-
Hospital Pediatrics Nov 2023Being in the hospital can be stressful for children and caregivers. Evidence-based play interventions to reduce this stress, such as play therapy or Child Life services,...
CONTEXT
Being in the hospital can be stressful for children and caregivers. Evidence-based play interventions to reduce this stress, such as play therapy or Child Life services, have been introduced in hospitals globally, with growing awareness of potential benefits.
OBJECTIVES
To evaluate the impact of nonmedical/illness-specific creative or play-based programs in hospital settings on children's (<18 years) and their caregivers' hospital experiences, wellbeing, and other health outcomes.
DATA SOURCES
PubMed, CINAHL, Google Scholar.
METHODS
We conducted a systematic review of original articles published since 2011, screening 2701 de-duplicated articles.
RESULTS
We identified 25 eligible articles, representing 1629 children (57% male), 422 caregivers, and 128 health professionals. Included studies most commonly evaluated professional children's entertainers (n = 8 studies), music therapy (n = 4), unstructured play (n = 3), and humanoid/animal robots (n = 3). Most studies evaluated the impact on the child's level of anxiety (n = 14/25), mostly supporting a reduction (n = 13/14 studies). Several studies provided evidence for a reduction in children's pain (n = 4/6), and negative emotional/behavioral outcomes (eg, sadness, anger, irritability; n = 5/6 studies). There was mixed evidence for the impact of the included interventions on physiologic outcomes (eg, systolic pressure, heart frequency; n = 3/5 studies) and fatigue (n = 1/2 studies). Evidence on caregiver outcomes and the impact on health care services was limited.
CONCLUSIONS
The findings of our review generally supported the value of play-based interventions on children's' wellbeing while in the hospital, particularly reducing anxiety and pain. Further evaluation of their impact on caregivers' outcomes and the health care system is needed.
Topics: Child; Humans; Male; Female; Anxiety; Hospitals; Pain; Caregivers
PubMed: 37830155
DOI: 10.1542/hpeds.2022-006994 -
Cureus Sep 2023Parkinson's disease (PD) is one of the most common neurological ailments. With diverse motor affectations (postural instability, resting tremor, bradykinesia, and... (Review)
Review
Parkinson's disease (PD) is one of the most common neurological ailments. With diverse motor affectations (postural instability, resting tremor, bradykinesia, and rigidity), people with Parkinson's disease (PwP) have a broad spectrum of non-motor symptoms. These include autonomic function changes, cognitive deterioration, neuropsychiatric difficulties, and sleep interruptions. Psychological disturbances, such as anxiety and sadness, are common among PwP. This discomfort is often accompanied by a decrease in general functioning, both at work and in social contacts. Furthermore, people who are experiencing psychological distress have a quick decrease in both physical and cognitive capacities. Furthermore, Pwp who also suffer from anxiety and depression are more likely to acquire dementia. It is worth noting that studies have shown good outcomes in the treatment of physical disabilities in PWP and the various therapeutics available for each affected body part, such as in the legs when they have walking problems, resting tremor in their hands, or micrography, which is a common symptom in these patients. The medical research databases PubMed/Medline, Google Scholar, and the Cochrane Library were used to look for relevant materials. Upon meticulous scrutiny, a thorough investigation was conducted on the papers at hand. A total of 10 publications were meticulously selected based on stringent qualifying criteria. The present investigation examines various perspectives regarding the physical rehabilitation of individuals diagnosed with PD. The majority of therapeutic interventions employed revolve around cutting-edge technologies, such as virtual reality (VR), combined with exercise regimens. These interventions have demonstrated notable statistical significance in terms of enhancing various physical aspects, including endurance, performance, gait capacity, perception, and overall independence in daily life activities. One of the gathered studies makes use of the therapeutic benefits of yoga to help PwP deal with their anxiety and improve their mental health. Based on the aforementioned information, further investigation is required to ascertain the optimal approach for physical rehabilitation management and develop diverse strategies aimed at assisting individuals with PD in attaining physical autonomy.
