following intensive care admission for COVID-19. J Intensive Care Soc 2023; 24:309-319. [PMID: 37744073 PMCID: PMC9679313 DOI: 10.1177/17511437221136828] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Background Approximately 50% of intensive care survivors experience persistent psychological symptoms. Eye-movement desensitisation and reprocessing (EMDR) is a widely recommended trauma-focussed psychological therapy, which has not been investigated systematically in a cohort of intensive care survivors: We therefore conducted a randomised pilot feasibility study of EMDR, using the Recent Traumatic Episode Protocol (R-TEP), to prevent psychological distress in intensive care survivors. Findings will determine whether it would be possible to conduct a fully-powered clinical effectiveness trial and inform trial design. Method We aimed to recruit 26 patients who had been admitted to intensive care for over 24 h with COVID-19 infection. Consenting participants were randomised (1:1) to receive either usual care plus remotely delivered EMDR R-TEP or usual care alone (controls). The primary outcome was feasibility. We also report factors related to safety and symptom changes in post-traumatic stress disorder, (PTSD) anxiety and depression. Results We approached 51 eligible patients, with 26 (51%) providing consent. Intervention adherence (sessions offered/sessions completed) was 83%, and 23/26 participants completed all study procedures. There were no attributable adverse events. Between baseline and 6-month follow-up, mean change in PTSD score was -8 (SD = 10.5) in the intervention group versus +0.75 (SD = 15.2) in controls (p = 0.126). There were no significant changes to anxiety or depression. Conclusion Remotely delivered EMDR R-TEP met pre-determined feasibility and safety objectives. Whilst we achieved group separation in PTSD symptom change, we have identified a number of protocol refinements that would improve the design of a fully powered, multi-centre randomised controlled trial, consistent with currently recommended rehabilitation clinical pathways. Trial registration ClinicalTrials.gov: NCT04455360.
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Affiliation(s)
- Andrew Bates
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton National Health Service Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hannah Golding
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton National Health Service Foundation Trust, Southampton, UK
| | - Sophie Rushbrook
- Intensive Psychological Therapies Service, Dorset Healthcare University National Health Service Foundation Trust, Poole, UK
| | - Elan Shapiro
- Independent EMDR Europe Consultant Practitioner, Haifa, Israel
| | - Natalie Pattison
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | - David S Baldwin
- Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Michael P W Grocott
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton National Health Service Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rebecca Cusack
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton National Health Service Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
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12
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Vranas KC, Hooker ER, Golden SE, Nugent S, Slatore CG. Association of Communication Quality With Patient-Centered Outcomes Among Patients With Incidental Pulmonary Nodules. Chest 2023; 164:556-559. [PMID: 36907374 DOI: 10.1016/j.chest.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023] Open
Affiliation(s)
- Kelly C Vranas
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System, Portland, OR; Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR
| | - Elizabeth R Hooker
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR
| | - Sara E Golden
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR
| | - Shannon Nugent
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Department of Psychiatry, Department of Medicine, Oregon Health & Science University, Portland, OR
| | - Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System, Portland, OR; Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR.
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13
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Carmichael J, Spitz G, Gould KR, Johnston L, Samiotis A, Ponsford J. Bifactor analysis of the Hospital Anxiety and Depression Scale (HADS) in individuals with traumatic brain injury. Sci Rep 2023; 13:8017. [PMID: 37198250 DOI: 10.1038/s41598-023-35017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023] Open
Abstract
Anxiety and depression symptoms are commonly experienced after traumatic brain injury (TBI). However, studies validating measures of anxiety and depression for this population are scarce. Using novel indices derived from symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably differentiated anxiety and depression in 874 adults with moderate-severe TBI. The results showed that there was a dominant general distress factor accounting for 84% of the systematic variance in HADS total scores. The specific anxiety and depression factors accounted for little residual variance in the respective subscale scores (12% and 20%, respectively), and overall, minimal bias was found in using the HADS as a unidimensional measure. Further, in a subsample of 184 participants, the HADS subscales did not clearly discriminate between formal anxiety and depressive disorders diagnosed via clinical interview. Results were consistent when accounting for degree of disability, non-English speaking background, and time post-injury. In conclusion, variance in HADS scores after TBI predominately reflects a single underlying latent variable. Clinicians and researchers should exercise caution in interpreting the individual HADS subscales and instead consider using the total score as a more valid, transdiagnostic measure of general distress in individuals with TBI.
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Affiliation(s)
- Jai Carmichael
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia.
