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Clinical Orthopaedics and Related... Mar 2024People who take active responsibility for their health demonstrate agency. Agency in the context of chronic illness management with disease-modifying treatments is...
BACKGROUND
People who take active responsibility for their health demonstrate agency. Agency in the context of chronic illness management with disease-modifying treatments is commonly linked to adherence and confidence in care seeking. In musculoskeletal health, agency is commonly observed in the accommodation of conditions related to aging and reflected in studies of people not seeking care. The development of agency measures originates from the realm of medical management of chronic illness rather than that of musculoskeletal disease, which is often optional or discretionary. With growing interest in the universal adoption of agency as a performance measure for quality payment programs, there is a need to better understand how agency is measured across musculoskeletal conditions, and how agency may be a modifiable correlate of capability, comfort, mindset, and circumstances.
QUESTIONS/PURPOSES
We systematically reviewed the evidence regarding agency among people seeking musculoskeletal specialty care and asked: (1) Are greater levels of agency associated with greater levels of comfort and capability? (2) Are greater levels of agency associated with better mental and social health?
METHODS
Following the PRISMA guidelines, we performed searches on May 22, 2023, with searches spanning September 1988 (in PubMed and Web of Science) and September 1946 (in Ovid Medline) to May 2023. We included original clinical studies addressing the relationship between agency and levels of comfort, capability, mindset, and circumstances (by utilizing patient-reported agency measures [PRAMs], patient-reported outcome measures [PROMs], and mental and social health measures) involving adult patients 18 years or older receiving specialist care for musculoskeletal conditions. We identified 11 studies involving 3537 patients that addressed the primary research question and three studies involving 822 patients that addressed the secondary question. We conducted an evidence quality assessment using the Methodological Index for Non-Randomized Studies (MINORS) and found the overall evidence quality to be relatively high, with loss to follow-up and lack of reporting of sample size calculation the most consistent study shortcomings. The measures of capability varied by anatomical region. The Patient Activation Measure (a validated 10- or 13-item survey originally designed to assess a patient's level of understanding and confidence in managing their health and ability to engage in healthcare related to chronic medical illness) was used as a measure of agency in 10 studies (one of which also used the Effective Consumer Scale) and attitudes regarding one's management of musculoskeletal disorders in one study. We registered this systematic review on PROSPERO (Reg CRD42023426893).
RESULTS
In general, the relationships between PRAMs and PROMs are weak to moderate in strength using the Cohen criteria, with 10 of 11 studies demonstrating an association between levels of agency and levels of comfort and capability. The three studies addressing mental health found a weak correlation (where reported) between levels of agency and levels of symptoms of depression and anxiety.
CONCLUSION
The finding that agency in patients seeking care for musculoskeletal conditions is associated with greater comfort, capability, and mental health supports the prioritization of agency modification during musculoskeletal specialty care. This might include behavioral health and cognitive debiasing strategies along with strategies and services promoting self-management. Our work also points to an opportunity to develop agency measures better suited for discretionary care that more directly assess the cultivation of healthy mindsets, behaviors, and accommodative attitudes toward the discomfort and incapability experienced during aging.
LEVEL OF EVIDENCE
Level II, prognostic study.
PubMed: 38446424
DOI: 10.1097/CORR.0000000000003027 -
Multiple Sclerosis and Related Disorders Apr 2024Fear of falling (FOF) is a common concern among persons with multiple sclerosis (MS) and affects the performance of their daily living activities. Falls may result in... (Review)
Review
BACKGROUND
Fear of falling (FOF) is a common concern among persons with multiple sclerosis (MS) and affects the performance of their daily living activities. Falls may result in FOF, leading to worsening of symptoms of MS, physical deconditioning, and exposure to future falls. This may trigger a vicious cycle between FOF and falls. A better understanding of the relationship between FOF and symptoms of MS may be helpful to develop a conceptual model to guide fall prevention interventions.
OBJECTIVE
To synthesize the correlational and predictive relationships between FOF and common symptoms of MS.
METHODS
Databases including PubMed, Embase, Web of Science, Scopus, CINHAL, PsycINFO, and SPORTDiscuss were searched from inception to October 2023. Studies examining correlations and/or predictions between FOF and common MS symptoms that include measures of gait, postural control, fatigue, cognition, pain, sleep, depression, and anxiety were identified by two independent reviewers. Both reviewers also conducted the methodological quality assessment of the included studies.