PubMed: 37809151
DOI: 10.7759/cureus.44739 -
Jornal de Pediatria 2024In this systematic review (SR), the authors aimed to identify the possible impact of the social restriction imposed by the Coronavirus Disease-19 (COVID-19) pandemic on... (Review)
Review
OBJECTIVE
In this systematic review (SR), the authors aimed to identify the possible impact of the social restriction imposed by the Coronavirus Disease-19 (COVID-19) pandemic on children/adolescents with Attention Deficit Hyperactivity Disorder (ADHD).
DATA SOURCES
This SR was registered on PROSPERO CRD42021255569. Eligible articles were selected from PubMed, Embase, and LILACS, according to the following characteristics: ADHD patients < 18 years old, exposed to the COVID-19 pandemic, and the outcomes, medications, relationships, sleep, media use, remote learning, and comorbidities such as depression/sadness, inattention, anxiety, and irritability/aggressiveness. Newcastle-Ottawa Scale (NOS) for cohort, cross-sectional and case-control studies was used to assess methodological quality and the risk of bias.
SUMMARY OF FINDINGS
Of the 222 articles identified, 27 were included, with information on 7,235 patients. Most studies (n = 22) were cross-sectional and received a mean NOS 4.63/10 followed by longitudinal (n = 4) with 3.75/8 points and case-control (n = 1), with 3/9 points. The pandemic affected patients' access to treatment, behavior, and sleep. Difficulties in remote learning and increased use of social media were described, as well as significant and positive changes in relationships with family and peers.
CONCLUSION
Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ADHD were mostly manifested affecting their behavior and sleep patterns.
Topics: Child; Humans; Adolescent; Attention Deficit Disorder with Hyperactivity; COVID-19; Pandemics; Case-Control Studies
PubMed: 37640234
DOI: 10.1016/j.jped.2023.06.003 -
Pharmaceuticals (Basel, Switzerland) Aug 2023Major depressive disorder (MDD) is a medical condition involving persistent sadness and loss of interest; however, conventional treatments with antidepressants and... (Review)
Review
Major depressive disorder (MDD) is a medical condition involving persistent sadness and loss of interest; however, conventional treatments with antidepressants and cognitive behavioral therapy have limitations. Based on the pathogenesis of MDD, treatments using herbal medicines (HM) have been identified in animal studies. We conducted a systematic review of clinical studies to identify neurobiological outcomes and evaluate the effectiveness of HM in treating MDD. A meta-analysis was performed by searching nine databases from their inception until 12 September 2022, including 31 randomized controlled trials with 3133 participants, to examine the effects of HM on MDD using neurobiological biomarkers and a depression questionnaire scale. Quality assessment was performed using a risk of bias tool. Compared to antidepressants alone, HM combined with an antidepressant significantly increased concentrations of serotonin (SMD = 1.96, 95% CI: 1.24-2.68, < 0.00001, I = 97%), brain-derived neurotrophic factor (SMD = 1.38, 95% CI: 0.92-1.83, < 0.00001, I = 91%), and nerve growth factors (SMD = 2.38, 95% CI: 0.67-4.10, = 0.006, I = 96%), and decreased cortisol concentrations (SMD = -3.78, 95% CI: -4.71 to -2.86, < 0.00001, I = 87%). Although HM or HM with an antidepressant benefits MDD treatment through improving neuroendocrine factors, these findings should be interpreted with caution because of the low methodological quality and clinical heterogeneity of the included studies.
