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Brain, Behavior, & Immunity - Health Jul 2024Intensive care unit (ICU) survivors can experience wide-ranging and long-lasting symptoms after hospital discharge. Cognitive impairment has received increased attention...
PURPOSE
Intensive care unit (ICU) survivors can experience wide-ranging and long-lasting symptoms after hospital discharge. Cognitive impairment has received increased attention in relation to the COVID-19 pandemic and can affect patients' long-term quality of life. This study aimed to investigate the prevalence of cognitive impairment using an objective neurocognitive test 6 and 12 months following ICU admission and possible predictive factors for scoring below the defined cut-off. We also explored the prevalence of subjective cognitive complaints at 12 months, including the associated factors.
METHODS
This was a prospective observational study of a national cohort of COVID-19 ICU survivors during the three first pandemic waves in Norway. Data was collected by the Norwegian Intensive Care and Pandemic Registry and the study group.
RESULTS
At the six-month follow-up, 23.1% (95% CI [18.2─28.5]) of the 273 respondents scored below the cut-off on the Mini-MoCA, indicating mild cognitive impairment. At the 12-month follow-up, the prevalence declined to 11.1% (95% CI [7.5─15.6]) in 253 respondents. Older age (OR 1.06, 95% CI [1.02─1.12]) and depression (OR 1.25, 95% CI [1.07─1.55]) were associated with cognitive impairment at six months. At 12 months, almost half of the patients reported subjective cognitive complaints. Symptoms of mental health problems and fatigue were associated with subjective cognitive complaints in our exploratory analyses.
CONCLUSION
Cognitive impairment declined significantly from 6 to 12 months in this cohort of COVID-19 ICU patients, while subjective cognitive complaints remained high at 12 months, perhaps attributed to a high total symptom burden.
PubMed: 38770194
DOI: 10.1016/j.bbih.2024.100786 -
Journal of Multidisciplinary Healthcare 2024Post-stroke Fatigue (PSF) after Intracerebral Hemorrhage (ICH) is a long-term symptom in stroke survivors. However, the pathogenesis of PSF remains inadequately...
BACKGROUND
Post-stroke Fatigue (PSF) after Intracerebral Hemorrhage (ICH) is a long-term symptom in stroke survivors. However, the pathogenesis of PSF remains inadequately understood and sufficient evidence-based treatments are lacking. Mobile health (mHealth) technology offers a promising approach to expanding access to high-quality and culturally tailored evidence-based mental care.
AIM
This study examined the role of mHealth called iHealth in the management of PSF after ICH.
METHODS
A total of 225 patients diagnosed with intracerebral hemorrhage (ICH) were included in the study and randomly assigned to either the Mobile Health Intervention Group (mHI Group) or the non-Mobile Health Intervention Group (non-mHI). The management involved the utilization of a digital healthcare application named iHealth, which incorporated digital questionnaires, fatigue scale tests, and online videos for the purpose of administering the Patient Fatigue Reporting Measurement Information System (PFRMIS) short form as part of the initial patient assessment following ICH. The study was conducted remotely via video conferencing over a 12-week period in mHI Group, with fatigue assessments being conducted 3 months post-ICH onset in two groups.
RESULTS
Following the administration of PSF by iHealth, Univariate Logistic analyses indicated a significant association between fatigue and the type of activity, with patients who were sedentary or did nothing experiencing higher levels of fatigue (β=2.332, p<0.001; β=2.517, p<0.001). Multivariate Logistic analyses demonstrated a positive association between the intensity of physical activity and decreased emotional well-being and family support, as well as increased fatigue. (p=0.001, p=0.002, p=0.001). The FSS results demonstrated a significantly reduced incidence of PSF in the MHI group in comparison to non-mHI group following the conclusion of the programme. (13.1% vs 40%, p<0.001).
CONCLUSION
This study explored the effectiveness of the iHealth app for PSF following ICH, indicating that iHealth is a clinically valuable tool that warrants further dissemination.
PubMed: 38770170
DOI: 10.2147/JMDH.S465902 -
Frontiers in Psychology 2024Good mental preparation of an athlete plays an important role in achieving optimal sports results. An athlete who enters a competition should not feel fatigue resulting...