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Kate Rachel Gould
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Lisa Johnston
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Alexia Samiotis
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
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14
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Edwards GD, Polgar O, Patel S, Barker RE, Walsh JA, Harvey J, Man WDC, Nolan CM. Mood disorder in idiopathic pulmonary fibrosis: response to pulmonary rehabilitation. ERJ Open Res 2023; 9:00585-2022. [PMID: 37228278 PMCID: PMC10204825 DOI: 10.1183/23120541.00585-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/23/2023] [Indexed: 05/27/2023] Open
Abstract
Background Pulmonary rehabilitation improves mood disorder in COPD, but there are limited data in idiopathic pulmonary fibrosis (IPF). The aims of this cohort study were to investigate whether pulmonary rehabilitation reduces mood disorder in IPF, and estimate the minimal important difference (MID) of the Hospital Anxiety and Depression Scale (HADS). Methods HADS and core pulmonary rehabilitation outcomes were measured in 166 participants before and after an 8-week, in-person, outpatient pulmonary rehabilitation programme. Anchor- and distribution-based methods were used to calculate the MID of HADS-Anxiety (A) and HADS-Depression (D). Results Suggestive or probable anxiety and depression (HADS ≥8) were present in 35% and 37% of participants, respectively, at baseline, and this reduced significantly following pulmonary rehabilitation (post-pulmonary rehabilitation: HADS-A 23%, HADS-D 26%). Overall, there was a significant reduction in HADS-D (mean change -1.1, 95% CI -1.6- -0.5), but not HADS-A (-0.6, -1.3-0.15) with pulmonary rehabilitation. Subgroup analysis of those with HADS ≥8 revealed significant improvements in HADS domains (mean change: HADS-A -4.5, 95% CI -5.7- -3.4; median change: HADS-D -4.0, interquartile range -6.0- -1.0). The mean (range) MID estimates for HADS-A and HADS-D were -2 (-2.3- -1.7) and -1.2 (-1.9- -0.5), respectively. Conclusion In people with IPF and suggestive or probable mood disorder, pulmonary rehabilitation reduces anxiety and depression.
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Affiliation(s)
- George D. Edwards
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Oliver Polgar
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - Suhani Patel
- National Heart and Lung Institute, Imperial College London, London, UK
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - Ruth E. Barker
- National Heart and Lung Institute, Imperial College London, London, UK
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Wessex Academic Health Science Network, Southampton, UK
| | - Jessica A. Walsh
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - Jennifer Harvey
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - William D-C. Man
- National Heart and Lung Institute, Imperial College London, London, UK
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
- These authors contributed equally
| | - Claire M. Nolan
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Brunel University London, College of Medicine, Health and Life Sciences, Department of Health Sciences, London, UK
- These authors contributed equally
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15
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Longo UG, Papalia R, De Salvatore S, Marinozzi A, Piergentili I, Lalli A, Bandini B, Franceschetti E, Denaro V. Establishing the Minimum Clinically Significant Difference (MCID) and the Patient Acceptable Symptom Score (PASS) for the Hospital Anxiety and Depression Scale (HADS) in Patients with Rotator Cuff Disease and Shoulder Prosthesis. J Clin Med 2023; 12:jcm12041540. [PMID: 36836074 PMCID: PMC9967741 DOI: 10.3390/jcm12041540] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Insufficiently treated shoulder pain may cause mental disturbances, including depression and anxiety. The Hospital Anxiety and Depression Scale (HADS) is a patient-reported outcome measure (PROM) that aims to identify depression and anxiety in patients in nonpsychiatric wards. The aim of this study was to identify the minimum clinically important difference (MCID) and patient acceptable symptom state (PASS) scores for the HADS in a cohort of individuals with rotator cuff disease. Using the HADS, participants' degrees of anxiety and depression were assessed at inception and at their final assessment 6 months after surgery. To calculate the MCID and the PASS, distribution and anchor approaches were employed. The MCID from inception to final assessment was 5.7 on the HADS, 3.8 on the HADS-A, and 3.3 on the HADS-D. A 5.7 amelioration on the HADS score, 3.8 on the HADS-A, and 3.3 on the HADS-D, from inception to final assessment, meant that patients had reached a clinically meaningful improvement in their symptom state. The PASS was 7 on the HADS, 3.5 on the HADS-A, and 3.5 on the HADS-D; therefore, for the majority of patients, a score of at least 7 on the HADS, 3.5 on the HADS-A, and 3.5 on the HADS-D at final evaluation was considered a satisfactory symptom state.
