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East Asian Archives of Psychiatry :... Mar 2024COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and...
BACKGROUND
COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and perceived stress among patients with COVID-19.
METHODS
Clinically stable patients with COVID-19 aged 18 to 60 years who were admitted between April 2021 and September 2021 to the MES Medical College in Kerala, India were prospectively recruited. They were assessed using the Montgomery-Asberg Depression Rating Scale, the Hamilton Anxiety Scale, and the Perceived Stress Scale.
RESULTS
Of 112 patients screened, 103 were included in the analysis. Depression scores were higher in patients of lower socio-economic status (p = 0.04), of unemployed (p = 0.01), and with longer hospital stays (p < 0.001). Anxiety scores were higher in patients aged 31 to 40 years (p = 0.04), of lower socio-economic status (p = 0.01), with a history of psychiatric illness (p = 0.006), and with a history of self-harm (p = 0.019). Perceived stress scores were higher in patients of lower socio-economic status (p = 0.02), with a history of psychiatric illness (p = 0.001), and with a history of self-harm (p = 0.022).
CONCLUSION
Socio-economic status, employment status, a history of psychiatric illness, and duration of hospital stay are associated with depression, anxiety, and stress among patients with COVID-19.
Topics: Humans; COVID-19; Adult; Male; Female; Prevalence; India; Middle Aged; Stress, Psychological; Depression; Anxiety; Young Adult; Adolescent; Hospitalization; Psychiatric Status Rating Scales; Prospective Studies; Length of Stay; SARS-CoV-2
PubMed: 38955778
DOI: 10.12809/eaap2346 -
Journal of Surgical Education Jul 2024While graphics are commonly used by clinicians to communicate information to patients, the impact of using visual media on surgical patients is not understood. This...
OBJECTIVE
While graphics are commonly used by clinicians to communicate information to patients, the impact of using visual media on surgical patients is not understood. This review seeks to understand the current landscape of research analyzing impact of using visual aids to communicate with patients undergoing surgery, as well as gaps in the present literature.
DESIGN
A comprehensive literature search was performed across 4 databases. Search terms included: visual aids, diagrams, graphics, surgery, patient education, informed consent, and decision making. Inclusion criteria were (i) full-text, peer-reviewed articles in English; (ii) evaluation of a nonelectronic visual aid(s); and (iii) surgical patient population.
RESULTS
There were 1402 articles identified; 21 met study criteria. Fifteen were randomized control trials and 6 were prospective cohort studies. Visual media assessed comprised of diagrams as informed consent adjuncts (n = 6), graphics for shared decision-making conversations (n = 3), other preoperative educational graphics (n = 8), and postoperative educational materials (n = 4). There was statistically significant improvement in patient comprehension, with an increase in objective knowledge recall (7.8%-29.6%) using illustrated educational materials (n = 10 of 15). Other studies noted increased satisfaction (n = 4 of 6), improvement in shared decision-making (n = 2 of 4), and reduction in patient anxiety (n = 3 of 6). For behavioral outcomes, visual aids improved postoperative medication compliance (n = 2) and lowered postoperative analgesia requirements (n = 2).
CONCLUSIONS
The use of visual aids to enhance the surgical patient experience is promising in improving knowledge retention, satisfaction, and reducing anxiety. Future studies ought to consider visual aid format, and readability, as well as patient language, race, and healthcare literacy.
PubMed: 38955659
DOI: 10.1016/j.jsurg.2024.06.002 -
Pain Management Nursing : Official... Jul 2024Peripheral intravenous catheter (PIC) implementation is among the most frequent and highly invasive nursing initiatives. PIC leads to anxiety with procedural pain,...
BACKGROUND
Peripheral intravenous catheter (PIC) implementation is among the most frequent and highly invasive nursing initiatives. PIC leads to anxiety with procedural pain, causing individuals to reject these procedures or negatively affecting the process's success.
AIM
The study was conducted to determine the effect of virtual reality glasses (VRG) on pain, anxiety, and patient satisfaction during the peripheral intravenous catheter (PIC) process in adults.
DESIGN
An experimental study.
SETTINGS
An emergency department of a university hospital.
METHODS
Individuals who were admitted to the emergency unit of the university hospital were recruited between the data collection dates. Data from individuals' "Patient Information Form," "Visual Pain Scale," "Visual Anxiety Scale," and "Visual Satisfaction Scale" were collected. "VR-Box 3D Glasses" was used as virtual reality glasses.