PubMed: 37631092
DOI: 10.3390/ph16081176 -
Progress in Neuro-psychopharmacology &... Dec 2023Facial emotion (or expression) recognition (FER) is a domain of affective cognition impaired across various psychiatric conditions, including bipolar disorder (BD). We... (Meta-Analysis)
Meta-Analysis
Facial emotion (or expression) recognition (FER) is a domain of affective cognition impaired across various psychiatric conditions, including bipolar disorder (BD). We conducted a systematic review and meta-analysis searching for eligible articles published from inception to April 26, 2023, in PubMed/MEDLINE, Scopus, EMBASE, and PsycINFO to examine whether and to what extent FER would differ between people with BD and those with other mental disorders. Thirty-three studies comparing 1506 BD patients with 1973 clinical controls were included in the present systematic review, and twenty-six of them were analyzed in random-effects meta-analyses exploring the discrepancies in discriminating or identifying emotional stimuli at a general and specific level. Individuals with BD were more accurate in identifying each type of emotion during a FER task compared to individuals diagnosed with schizophrenia (SCZ) (SMD = 0.27; p-value = 0.006), with specific differences in the perception of anger (SMD = 0.46; p-value = 1.19e-06), fear (SMD = 0.38; p-value = 8.2e-04), and sadness (SMD = 0.33; p-value = 0.026). In contrast, BD patients were less accurate than individuals with major depressive disorder (MDD) in identifying each type of emotion (SMD = -0.24; p-value = 0.014), but these differences were more specific for sad emotional stimuli (SMD = -0.31; p-value = 0.009). No significant differences were observed when BD was compared with children and adolescents diagnosed with attention-deficit/hyperactivity disorder. FER emerges as a potential integrative instrument for guiding diagnosis by enabling discrimination between BD and SCZ or MDD. Enhancing the standardization of adopted tasks could further enhance the accuracy of this tool, leveraging FER potential as a therapeutic target.
Topics: Adolescent; Child; Humans; Bipolar Disorder; Depressive Disorder, Major; Facial Recognition; Emotions; Anger
PubMed: 37625644
DOI: 10.1016/j.pnpbp.2023.110847 -
European Journal of Psychotraumatology 2023Pre-and post-traumatic hypothalamic-pituitary-adrenal (HPA) axis markers have been studied to predict posttraumatic stress disorder (PTSD) risk, but its acute... (Meta-Analysis)
Meta-Analysis Review
Pre-and post-traumatic hypothalamic-pituitary-adrenal (HPA) axis markers have been studied to predict posttraumatic stress disorder (PTSD) risk, but its acute reactivity cannot be measured in real-life settings. Experimental paradigms can depict the cortisol response to stimuli that simulate traumatic events. To review experimental studies on the cortisol response to traumatic stimuli and the correlation between cortisol and PTSD symptoms. Experimental, (un-)published studies in German or English from any year were eligible if they confronted non-traumatized humans with traumatic stimuli, assessed cortisol before, during or after stimulus presentation and subsequent PTSD symptoms. The literature was searched via PubMed, PubPsych, PsychINFO, PsycArticle, Web of Science, EMBASE, ProQuest and ClinicalTrials.gov up to 16th February 2021. Risk of bias was assessed with the Cortisol Assessment List. Multilevel-meta-analyses were conducted under the random effects model. The standardized mean change () indicated the cortisol response. Coefficient indicated the correlations between cortisol and PTSD symptoms. 14 studies, investigating 1004 individuals, were included. A cortisol response was successfully induced between 21 and 40 min post-presentation onset (= 25, = 0.15 [.03; .26]). Cortisol was not associated with overall or cluster-level PTSD symptoms. On a symptom-level, higher pre-presentation onset cortisol was correlated with lower state tension (= 8, = -.18 [-.35; -.01]), higher state happiness (= 8, = -.34 [-.59; -.03], variable inverted) and lower state anger (= 9, = -.14 [-.26; -.01]). Higher post-presentation onset cortisol was correlated with higher state happiness (= 16, = -.20 [-.33; -.06]) and lower state sadness (= 17, = -.16 [-.25; -.05]), whereas cortisol response was positively correlated with state anxiety (= 9, = .16 [0.04; 0.27]). Experimental paradigms effectively induce a cortisol response. Higher basal cortisol, higher cortisol, as measured after traumatic stimulus presentation, and a lower cortisol response were associated with more adaptive emotional reactions. These markers did not predict longer-term PTSD symptoms.