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Affiliation(s)
- Umile Giuseppe Longo
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
- Correspondence: ; Tel.: +39-06-225411613
| | - Rocco Papalia
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
| | - Sergio De Salvatore
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
| | - Andrea Marinozzi
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
| | - Ilaria Piergentili
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alberto Lalli
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
| | - Benedetta Bandini
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
| | - Edoardo Franceschetti
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
| | - Vincenzo Denaro
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy
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16
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The effectiveness of a mobile application-based programme for rehabilitation after total hip or knee arthroplasty: A randomised controlled trial. Int J Nurs Stud 2023; 140:104455. [PMID: 36821950 DOI: 10.1016/j.ijnurstu.2023.104455] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Total hip arthroplasty and total knee arthroplasty are widely performed worldwide. Patients undergoing total hip or knee arthroplasty are often discharged after a short hospital stay. Using information and communication technologies, such as mobile applications, to provide rehabilitation services remotely may be a strategy to support patients' postoperative recovery. OBJECTIVE This study aimed to evaluate the effectiveness of a rehabilitation programme delivered via a mobile application among Chinese patients after total hip or knee arthroplasty. DESIGN Randomised controlled trial. SETTING A teaching hospital in Shanghai, China. PARTICIPANTS Eighty-six patients who received a unilateral primary total hip or knee arthroplasty. METHODS The participants were recruited in the hospital and randomised into either the experimental or control group. Once discharged from the hospital, the control group (n = 43) received usual care, and the experimental group (n = 43) received usual care plus a 6-week mobile rehabilitation programme. Outcomes were assessed three times: the day before hospital discharge and 6 and 10 weeks after discharge. Primary outcomes were the changes in scores of self-efficacy and patient-reported physical function from baseline to 6 weeks post-discharge. Secondary outcomes included changes in scores of pain, depression, anxiety, and health-related quality of life. Data were analysed using generalised estimating equations. RESULTS At 6 weeks after hospital discharge, the experimental group showed statistically significant improvements compared to the control in scores of self-efficacy (adjusted mean difference = 0.72, 95% CI 0.31 to 1.14, P < .001) and patient-reported physical function (adjusted mean difference = 4.57, 95% CI 1.24 to 7.90, P = .007). The between-group difference in self-efficacy probably reached clinical significance. At week-10 follow-up, the experimental group had statistically significant improvements in scores of self-efficacy (adjusted mean difference = 0.64, 95% CI 0.33 to 0.95, P < .001), health-related quality of life (adjusted mean difference = 0.06, 95% CI 0.01 to 0.10, P = .018), anxiety (adjusted mean difference = -0.51, 95% CI -0.91 to -0.10, P = .015), and depression (adjusted mean difference = -0.37, 95% CI -0.66 to -0.08, P = .012). The between-group difference in self-efficacy and health-related quality of life may be clinically significant. CONCLUSION Mobile application-based rehabilitation demonstrated potentially positive effects on patients' self-efficacy, patient-reported physical function, health-related quality of life, and levels of anxiety and depression. TRIAL REGISTRATION Registered with the Australian New Zealand Clinical Trials Registry on 6 July 2021 (ACTRN12621000867897).
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18
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Jones RA, Mueller J, Sharp SJ, Griffin SJ, Ahern AL. Long-term impact of a behavioral weight management program on depression and anxiety symptoms: 5-year follow-up of the WRAP trial. Obesity (Silver Spring) 2022; 30:2396-2403. [PMID: 36300839 PMCID: PMC9828709 DOI: 10.1002/oby.23570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/01/2022] [Accepted: 07/26/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Behavioral weight management programs may support short-term mental health; however, limited evidence reports the long-term impacts. This study investigated the impact of behavioral weight management programs on depression and anxiety symptoms at 5 years from baseline. METHODS The Weight loss Referrals for Adults in Primary care (WRAP) trial randomized 1267 adults with BMI ≥ 28 kg/m2 to a brief intervention (BI) or commercial behavioral weight management program (WW; formerly Weight Watchers) for 12 or 52 weeks (CP12 and CP52, respectively). Linear regression was used to separately compare 5-year changes in depression and anxiety symptoms (by Hospital Anxiety and Depression Scale) between randomized groups, adjusting for baseline depression/anxiety symptoms, gender, and research center. RESULTS A total of 643 (51%) participants attended the 5-year study follow-up visit. There was no evidence of a difference between the randomized groups for 5-year changes in depression (BI: -0.08 ± 3.29; CP12: 0.02 ± 3.01; CP52: -0.09 ± 3.41) or anxiety (BI: 0.16 ± 3.50; CP12: -0.05 ± 3.55; CP52: -0.66 ± 3.59) symptoms. CONCLUSIONS This study found no evidence that commercial weight management programs differed in 5-year changes in depression and anxiety symptoms, compared with BI. These are average effects; some individuals experienced increases or decreases in symptoms. Future research should investigate who is at most risk of mental health declines and investigate how to support them. Future trials should transparently report long-term mental health outcomes to strengthen understanding.