RESULTS
In our study, when the pain point averages with VAS were compared during the PIC process, the pain score average of the patients in the control group was 5.78 ± 1.23 visual anxiety scale 5.89 ± 1.23 and patient satisfaction scale 3.86 ± 2.48, The visual pain score average of patients in the VRG group is 4.12 ± 2.16, visual anxiety scale 3.14 ± 1.76 and visual patient satisfaction scale 7.64 ± 3.26. In short, it has been detected that the pain, anxiety, and patient satisfaction score averages of patients in the VRG group are statistically significant compared to the pain score averages of patients in the control group (p < .005). Our study unearthed a statistically significant relationship at an average level of negative direction between PIC post-treatment pain, anxiety, and patient satisfaction (r = - 0.476).
CONCLUSION
Utilization of VRG has been detected to reduce pain and anxiety felt during the PIC process in adult patients and increase process satisfaction. VRG, a non-pharmacological, non-invasive, inexpensive, and feasible nursing initiative, may be recommended for use in pain and anxiety control in patients undergoing PIC treatment.
PubMed: 38955551
DOI: 10.1016/j.pmn.2024.05.009 -
Pain Management Nursing : Official... Jul 2024To determine the effects of virtual reality (VR) interventions on pre- and postoperative anxiety, pain, and parental satisfaction in children.
PURPOSE
To determine the effects of virtual reality (VR) interventions on pre- and postoperative anxiety, pain, and parental satisfaction in children.
DESIGN
A randomized controlled trial.
METHODS
Children undergoing surgery for the first time and their families were randomly assigned to the control or VR group. The control group received conventional education regarding the perioperative process. The VR group watched a VR video illustrating the operating theater and explaining the perioperative process. The primary outcome of interest was preoperative anxiety, evaluated using the Children's State Anxiety Scale. Secondary outcomes of interest included postoperative pain ratings using the Wong-Baker Faces Pain Rating Scale and parental satisfaction scores using the PedsQL Health Care Satisfaction Scale.
RESULTS
The analysis included 70 children and their families (control = 35, VR = 35). Demographic characteristics were similar between the groups. Children in the VR group had significantly lower preoperative anxiety scores (p < .001) and postoperative anxiety scores (p = .010) compared to the control group. Parental satisfaction scores were significantly higher in the VR group (p < .001). The VR group had lower postoperative pain scores, but this difference was not statistically significant (p > .05).
CONCLUSIONS
Preoperative education using VR tours may reduce preoperative anxiety and increase parental satisfaction. However, the lack of baseline measurements limits our ability to definitively attribute these effects to the VR intervention. Despite this, VR is a promising nonpharmacological strategy for managing children's anxiety and increasing parental satisfaction.
CLINICAL IMPLICATIONS
Virtual reality interventions offer an effective nonpharmacological strategy for perioperatively managing children's anxiety and increasing parental satisfaction.
PubMed: 38955550
DOI: 10.1016/j.pmn.2024.06.002 -
British Journal of Health Psychology Jul 2024Anxiety in pregnancy and postnatally is highly prevalent but under-recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are...
BACKGROUND
Anxiety in pregnancy and postnatally is highly prevalent but under-recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are pregnant or postnatal.
METHODS
A qualitative study of women's experiences of anxiety and mental health assessment during pregnancy and after birth and views on the acceptability of perinatal anxiety assessment. Semi-structured interviews were conducted with 41 pregnant or postnatal women. Results were analysed using Sekhon et al.'s acceptability framework, as well as inductive coding of new or emergent themes.
RESULTS
Women's perceptions of routine assessment for perinatal anxiety were generally favourable. Most participants thought assessment was needed and that the benefits outweighed potential negative impacts, such as unnecessary referrals to specialist services. Six themes were identified of: (1) Raising awareness; (2) Improving support; (3) Surveillance and stigma; (4) Gatekeeping; (5) Personalized care and (6) Trust. Assessment was seen as a tool for raising awareness about mental health during the perinatal period and a mechanism for normalizing discussions about mental health more generally. However, views on questionnaire assessments themselves were mixed, with some participants feeling they could become an administrative 'tick box' exercise that depersonalizes care and does not provide a space to discuss mental health problems.