Topics: Humans; Stress Disorders, Post-Traumatic; Hydrocortisone; Pituitary-Adrenal System; Anxiety Disorders; Anxiety
PubMed: 37401356
DOI: 10.1080/20008066.2023.2225153 -
Behavioral Sciences (Basel, Switzerland) Jun 2023Physical activity is an effective treatment for paediatric spinal pain. However, participation rates remain low and review evidence is needed to establish why. This... (Review)
Review
Factors Influencing Participation in Physical Activity, Sports, and Exercise in Children and Adolescents with Spinal Pain or Spinal Conditions: A Systematic Review and Meta-Ethnography.
BACKGROUND
Physical activity is an effective treatment for paediatric spinal pain. However, participation rates remain low and review evidence is needed to establish why. This review identifies factors influencing participation in sports, exercise, and physical activity in those aged 18 or under with spinal pain or spinal conditions. Trends or differences between discrete sub-populations are identified.
METHODS
A meta-ethnographic review was undertaken. Qualitative papers were identified and appraised using the JBI checklist. Thematic trends were mapped onto the biopsychosocial model and subthemes identified. Uniqueness was calculated and the confidence in the evidence was evaluated using the GRADE-CERQual tool.
RESULTS
Data were gathered from nine qualitative papers (384 participants). Three themes were identified: (1) biological: physical challenges and bladder and bowel care; (2) psychological: perceptions of differences to peers, struggle, anger, sadness, adjustment, and acceptance; and (3) sociological: influence of friends, social acceptance, negative attitudes from others, and the influence of their disability on family routine.
CONCLUSIONS
Sociological factors were most influential on exercise participation alongside related psychological and biological factors. Adolescents over 14 years offered greater critical insight compared to the younger children. Results are best applied to neuromuscular conditions with further robust evidence required in paediatric musculoskeletal spinal pain.
PubMed: 37366738
DOI: 10.3390/bs13060486 -
Scientific Reports Mar 2023The use of open-label placebos (OLPs) has shown to be effective in clinical trials. We conducted a systematic review and meta-analysis to examine whether OLPs are... (Meta-Analysis)
Meta-Analysis
The use of open-label placebos (OLPs) has shown to be effective in clinical trials. We conducted a systematic review and meta-analysis to examine whether OLPs are effective in experimental studies with non-clinical populations. We searched five databases on April 15, 2021. We conducted separate analyses for self-reported and objective outcomes and examined whether the level of suggestiveness of the instructions influenced the efficacy of OLPs. Of the 3573 identified records, 20 studies comprising 1201 participants were included, of which 17 studies were eligible for meta-analysis. The studies investigated the effect of OLPs on well-being, pain, stress, arousal, wound healing, sadness, itchiness, test anxiety, and physiological recovery. We found a significant effect of OLPs for self-reported outcomes (k = 13; standardized mean difference (SMD) = 0.43; 95% CI = 0.28, 0.58; I = 7.2%), but not for objective outcomes (k = 8; SMD = - 0.02; 95% CI = - 0.25, 0.21; I = 43.6%). The level of suggestiveness of the instructions influenced the efficacy of OLPs for objective outcomes (p = 0.02), but not for self-reported outcomes. The risk of bias was moderate for most studies, and the overall quality of the evidence was rated low to very low. In conclusion, OLPs appear to be effective when examined in experimental studies. However, further research is needed to better understand the mechanisms underlying OLPs.
Topics: Humans; Arousal; Databases, Factual; Pain; Sadness; Self Report
PubMed: 36871028
DOI: 10.1038/s41598-023-30362-z -
Frontiers in Psychiatry 2022Facial emotion identification (FEI) deficits are associated with impaired social functioning in persons living with schizophrenia (PLwS), but the research on...