RESULTS
Twenty-three studies with a total of 2819 participants were included in the review. Correlational findings indicated that increased FOF was significantly associated with greater walking deficits (lower gait speed, smaller steps), reduced mobility, and poorer balance. Increased FOF was also significantly correlated with higher cognitive impairments, more fatigue, sleep disturbances, and depression. Decreased gait parameters, reduced balance, lower physical functions, cognitive impairments, and sleep deficits were found as significant predictors of increased FOF.
CONCLUSION
Evidence indicates significant correlational and bidirectional predictive relationships exist between FOF and common MS symptoms. A comprehensive conceptual framework accounting for the interaction between FOF and MS symptoms is needed to develop effective falls prevention strategies.
Topics: Humans; Multiple Sclerosis; Depression; Fear; Cognition; Fatigue; Postural Balance
PubMed: 38422635
DOI: 10.1016/j.msard.2024.105506 -
Current Opinion in Psychiatry May 2024Economic development and urbanisation have prompted many Chinese parents to move from rural to urban regions for better job opportunities. Their children, who remain... (Meta-Analysis)
Meta-Analysis
PURPOSE OF REVIEW
Economic development and urbanisation have prompted many Chinese parents to move from rural to urban regions for better job opportunities. Their children, who remain behind in rural regions, become left-behind children (LBC). With absent parents, children and adolescents are unable to maintain the secure attachment required for healthy social and emotional development, increasing the risk of mental illness. This study aimed to compare risk of self-harm and suicidal ideation in LBC and non-LBC in China.
RECENT FINDINGS
Greater risks for poor mental health outcomes including worse depression, loneliness and anxiety have been identified in LBC in cross-sectional studies. Previous studies have also identified higher prevalence of bullying victimization, poorer school performance and worse school attendance amongst LBC.
SUMMARY
Findings indicate that prolonged separation from parents put LBC at greater risks of poor mental health. Policy changes to allow children to migrate with their parents and policies to reduce inequalities in job opportunities between urban and rural regions are needed.
Topics: Child; Humans; Adolescent; Urbanization; Suicidal Ideation; Cross-Sectional Studies; Mental Health; China
PubMed: 38415715
DOI: 10.1097/YCO.0000000000000927 -
Scientific Reports Feb 2024Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of... (Meta-Analysis)
Meta-Analysis
Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of medically defined sleep disorders (SDs) remains unclear. This meta-analysis determines SD prevalence and identifies associated factors among medical students in the MENA. PubMed, Web of Science, Google Scholar, and reference lists of included studies were searched (latest search: June 2022). Meta-analyses included 22 studies and were performed using random-effect models. Included studies used self-reported screening tools for assessing SDs and then estimated the proportion of participants at high risk of developing a SD. Central disorders of hypersomnolence were the most prevalent SD [prevalence range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia disorders [prevalence range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm sleep-wake disorders [prevalence range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], sleep-related breathing disorders [prevalence range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalence range: 5.9% (Egypt) to 30.6% (Saudi Arabia)], and parasomnias [prevalence range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. Female sex, studying in the latter academic years, having anxiety, excessive internet use, and poor academic performance were significantly associated with SDs. SDs are prevalent among MENA medical students. Implementing student-centered interventions targeting high risk groups in medical schools should be considered to improve students' health and wellbeing.
Topics: Humans; Female; Students, Medical; Middle East; Africa, Northern; Jordan; Sleep Wake Disorders
PubMed: 38409132
DOI: 10.1038/s41598-024-53818-2 -
The Science of the Total Environment Apr 2024Listening to natural sounds, both live and recorded, in either a natural or built environment is considered natural sound exposure (NSE). Sound is closely related to... (Meta-Analysis)
Meta-Analysis
Listening to natural sounds, both live and recorded, in either a natural or built environment is considered natural sound exposure (NSE). Sound is closely related to daily life, and research on the restorative effects of natural sounds is expanding. However, there is a lack of quantitative and comprehensive analysis on the impact of NSE on health recovery. This study systematically reviewed and conducted a meta-analysis on the impact of NSE on health recovery. Fifteen studies (1285 participants) were selected for the meta-analysis out of the 1157 literatures about the recovery of the NSE, searched from the Web of Science and Science Direct. The results indicate that NSE has certain positive effects: (a) In terms of emotional changes, NSE significantly reduces anxiety as measured by both the Visual Analog Scale (VAS) -2.31 (95 % CI -2.83, -1.79) and the State Anxiety Inventory (SAI) -12.22 (95 % CI -22.46, -1.98). (b) In terms of physiological reaction, NSE resulted in reduced heart rate (HR) -5.46 (95 % CI -9.62, -1.31), systolic blood pressure (SBP) -11.74 (95 % CI -15.51, -7.97), diastolic blood pressure (DBP) -13.98 (95 % CI -24.96, -2.99) and respiratory rate (RR) -1.58 (95 % CI -3.06, -0.10). (c) While the potential for restoration of cognitive performance by NSE was found, no consistent conclusions have been reached yet. However, there was significant heterogeneity between studies, primarily attributed to variations in study populations and methodologies. Because of the limited literature, we did not conduct subgroup analysis and meta-regression analysis. It is recommended that future studies address this heterogeneity by including more and higher-quality literature and employing rigorous methodologies to establish a robust foundation for evidence-based medicine. This will be of great significance for the application natural sounds in landscape planning and medical rehabilitation environments, and has the potential to promote improvements in public health.