CONCLUSION
Routine assessment of perinatal anxiety was generally viewed as positive and acceptable; however, this was qualified by the extent to which it was informed and personalized as a process. Approaches to assessment should ideally be flexible, tailored across the perinatal period and embedded in continuity of care.
PubMed: 38955505
DOI: 10.1111/bjhp.12740 -
The Journal of Pharmacology and... Jul 2024People with sickle cell disease (SCD) often experience chronic pain as well as unpredictable episodes of acute pain, which significantly affect their quality of life and...
People with sickle cell disease (SCD) often experience chronic pain as well as unpredictable episodes of acute pain, which significantly affect their quality of life and life expectancy. Current treatment strategies for SCD-associated pain primarily rely on opioid analgesics, which have limited efficacy and cause serious adverse effects. Cannabis has emerged as a potential alternative, yet its efficacy remains uncertain. In this study, we investigated the antinociceptive effects of Δ-tetrahydrocannabinol (THC), cannabis' intoxicating constituent, in male HbSS mice, which express >99% human sickle hemoglobin, and male HbAA mice, which express normal human hemoglobin A, as a control. Acute THC administration (0.1-3 mg-kg, intraperitoneal, i.p.) dose-dependently reduced mechanical and cold hypersensitivity in HbSS, but not HbAA mice. In the tail-flick assay, THC (1 and 3 mg-kg, i.p.) produced substantial antinociceptive effects in HbSS mice. By contrast, THC (1 mg-kg, i.p.) did not alter anxiety-like behavior (elevated plus maze) or long-term memory (24-h novel object recognition). Subchronic THC treatment (1 and 3 mg-kg, i.p.) provided sustained relief of mechanical hypersensitivity but led to tolerance in cold hypersensitivity in HbSS mice. Together, the findings identify THC as a possible therapeutic option for the management of chronic pain in SCD. Further research is warranted to elucidate its mechanism of action and possible interaction with other cannabis constituents. The study explores THC's efficacy in alleviating pain in sickle cell disease (SCD) using a humanized mouse model. Findings indicate that acute THC administration reduces mechanical and cold hypersensitivity in SCD mice without impacting emotional and cognitive dysfunction. Subchronic THC treatment offers sustained relief of mechanical hypersensitivity but leads to cold hypersensitivity tolerance. These results offer insights into THC's potential as an alternative pain management option in SCD, highlighting both its benefits and limitations.
PubMed: 38955494
DOI: 10.1124/jpet.124.002285 -
Women & Health Jul 2024Pregnancy and motherhood are some of the most physically and mentally challenging periods in a woman's life. The aim of current study was to examine aspects of cognitive...
Pregnancy and motherhood are some of the most physically and mentally challenging periods in a woman's life. The aim of current study was to examine aspects of cognitive functions in pregnancy and motherhood that are controversial in the literature. The study included 30 healthy pregnant women aged between 18-40 years in their second and third trimesters, 30 healthy controls (nulliparous and non-pregnant women) and 30 healthy mothers matched with the pregnant women for age, handedness and education level. Edinburgh Postpartum Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Trail Making, Stroop, Digit Span, Verbal Fluency and Rey Auditory and Verbal Learning Tests (RAVLT) were applied to all participants. The pregnant group showed significantly lower performance in trail making, digit span, verbal fluency as well as RAVLT compared to other two groups suggesting deficiencies in cognitive areas such as attention, set-shifting, planning, learning, language functions, semantic memory, working memory, encoding memory and retrieval. A trend toward increased function in response inhibition was observed in the mothers. Regression analyses revealed that pregnancy significantly decreased performance in verbal fluency, trail making, and RAVLT. Our findings from rigorously selected participants may help comprehend alterations in cognitive functioning during pregnancy and motherhood, as well as shed light on the contradictory literature.
PubMed: 38955489
DOI: 10.1080/03630242.2024.2371812 -
BMJ Supportive & Palliative Care Jul 2024To identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians.
OBJECTIVE
To identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians.
METHODS
Cross-sectional analytical study with non-probability sampling. We included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale.
RESULTS
42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. Less than half of the participants considered demonstrated high levels of resilience. We found an inverse and significant correlation between the factors that make up the Resilience Scale and the manifestation of psychological and physical symptoms of anxiety.
CONCLUSION
Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.