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Affiliation(s)
| | - Julia Mueller
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | | | - Simon J. Griffin
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
- Primary Care Unit, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Amy L. Ahern
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
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19
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DeForge CE, George M, Baldwin MR, South K, Beauchemin M, McHugh ME, Smaldone A. Do Interventions Improve Symptoms Among ICU Surrogates Facing End-of-Life Decisions? A Prognostically-Enriched Systematic Review and Meta-Analysis. Crit Care Med 2022; 50:e779-e790. [PMID: 35997501 PMCID: PMC10193371 DOI: 10.1097/ccm.0000000000005642] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Evaluate the efficacy of interventions to improve symptoms for ICU surrogates at highest risk of developing psychologic distress: those facing end-of-life care decisions. DATA SOURCES MEDLINE, CINAHL, PsycInfo, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched through April 16, 2022. STUDY SELECTION Following an a priori protocol, randomized trials of interventions delivered to surrogates of adult ICU patients who died or had high likelihood of mortality evaluating surrogate symptoms were identified. DATA EXTRACTION Two reviewers performed screening and data extraction and assessed risk of bias (Cochrane Risk of Bias [RoB] 2 tool). Trials were eligible for meta-analysis if group mean symptom scores were provided at 3 or 6 months. Pooled effects were estimated using a random effects model. Heterogeneity was assessed (Cochrane Q, I2 ). Certainty of evidence was assessed (Grading of Recommendations Assessment, Development and Evaluation). DATA SYNTHESIS Of 1,660 records, 10 trials met inclusion criteria representing 3,824 surrogates; eight were included in the meta-analysis. Overall RoB was rated Some Concerns. Most ( n = 8) interventions focused on improving communication and enhancing psychologic support in the ICU. All trials measured anxiety, depression, and posttraumatic stress. Significant improvement was seen at 3 months (depression, mean difference [MD], -0.68; 95% CI, -1.14 to -0.22, moderate certainty; posttraumatic stress, standardized MD, -0.25; 95% CI, -0.49 to -0.01, very low certainty) and 6 months (anxiety, MD, -0.70; 95% CI, -1.18 to -0.22, moderate certainty). Sensitivity analyses suggest significant findings may be unstable. Subgroup analyses demonstrated differences in effect by trial location, interventionist, and intervention dose. CONCLUSIONS Communication and psychological support interventions in the ICU yielded small but significant improvement in psychological symptoms with moderate to very low certainty evidence in a prognostically-enriched sample of ICU surrogates facing end-of-life care decisions. A new approach to interventions that extend beyond the ICU may be needed.
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Affiliation(s)
| | | | - Matthew R Baldwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | | | | | - Marlene E McHugh
- Columbia University School of Nursing, New York, NY
- Palliative Care Service, Department of Family Medicine, Montefiore Medical Center, New York, NY
| | - Arlene Smaldone
- Columbia University School of Nursing, New York, NY
- College of Dental Medicine, Columbia University Irving Medical Center, New York, NY
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20
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Welford P, Gunillasdotter V, Andréasson S, Hallgren M. Effects of physical activity on symptoms of depression and anxiety in adults with alcohol use disorder (FitForChange): Secondary outcomes of a randomised controlled trial. Drug Alcohol Depend 2022; 239:109601. [PMID: 35994841 DOI: 10.1016/j.drugalcdep.2022.109601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the effects of yoga, aerobic exercise, and usual care on anxiety and depressive symptoms in non-treatment seeking adults with AUD. METHOD Parallel, three-group, open-label randomised (1:1:1) controlled trial with blinded follow-up assessment. Non-treatment seeking adults (aged 18-75 years) were recruited via advertisements in a free newspaper in Stockholm, Sweden. All participants had clinician-diagnosed AUD prior to randomisation. This trial excluded those who were physically active, or for whom supervised physical activity was contraindicated. Participants were randomly assigned to 12-weeks of aerobic exercise, yoga, or usual care (telephone counselling). The secondary outcome of interest was the Hospital Anxiety and Depression Scale (HADS), assessed at baseline and 12-week follow-up. Primary analyses consisted of linear regression models and followed intention-to-treat (ITT) principals. RESULTS In total, 140 participants (mean age 53.7 years, SD=11.8) were recruited. Follow-up was completed for 42/45 participants randomised to TAU, 42/49 to aerobic exercise and 43/46 to yoga. ITT analyses included 126 trial participants. There were statistically significant within-group improvements in total HADS in all three intervention groups. Effect sizes for usual care and aerobic exercise were small (Hedges' g=0.48, 95% CI=0.16, 0.80 and g=0.41, 95% CI=0.09, 0.72, respectively), while yoga was associated with a large treatment effect (g=1.06, 95% CI=0.69, 1.43). There were significant between-group differences in these improvements favouring yoga (B=-2.15, 95% CI=-4.16, -0.15, p = .035) relative to usual care, but no significant differences between yoga and aerobic exercise. No injuries were reported. CONCLUSIONS Findings support the recommendation of yoga for non-treatment seeking adults with AUD.