Good mental preparation of an athlete plays an important role in achieving optimal sports results. An athlete who enters a competition should not feel fatigue resulting from intense physical exercise. Therefore, new and effective methods are being sought that could help accelerate the process of both physical and mental regeneration. Vibrotherapy is one of them. The aim of the study was to determine the optimal frequency of vibration, its duration and the position in which the subjects were placed during the treatments, in relation to the reduction of subjectively perceived exertion muscle pain, mental discomfort, emotional states and the level of cognitive processes that were disturbed by intense physical activity. Sixteen healthy male volunteers were involved in this study. The participants were assessed for their aerobic and anaerobic capacity. Each of the subjects performed a set of intensive physical exercises and then underwent vibrotherapy treatment. In random order, each of the men tested the effectiveness of eight combinations of frequency, duration, and body position. Psychological tests were conducted for each combination: frequency, duration of treatment, and position during treatment, in four stages: (1) before the start of the experiment (baseline POMS measurements), (2) immediately after the exercise (VAS scale, scale examining psychological discomfort and STROOP test), (3) immediately after the vibration treatment (POMS measurements, VAS scale, scale examining psychological discomfort and STROOP test), (4) 24 h after the vibration treatment (VAS scale examining subjective assessment of perceived pain and psychological discomfort). Based on the results, it was concluded that all the studied variables improved significantly over time (after the vibration treatment and 24 h after training). In addition, a statistically significant interaction measurement × frequency was noted for vigor scale (52HZ favored greater improvement in this state), and a statistically significant interaction was found for measurement × time for the VAS scale ( < 0.05) - the lower pain value was indicated 24 h after the 10-min vibration treatment. The type of frequency used, position, and duration of the treatment did not play a statistically significant role in changing STROOP test results and severity of psychological discomfort ( > 0.05).
PubMed: 38765830
DOI: 10.3389/fpsyg.2024.1380282 -
International Journal of Qualitative... Dec 2024The purpose of this concept delineation was to differentiate similar concepts impacting nurse well-being during the COVID-19 pandemic, including: compassion fatigue,... (Review)
Review
PURPOSE
The purpose of this concept delineation was to differentiate similar concepts impacting nurse well-being during the COVID-19 pandemic, including: compassion fatigue, burnout, moral injury, secondary traumatic stress, and second victim.
METHODS
A total of 63 articles were reviewed for concept delineation. Morse's (1995) approach to concept delineation was utilized to analyse the articles.
RESULTS
Concepts were described interchangeably but were found to present themselves in a sequence. A nurse may experience moral injury, leading to a second victim experience, synonymous with secondary traumatic stress, then compassion fatigue and/or burnout that can be acute or chronic in nature. An Occupational Trauma Conceptual Model was created to depict how these concepts interact based on concept delineation findings.
CONCLUSION
Nurses are experiencing long-lasting occupational trauma and future intervention research should centre on optimizing nurse well-being to ensure the sustainability of nursing profession.
Topics: Humans; COVID-19; Burnout, Professional; Compassion Fatigue; Nurses; SARS-CoV-2; Occupational Injuries
PubMed: 38758981
DOI: 10.1080/17482631.2024.2355711 -
British Journal of Pain Jun 2024Fibromyalgia (FM) is a chronic pain disorder characterised by widespread pain, fatigue and cognitive symptoms. Acceptance and commitment therapy (ACT) aims to improve...
BACKGROUND
Fibromyalgia (FM) is a chronic pain disorder characterised by widespread pain, fatigue and cognitive symptoms. Acceptance and commitment therapy (ACT) aims to improve psychological flexibility and has been found to be beneficial in treating chronic pain; however, there are few studies evaluating its efficacy in treating FM.
AIM
This systematic review and meta-analysis evaluated the efficacy of acceptance and commitment therapy in patients with fibromyalgia.
METHODS
PubMed, Embase and PsychInfo databases were searched. Randomised Controlled Trials (RCTs) were eligible for inclusion if participants had FM, and the intervention was based on the ACT framework/model, and not combined with any other active therapy; any non-ACT control was accepted. A meta-analysis was performed, with the primary outcomes pain acceptance (chronic pain acceptance questionnaire, CPAQ), health-related quality of life (fibromyalgia impact questionnaire, FIQ), attrition rate and frequency of adverse events, and the secondary outcomes pain intensity, disability, depression, anxiety, and fatigue.