Topics: Humans; Anxiety; Emotions; Public Health; Sound
PubMed: 38373459
DOI: 10.1016/j.scitotenv.2024.171052 -
Frontiers in Neurology 2024A comprehensive analysis was conducted on the relevant literature pertaining to the application of traditional Chinese exercises in stroke rehabilitation over the past...
BACKGROUND
A comprehensive analysis was conducted on the relevant literature pertaining to the application of traditional Chinese exercises in stroke rehabilitation over the past 20 years. Additionally, a scientific knowledge map was created to elucidate the current research status, investigate its development process and research trends, and offer novel research perspectives for future studies.
METHODS
The data is sourced from the WOS Core Collection, and CiteSpace software is used to analyze the relevant literature on traditional Chinese exercises in stroke rehabilitation. The analysis began with the selection of publications, countries, institutions, highly cited authors, and co-cited references to summarize the current research status of traditional exercises in stroke rehabilitation. Second, keywords were employed to identify research hotspots, and keyword clustering time zone diagrams were chosen to track the research development process. Finally, burst keywords were employed to explore the research frontiers and trends in this field.
RESULTS
In total, 937 documents were retrieved, and the annual publication volume consistently and sustainably increased. China and the USA emerged as significant contributors. The Chinese University of Hong Kong had the highest publication count, with ADA L from the University of Sydney being a highly cited author. Initially, keywords focused on cardiac output, blood flow, pressure, and performance. Over time, the focus shifted to heart failure, muscle strength, mortality, and exercise capacity. Current trends encompass outcome, impact, virtual reality, and anxiety.
CONCLUSION
Integrating key elements of traditional exercise approaches with the specific attributes of movement disorders during the stroke recovery phase is essential. Therefore, enhancing the stroke rehabilitation training program and exploring novel avenues for traditional exercise-based interventions are critical.
PubMed: 38361637
DOI: 10.3389/fneur.2024.1260643 -
Sports Medicine - Open Feb 2024Elite-level coaches are exposed to multiple performance, organisational and personal stressors which may contribute to reduced mental health and wellbeing. This...
BACKGROUND
Elite-level coaches are exposed to multiple performance, organisational and personal stressors which may contribute to reduced mental health and wellbeing. This systematic scoping review examined the current body of evidence to explore what is known about the mental health of elite-level coaches (i.e. wellbeing and mental ill-health), the risk and protective factors that influence coach mental health, and the relationship between mental health and coaching effectiveness.
METHODS
The review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was undertaken and updated in September 2022 using six electronic databases.
RESULTS
12,376 studies were identified and screened, with 42 studies satisfying the inclusion criteria. Despite the paucity of high-quality research, findings indicated that 40% of the included studies examined themes connected to wellbeing, with 76% assessing the nature or prevalence of mental ill-health in elite-level coaches. Among studies exploring mental ill-health, coach burnout was the primary focus, while scant research examined symptoms associated with clinical disorders (e.g. anxiety and depression). Overall, psychological outcomes for elite-level coaches were shaped by risk and protective factors operating at the individual, interpersonal, organisational and societal level. Preliminary evidence was also found to suggest that poor mental health may contribute to reduced coaching effectiveness. It is proposed that coaching effectiveness could therefore be employed as a 'hook' to engage elite-level coaches in greater consideration of their mental health needs.
CONCLUSION
Alongside the development of methodologically robust research, there is a need to examine dynamic individual (e.g. psychological skills), interpersonal (e.g. strong social supports) and organisational (e.g. workload) factors that aim to preserve the mental health and optimise the efficacy of elite-level coaches.
PubMed: 38341831
DOI: 10.1186/s40798-023-00655-8 -
CNS Neuroscience & Therapeutics Feb 2024This systematic review and meta-regression aimed to examine available literature reporting measures of physical function, anxiety, and/or depression and whether any... (Review)
Review
AIMS
This systematic review and meta-regression aimed to examine available literature reporting measures of physical function, anxiety, and/or depression and whether any relationships exist between these measures in individuals with Parkinson's disease.