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Victoria Gunillasdotter
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Sven Andréasson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
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21
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Anxiety and Depression in Patients with Prostate Cancer, at Cancer Diagnosis and after a One-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159122. [PMID: 35897487 PMCID: PMC9368515 DOI: 10.3390/ijerph19159122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
Prostate cancer (PCa) is the most prevalent among men, and psychological symptoms may affect many patients. This study aims to describe the prevalence of probable anxiety and depression before PCa treatments and after one year and to identify sociodemographic and clinical factors associated with these outcomes. Between February 2018 and March 2020, 292 patients recently diagnosed with PCa were recruited at the Instituto Português de Oncologia—Porto. The Hospital Anxiety and Depression Scale (HADS) was used to define probable anxiety and depression (cutoff = 11). The prevalence of probable anxiety remained stable from baseline to one year (7.8% vs. 8.5%, p = 0.866) while there was an increase in probable depression (3.1% vs. 6.8%, p = 0.012). After one year, probable depression persisted in 55.6% of patients with probable depression at baseline and 47.8% of those with probable anxiety at the first assessment had normal anxiety scores. At baseline, anxiety was more frequent among dwellers in rural areas (adjusted odds ratio—aOR, 95%CI: 2.80, 0.91–8.58) and less frequent in patients with body mass index 25–29.9 kg/m2 (aOR, 95%CI: 0.33, 0.12–0.91) compared to 18.5–24.9 Kg/m2, while those living alone had higher odds of depression (aOR, 95%CI: 6.35, 1.43–28.30). The frequency of anxiety and depression fluctuated during the course of treatment. Monitoring these symptoms would identify the most affected patients, contributing for a better use of mental health services.
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22
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Yeh JJ, Lin HC, Yang YC, Hsu CY, Kao CH. Asthma Therapies on Pulmonary Tuberculosis Pneumonia in Predominant Bronchiectasis-Asthma Combination. Front Pharmacol 2022; 13:790031. [PMID: 35431916 PMCID: PMC9006509 DOI: 10.3389/fphar.2022.790031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background: It is sometimes difficult to distinguish between asthma and bronchiectasis as their symptoms overlap, and these two diseases are associated with pulmonary tuberculosis (PTB) or pneumonia. Objective: The purpose of this study is to determine the effects of bronchodilator drugs, steroids, antidepressants drugs, and antianxiety drugs on the risks of PTB or pneumonia in patients with bronchiectasis–asthma combination or bronchiectasis–asthma–chronic obstructive pulmonary disease combination—BCAS cohort. Methods: After propensity score matching, we retrospectively studied patients with BCAS (N = 620) and without BCAS (N = 2,314) through an analysis. The cumulative incidence of PTB or pneumonia was analyzed through Cox proportional regression. After adjustment for sex, age, comorbidities, and medications [including long-acting beta2 agonist/muscarinic antagonists (LABAs/LAMAs), short-acting beta2 agonist/muscarinic antagonists (SABAs/SAMAs), leukotriene receptor antagonist, montelukast, steroids (inhaled corticosteroids, ICSs; oral steroids, OSs), anti-depressants (fluoxetine), and anti-anxiety drugs (benzodiazepines, BZDs)], we calculated the adjusted hazard ratios (aHR) and their 95% confidence intervals (95% CI) for these risks. Similar to OSs, ICSs are associated with an increased risk of PTB or pneumonia, lumping these two as steroids (ICSs/OSs). Results: For the aHR (95% CI), with non-LABAs/non-OSs as the reference 1, the use of LABAs [0.70 (0.52–0.94)]/OSs [0.35 (0.29–0.44)] was associated with a lower risk of PTB or pneumonia. However, the current use of LABAs [2.39 (1.31–4.34)]/SABAs [1.61 (1.31–1.96)], steroids [ICSs 3.23 (1.96–5.29)]/OSs 1.76 (1.45–2.14)], and BZDs [alprazolam 1.73 (1.08–2.75)/fludiazepam 7.48 (1.93–28.9)] was associated with these risks. The current use of LAMAs [0.52 (0.14–1.84)]/SAMAs [1.45 (0.99–2.11)] was not associated with these risks. Conclusion: The current use of LAMAs/SAMAs is relatively safe with respect to PTB or pneumonia risks, but LABAs/SABAs, steroids, and BZDs could be used after evaluation of the benefit for the BCAS cohort. However, we must take the possible protopathic bias into account.