BACKGROUND
Facial emotion identification (FEI) deficits are associated with impaired social functioning in persons living with schizophrenia (PLwS), but the research on emotion-specific FEI deficits remains inconclusive. Furthermore, existing studies on FEI deficits are limited by their small sample sizes. We performed a meta-analysis of studies comparing the FEI abilities between Chinese PLwS and healthy controls in terms of the six basic facial emotions (happiness, sadness, fear, disgust, anger, and surprise), as well as contempt, calmness, and neutral facial expressions.
METHODS
Major Chinese- and English-language databases were searched to retrieve case-control studies that compared the FEI task performance between Chinese PLwS and healthy controls (HCs) and reported the emotion-specific correct identification scores for PLwS and HCs. The Joanna Briggs Institute Critical Appraisal Checklist for Case-control Studies ("JBI checklist," hereafter) was used to assess the risk of bias (RoB) of the included studies. Statistical analysis was performed using the "meta" package of R 4.1.2.
RESULTS
Twenty-three studies with a total of 28 case-control cohorts and 1,894 PLwS and 1,267 HCs were included. The RoB scores of the included studies ranged from two to seven. PLwS had statistically significantly lower FEI scores than HCs and the corresponding emotion-specific pooled standard mean differences (95% confidence intervals) were -0.69 (-0.88, -0.50) for happiness, -0.88 (-1.12, -0.63) for sadness, -1.44 (-1.83, -1.06) for fear, -1.18 (-1.60, -0.76) for disgust, -0.91 (-1.24, -0.57) for anger, -1.09 (-1.39, -0.78) for surprise, -0.26 (-0.51, -0.01) for contempt, -0.31 (-0.52, -0.09) for calmness, and -0.42 (-0.65, -0.18) for neutral. In the analyses of sources of heterogeneity, drug-naïve status, clinical setting, positive and negative psychotic symptoms, and RoB were significant moderators of the magnitudes of FEI deficits.
CONCLUSIONS
Chinese PLwS have significant FEI impairments in terms of recognizing the six basic facial emotions, contempt, calmness, and neutral emotions, and the magnitude of impairment varies depending on the type of emotion, clinical characteristics, and the level of RoB of the study. It is necessary to consider the characteristics of FEI deficits and the clinical moderators in the FEI deficits to develop remediation strategies targeting FEI deficits in schizophrenia.
PubMed: 36606133
DOI: 10.3389/fpsyt.2022.1097350 -
Journal of Pediatric Nursing 2023Grieving is an adaptive process in the face of the death of somebody close. Children grieve the loss of a family member or friend and need support from their caregivers...
BACKGROUND
Grieving is an adaptive process in the face of the death of somebody close. Children grieve the loss of a family member or friend and need support from their caregivers and the professionals who care for them during this process. Failure to talk to children about the death of a family member or friend can lead to prolonged grief. Children's story books are one of the resources available for providing this type of support.
OBJECTIVE
To provide the nursing professional with information on story books aimed at children from 7 to 11 years of age as a tool to help them understand and cope with grief.
DESIGN
A systematic integrative review was conducted.
METHODS
A search was performed in the ISBN database of the Ministry of Culture and the University Libraries Network. Data extraction was performed by two coders using a protocol registered in PROSPERO.
RESULTS
Fifty-six books met the inclusion criteria. Twenty-five percent of the deceased characters were grandparents and 30.4% died due to illness. The most frequent emotion was sadness, (43.3%) and the most repeated coping strategy was remembering the deceased person, (28.7%). The grieving process was depicted in 32.1% of the selected stories.
CONCLUSION
The children's books reviewed support understanding and coping with grief. However, some limitations were detected, and therefore it is advisable to accompany the child while reading these books to discuss aspects that have not been addressed.
Topics: Child; Humans; Grief; Emotions; Family; Adaptation, Psychological; Books
PubMed: 36599739
DOI: 10.1016/j.pedn.2022.12.012