METHODS
MEDLINE, CINAHL, AMED, and APA PsychInfo databases were systematically searched. Screening, quality assessment, and data extraction were completed alongside meta-regression analysis.
RESULTS
Of 1175 studies retrieved, 40 were selected for analysis with only one study assessing the relationship between physical and psychological outcomes within their cohort. A total of 27 studies were also eligible for meta-regression analysis-a total sample of 1211 participants. Meta-regressions of five combinations of paired physical and psychological outcomes showed a significant moderating effect of symptoms of depression (Beck Depression Inventory) on mobility (Timed-Up-and-Go test; coefficient = 0.37, 95% CI 0.09 to 0.65, p = 0.012) and balance (Berg Balance Score) scores (coefficient = -1.25, 95% CI -1.77 to -0.73, p < 0.001).
CONCLUSION
Although physical and psychological outcomes of interest were used in all included studies, only one examined their relationship. Our analysis suggests that symptoms of depression may influence measures of mobility and balance. Specifically, as the severity of symptoms of depression increases, performance on measures of mobility and balance worsens.
Topics: Humans; Parkinson Disease; Postural Balance; Time and Motion Studies; Anxiety; Quality of Life
PubMed: 38334239
DOI: 10.1111/cns.14562 -
Frontiers in Psychology 2023Investigation of the psychological impact on soccer athletes during the pandemic is essential given their unique challenges, including training disruptions and...
INTRODUCTION
Investigation of the psychological impact on soccer athletes during the pandemic is essential given their unique challenges, including training disruptions and competition postponements. Understanding these effects will allow the development of specific strategies to preserve the mental health and performance of elite athletes, contributing to effective interventions with both short and long-term benefits.
OBJECTIVE
To analyze the impact of the COVID-19 pandemic on the psychological aspects and mental health of elite soccer athletes.
METHOD
The review adhered to PRISMA criteria, and the study protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022341545). Searches were conducted until July 2023 in databases including Cochrane, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science. Only original, peer-reviewed studies in English, Portuguese, or Spanish assessing the impact of the COVID-19 pandemic on the psychological aspects and mental health of elite soccer athletes were included.
RESULTS
The search identified 1,055 records and 43 studies were included in this review between 2020 and 2023. In total, the sample included 16,321 soccer athletes of different age groups. Anxiety, depression, mood states, and mental well-being were the most investigated variables. Increased levels of anxiety, depression, and worsening mental well-being were observed in elite soccer athletes. Maintaining fitness during the pandemic showed positive results. Other variables, such as coping, resilience, and sleep quality monitoring, were less widely investigated. Evaluating methodological quality was considered regular for observational and experimental studies.
CONCLUSION
The study reveals a negative impact of the COVID-19 pandemic on elite soccer athletes, considering psychological aspects and their mental health, notably heightened anxiety and depression. Observational methods predominated, showing mood swings linked to individual characteristics and fitness maintenance efforts. Studies with better-designed methodological approaches and controlled experimental interventions are recommended in the future to mitigate the negative effects of the pandemic on soccer players.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?, identifier (CRD42022341545).
PubMed: 38333426
DOI: 10.3389/fpsyg.2023.1295652 -
Heliyon Feb 2024Myocardial infarction (MI) is one of the main causes of disability and death worldwide. Peer-support can ameliorate the psychological and physical morbidities associated...
OBJECTIVE
Myocardial infarction (MI) is one of the main causes of disability and death worldwide. Peer-support can ameliorate the psychological and physical morbidities associated with heart diseases. The aim of this study was to determine whether peer-support interventions could improve the psychological and behavioral health outcomes commonly experienced by MI patients.
METHODS
In this systematic review, international databases (PubMed, Web of Science, and Scopus) were searched to gather related publications up to March 2023. Eligible papers were those addressing the outcomes of peer-support interventions in individuals with a history of MI.
RESULT
Twelve clinical trials published in English with a Jadad score of 3 or 4 (out of 5) were included in the final review. These studies used four approaches to deliver peer-support interventions: face-to-face, telephone-based, educational videos, and group discussion. The results showed that peer-support could have a positive effect on depression, anxiety, quality of life, sexual performance, self-care, and medication adherence.
CONCLUSION
Considering the serious impacts of MI on life, these patients need empowerment training. Peer-support can be used as a complementary supportive method to reduce MI patients' psychological complications and improve their behavioral outcomes.
PubMed: 38327461
DOI: 10.1016/j.heliyon.2024.e25314