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Affiliation(s)
- Jun-Jun Yeh
- Department of Family Medicine, Geriatric Medicine, Chest Medicine and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Hui-Chuan Lin
- Department of Pharmacy, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Yu-Cih Yang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chung-Y Hsu
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
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23
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Yang F, Gao L, Wang Q, Deng W, Gao W. Effect of exercise-based pulmonary rehabilitation in patients with bronchiectasis: A meta-analysis. Respir Med Res 2022; 81:100910. [PMID: 35461014 DOI: 10.1016/j.resmer.2022.100910] [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: 10/23/2021] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We aimed to assess the effectiveness of exercise training in patients with bronchiectasis in terms of exercise capacity, pulmonary function, and quality of life. METHODS PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) examining pulmonary rehabilitation to treat bronchiectasis, and the search timeline was from inception through November 2020. Two researchers independently screened the literature, extracted data, evaluated the risk of bias in the included studies, and used Review Manager 5.3 software to perform the meta-analysis. The primary outcomes were incremental shuttle walk distance (ISWD) and 6-minute walk distance (6-MWD) at 8 weeks. The secondary outcomes were forced expiratory volume in 1 second (FEV1), St. George's Respiratory Questionnaire (SGRQ) score, and Leicester Cough Questionnaire (LCQ) score at 8 weeks. RESULTS A total of five RCTs with a total of 198 patients were included. A pooled analysis showed that improvements in ISWD (mean difference [MD] = 92.47 m, 95% confidence interval [CI] 49.87, 135.08; P < 0.0001), 6-MWD (MD = 31.01 m, 95% CI 1.60, 60.42; P = 0.04), and FEV1 (MD = 0.08 L, 95% CI 0.04, 0.12; P = 0.0002) in the pulmonary rehabilitation group were more marked than in the control group. There was no significant difference between the two groups in terms of the improvement in SGRQ and LCQ scores. CONCLUSIONS Pulmonary rehabilitation improves exercise capacity and pulmonary function (specifically FEV1) in patients with bronchiectasis. However, due to limitations in the number and quality of current studies, the above conclusions need to be verified in future research.
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Affiliation(s)
- Feng Yang
- Department of Respiratory and Critical Care Medicine, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, 100068, China
| | - Lianjun Gao
- Department of Respiratory and Critical Care Medicine, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, 100068, China
| | - Qimin Wang
- Department of Respiratory and Critical Care Medicine, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, 100068, China
| | - Weiping Deng
- Department of Respiratory and Critical Care Medicine, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, 100068, China
| | - Wei Gao
- Department of Respiratory and Critical Care Medicine, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, 100068, China.
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24
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Brédart A, Kop JL, Tüchler A, De Pauw A, Cano A, Dick J, Rhiem K, Devilee P, Schmutzler R, Stoppa-Lyonnet D, Dolbeault S. Assessment of psychosocial difficulties by genetic clinicians and distress in women at high risk of breast cancer: a prospective study. Eur J Hum Genet 2022; 30:1067-1075. [PMID: 35399119 PMCID: PMC9437045 DOI: 10.1038/s41431-022-01096-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
We examined how often genetic clinicians correctly identify psychosocial difficulties in women at high breast cancer risk and explored effects of this assessment and the genetic test result on counselees’ distress. A prospective observational study of counselee–clinician dyads was performed in three French, German and Spanish genetic clinics, involving 709 counselees (participation rate, 83.4%) and 31 clinicians (participation rate, 100%). Counselee–clinician agreement in perceived psychosocial difficulties was measured after the pre-test genetic consultation. Multivariate mixed linear models accounting for clinicians were tested. Predicted distress levels were assessed after the pre- (T1) and post-test result disclosure consultations (T2). Depending on the difficulty domain, clinicians adequately assessed the presence or absence of difficulties in 51% (“familial issues”) to 59% (“emotions”) of counselees. When counselees’ and clinicians’ perceptions disagreed, difficulties were generally underestimated by clinicians. Counselees’ distress levels remained stable from T1 to T2, irrespective of clinicians’ appraisal adequacy, and the genetic test result disclosure. Psychological referral need were found in 20–42% of counselees, more frequently observed for difficulties in the “emotions” domain. Our findings suggest that the genetic test result is a suboptimal indicator for psychological referral. Instead, clinicians should focus on emotions expressed by counselees to appraise their needs for psychological support.