PubMed: 38955460
DOI: 10.1136/spcare-2023-004455 -
Saudi Medical Journal Jul 2024To determine the effect of elevated supine position with back support on back pain, anxiety and comfort in patients undergoing coronary angiography. (Randomized Controlled Trial)
Randomized Controlled Trial
The effect on back pain, anxiety, and comfort levels of an elevated supine position and back support applied to patients undergoing coronary angiography: A randomized controlled experimental study.
OBJECTIVES
To determine the effect of elevated supine position with back support on back pain, anxiety and comfort in patients undergoing coronary angiography.
METHODS
This randomized-controlled, experimental study was conducted in the Coronary Intensive Care Unit between September 2021 and January 2022, with an intervention group of 51 patients and a control group of 53 patients. Data were collected using a patient information form, a visual analog scale, the anxiety state inventory and the immobilization comfort questionnaire. Following angiography, the intervention group received pillow support to the back and the bedhead was elevated to 30 degrees. Routine nursing care was applied to the control group. In both groups, the severity of back pain was measured at 0, 2, and 4 hours, and anxiety and comfort at 0 and 4 hours.
RESULTS
The pain severity at 2 and 4 hours after the procedure was determined to be significantly lower in the intervention group than in the control group (<0.001, <0.001). At 4 hours, the anxiety levels were similar in both groups (<0.05), and the comfort level was higher in the intervention group (<0.001). The mean pain value was 6.003 points lower and the comfort level was 20.499 points higher in the intervention group than in the control group.
CONCLUSION
The elevated supine position with back support was seen to reduce back pain, increase comfort, and did not change anxiety levels..
Topics: Humans; Anxiety; Coronary Angiography; Male; Female; Middle Aged; Supine Position; Back Pain; Patient Comfort; Aged; Pain Measurement; Patient Positioning; Adult
PubMed: 38955437
DOI: 10.15537/smj.2024.45.7.20240201 -
CMAJ : Canadian Medical Association... Jul 2024Canada's health care systems underserve people who are transgender and gender diverse (TGD), leading to unique disparities not experienced by other patient groups, such...
BACKGROUND
Canada's health care systems underserve people who are transgender and gender diverse (TGD), leading to unique disparities not experienced by other patient groups, such as in accessing gender-affirmation surgery. We sought to explore the experiences of TGD people seeking and accessing gender-affirmation surgery at a publicly funded hospital in Canada to identify opportunities to improve the current system.
METHODS
We used hermeneutic phenomenology according to Max van Manen to conduct this qualitative study. Between January and August 2022, we conducted interviews with TGD people who had undergone penile-inversion vaginoplasty at Women's College Hospital, Toronto, Ontario, since June 2019. We conducted interviews via Microsoft Teams and transcribed them verbatim. We coded the transcripts using NVivo version 12. Using inductive analysis, we constructed themes, which we mapped onto van Manen's framework of lived body, lived time, lived space, and lived human relations.
RESULTS
We interviewed 15 participants who had undergone penile-inversion vaginoplasty; they predominantly self-identified as transgender women ( = 13) and White ( = 14). Participants lived in rural ( = 4), suburban ( = 5), or urban ( = 6) locations. Their median age was 32 (range 27-67) years. We identified 11 themes that demonstrated the interconnected nature of TGD peoples' lived experiences over many years leading up to accessing gender-affirmation surgery. These themes emphasized the role of the body in experiencing the world and shaping identity, the lived experience of the body in shaping human connectedness, and participants' intersecting identities and emotional pain (lived body); participants' experiences of the passage of time and progression of events (lived time); environments inducing existential anxiety or fostering affirmation, the role of technology in shaping participants' understanding of the body, and the effect of liminal spaces (lived space); and finally, the role of communication and language, empathy and compassion, and participants' experiences of loss of trust and connection (lived human relations).
INTERPRETATION
Our findings reveal TGD patients' lived experiences as they navigated a lengthy and often difficult journey to penile-inversion vaginoplasty. They suggest a need for improved access to gender-affirmation surgery by reducing wait times, increasing capacity, and improving care experiences.
Topics: Humans; Female; Adult; Transgender Persons; Male; Vagina; Penis; Middle Aged; Qualitative Research; Canada; Sex Reassignment Surgery; Ontario
PubMed: 38955411
DOI: 10.1503/cmaj.231250