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Affiliation(s)
- Anne Brédart
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d'Ulm, 75005, Paris Cedex 05, France. .,Psychopathology and Health Process Laboratory UR4057, Psychology Institute, Paris University, 71 Avenue Edouard Vaillant, 92774, Boulogne-Billancourt, France.
| | - Jean-Luc Kop
- Université de Lorraine, 2LPN, 3 Place Godefroy de Bouillon, 54015, Nancy Cedex, France
| | - Anja Tüchler
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Antoine De Pauw
- Institut Curie, Department of Genetics, INSERM U830, Paris University, 26 rue d'Ulm, 75005, Paris Cedex 05, France
| | - Alejandra Cano
- University Autónoma of Barcelona, Clinical and Health Psychology Department, Barcelona, Spain
| | - Julia Dick
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Peter Devilee
- Leiden University Medical Centre, Department of Human Genetics, Department of Pathology, S4-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Department of Genetics, INSERM U830, Paris University, 26 rue d'Ulm, 75005, Paris Cedex 05, France
| | - Sylvie Dolbeault
- Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d'Ulm, 75005, Paris Cedex 05, France.,CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, 16 Avenue Paul Vaillant-Couturier, 94807, Villejuif Cedex, France
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25
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Heesakkers H, van der Hoeven JG, Corsten S, Janssen I, Ewalds E, Simons KS, Westerhof B, Rettig TCD, Jacobs C, van Santen S, Slooter AJC, van der Woude MCE, van den Boogaard M, Zegers M. Clinical Outcomes Among Patients With 1-Year Survival Following Intensive Care Unit Treatment for COVID-19. JAMA 2022; 327:559-565. [PMID: 35072716 PMCID: PMC8787680 DOI: 10.1001/jama.2022.0040] [Citation(s) in RCA: 141] [Impact Index Per Article: 70.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE One-year outcomes in patients who have had COVID-19 and who received treatment in the intensive care unit (ICU) are unknown. OBJECTIVE To assess the occurrence of physical, mental, and cognitive symptoms among patients with COVID-19 at 1 year after ICU treatment. DESIGN, SETTING, AND PARTICIPANTS An exploratory prospective multicenter cohort study conducted in ICUs of 11 Dutch hospitals. Patients (N = 452) with COVID-19, aged 16 years and older, and alive after hospital discharge following admission to 1 of the 11 ICUs during the first COVID-19 surge (March 1, 2020, until July 1, 2020) were eligible for inclusion. Patients were followed up for 1 year, and the date of final follow-up was June 16, 2021. EXPOSURES Patients with COVID-19 who received ICU treatment and survived 1 year after ICU admission. MAIN OUTCOMES AND MEASURES The main outcomes were self-reported occurrence of physical symptoms (frailty [Clinical Frailty Scale score ≥5], fatigue [Checklist Individual Strength-fatigue subscale score ≥27], physical problems), mental symptoms (anxiety [Hospital Anxiety and Depression {HADS} subscale score ≥8], depression [HADS subscale score ≥8], posttraumatic stress disorder [mean Impact of Event Scale score ≥1.75]), and cognitive symptoms (Cognitive Failure Questionnaire-14 score ≥43) 1 year after ICU treatment and measured with validated questionnaires. RESULTS Of the 452 eligible patients, 301 (66.8%) patients could be included, and 246 (81.5%) patients (mean [SD] age, 61.2 [9.3] years; 176 men [71.5%]; median ICU stay, 18 days [IQR, 11 to 32]) completed the 1-year follow-up questionnaires. At 1 year after ICU treatment for COVID-19, physical symptoms were reported by 182 of 245 patients (74.3% [95% CI, 68.3% to 79.6%]), mental symptoms were reported by 64 of 244 patients (26.2% [95% CI, 20.8% to 32.2%]), and cognitive symptoms were reported by 39 of 241 patients (16.2% [95% CI, 11.8% to 21.5%]). The most frequently reported new physical problems were weakened condition (95/244 patients [38.9%]), joint stiffness (64/243 patients [26.3%]) joint pain (62/243 patients [25.5%]), muscle weakness (60/242 patients [24.8%]) and myalgia (52/244 patients [21.3%]). CONCLUSIONS AND RELEVANCE In this exploratory study of patients in 11 Dutch hospitals who survived 1 year following ICU treatment for COVID-19, physical, mental, or cognitive symptoms were frequently reported.
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Affiliation(s)
- Hidde Heesakkers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
| | - Johannes G. van der Hoeven
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
| | - Stijn Corsten
- Department of Intensive Care Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Inge Janssen
- Department of Intensive Care Medicine, Maasziekenhuis Pantein, Beugen, the Netherlands
| | - Esther Ewalds
- Department of Intensive Care Medicine, Bernhoven Hospital, Uden, the Netherlands
| | - Koen S. Simons
- Department of Intensive Care Medicine, Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands
| | - Brigitte Westerhof
- Department of Intensive Care Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Thijs C. D. Rettig
- Department of Anesthesiology, Intensive Care and Pain Medicine, Amphia Hospital, Breda, the Netherlands
| | - Crétien Jacobs
- Department of Intensive Care Medicine, Elkerliek Hospital, Helmond, the Netherlands
| | - Susanne van Santen
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Arjen J. C. Slooter
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Mark van den Boogaard
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
| | - Marieke Zegers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
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26
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Donaldson GC, Ritchie AI, Calverley PMA, Vestbo J, Fageras M, de la Hoz A, Bucchioni E, Compton CH, Mezzi K, Wedzicha JA. Impact of the UK lockdown on people at risk of COPD. ERJ Open Res 2021; 7:00358-2021. [PMID: 34820444 PMCID: PMC8607069 DOI: 10.1183/23120541.00358-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/29/2021] [Indexed: 11/29/2022] Open
Abstract
On 23 March 2020, the UK Government announced a nationwide lockdown in response to the COVID-19 epidemic, with people banned from leaving their homes except for essential journeys and exercise. Impact of the UK lockdown on early COPDhttps://bit.ly/3laMsmi
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Affiliation(s)
- Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew I Ritchie
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Jorgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | | | - Alberto de la Hoz
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
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27
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A Short-term Psychological Intervention for People Living with HIV During the First Wave of COVID-19. Int J Cogn Ther 2021; 15:21-41. [PMID: 34804328 PMCID: PMC8589225 DOI: 10.1007/s41811-021-00127-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 12/21/2022]
Abstract
Research on the psychosocial impact of COVID-19 has found significant levels of distress among the general population, and among those especially vulnerable due to chronic social or health challenges. Among these are individuals aging with HIV infection, who are encountering COVID-19 as a new infectious threat to their health and wellbeing. In a longitudinal observational study of the psychosocial impact of COVID-19 in middle-aged and older people living with HIV, we identified a subset of participants who expressed heightened levels of distress and were referred for clinical intervention. This paper describes the supportive and contemporary cognitive-behavioral interventions that were provided and presents data on changes in distress in this case series. This work provides a model for identifying people in at-risk groups in acute need of psychological intervention and for implementing an individualized clinical response that can be safely delivered in the context of COVID-19 and future crisis situations.
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28
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Exploring the impact of exercise and mind-body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery. Support Care Cancer 2021; 30:2027-2036. [PMID: 34648061 DOI: 10.1007/s00520-021-06617-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the impact of exercise and mind-body prehabilitation interventions on changes in quality of life and cancer treatment-related symptoms in women with newly diagnosed breast cancer. METHODS The following describes a secondary analysis of a randomized window of opportunity trial (The Pre-Operative Health and Body Study). Forty-nine women were randomized to participate in either an exercise prehabilitation intervention or a mind-body prehabilitation intervention from the time of enrollment to surgery. Participants (N = 47) completed measures of quality of life, anxiety, depression, and stress at the time of enrollment (T1), post-intervention/surgery (T2), and one-month post-surgery (T3). Changes in outcome measures between groups were compared over time using longitudinal models. RESULTS Mind-body group participants experienced significant improvements in cognitive functioning in comparison to exercise group participants between T1 and T3 (difference in average change: -9.61, p = 0.04, d = 0.31), otherwise, there were no significant differences between groups. Within group comparisons demonstrated that both groups experienced improvements in anxiety (exercise: average change = -1.18, p = 0.03, d = 0.34; mind-body: average change = -1.69, p = 0.006, d = 0.43) and stress (exercise: average change = -2.33, p = 0.04, d = 0.30; mind-body: average change = -2.59, p = 0.05, d = 0.29), while mind-body group participants experienced improvements in insomnia (average change = -10.03, p = 0.04, d = 0.30) and cognitive functioning (average change = 13.16, p = 0.0003, d = 0.67). CONCLUSIONS Both prehabilitation interventions impacted cancer treatment-related symptoms. Further work in larger groups of patients is needed to evaluate the efficacy of prehabilitation interventions on quality of life in women with breast cancer. Pre-operative exercise and mind-body interventions may impact physical and/or psychological effects of cancer diagnosis and treatment in women with breast cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01516190. Registered January 24, 2012.
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