RESULTS
Six RCTs, with a total of 384, mostly-female, participants were included, with ACT being delivered online, in a group setting, or one-to-one. ACT was superior to controls in improving FIQ score at post-intervention (SMD -1.05, 95% CI -2.02, -0.09) and follow-up (SMD -1.43, 95% CI -2.17, -0.69) and CPAQ post-intervention (SMD 1.05, 95% CI 0.61, 1.49) and at follow-up (SMD 0.95, 95% CI 0.40, 1.49). Attrition was below 20% in 4/6 studies and no adverse events were reported as attributable to ACT. All secondary outcomes showed large-to-moderate pooled effect estimates post-intervention, indicating improvement in anxiety, depression, pain and disability. Fatigue also improved, with a large negative effect.
CONCLUSIONS
The results suggest ACT improved outcomes in patients with FM: there was an overall improvement in all outcomes post-intervention, with most maintained at follow-up. This review was, however, limited by the small body of evidence and differing methodologies of included studies.
PubMed: 38751564
DOI: 10.1177/20494637231221451 -
The Canadian Journal of Nursing... May 2024The intersection of the COVID-19 pandemic with systemic anti-Black racism in the form of police violence and the subsequent Black Lives Matter movement has created an...
BACKGROUND
The intersection of the COVID-19 pandemic with systemic anti-Black racism in the form of police violence and the subsequent Black Lives Matter movement has created an especially critical juncture to examine the mental health of Black youth.
PURPOSE
The purpose of this study was to understand the intersecting impacts of anti-Black racism and the COVID-19 pandemic on the mental health of Black youth.
METHODS
A youth-engaged research approach and intersectionality framework were utilized. Semi-structured interviews with Black youth across Canada (ages 16 to 30, n = 48) were conducted online via Zoom and analyzed using thematic analysis. Fourteen Black youth were hired to form a Black youth advisory committee, who guided the research process.
RESULTS
The "dual pandemics" of the COVID-19 pandemic alongside highly publicized incidents of racism and the subsequent Black Lives Matter movement negatively impacted participants' mental health. Four main themes emerged: (1) ongoing exposure to acts of anti-Black racism (2) compounding effect of racism on mental health; (3) high stress levels and fear; and (4) anger and emotional fatigue from lack of shared, long-term solutions.
CONCLUSION
The simultaneous occurrence of the COVID-19 pandemic and instances of systemic anti-Black racism in the form of police violence presented "dual pandemics" for the Black community, profoundly impacting the mental health of Black youth and adding urgency and impetus to its prioritization. Results of this study indicate that it is critical to explore each event individually as well as the combined impact on the mental health of Black youth, particularly from a racial perspective.
PubMed: 38751058
DOI: 10.1177/08445621241253116 -
Cureus May 2024We present a case of a 76-year-old Caucasian female with a recurrent solitary fibrous tumor (SFT) of the pleura, showcasing a rare manifestation of hypoglycemia...
We present a case of a 76-year-old Caucasian female with a recurrent solitary fibrous tumor (SFT) of the pleura, showcasing a rare manifestation of hypoglycemia associated with Doege-Potter syndrome (DPS). Having undergone two previous surgeries for SFT, the patient presented to the emergency department with severe fatigue, recurrent episodes of loss of consciousness, and hypoglycemia, despite lacking a history of diabetes mellitus. Radiological evaluation revealed a substantial recurrent SFT in the left lung, prompting excision through a left posterolateral thoracotomy. Remarkably, the patient's altered mental status and hypoglycemia resolved postoperatively. The case meets the criteria for aggressive SFT behavior, warranting consideration for adjuvant radiation therapy to control the risk of recurrence. This report highlights the nuanced interplay between SFT recurrence, paraneoplastic syndromes like DPS, and the potential benefits of adjuvant therapeutic strategies in managing these complex clinical scenarios.
PubMed: 38746482
DOI: 10.7759/cureus.60256 -
BMC Pulmonary Medicine May 2024COVID-19 survivors may develop long-term symptoms of fatigue, dyspnea, mental health issues, and functional limitations: a condition termed post-acute sequelae of...
BACKGROUND
COVID-19 survivors may develop long-term symptoms of fatigue, dyspnea, mental health issues, and functional limitations: a condition termed post-acute sequelae of COVID-19 (PASC). Pulmonary rehabilitation (PR) is a recommended treatment for PASC; however, there is a lack of data regarding PR's effect on multiple health indices and the factors that influence patient outcomes. The aim of our study is to evaluate the impact of pulmonary rehabilitation on functional and psychological parameters in patients diagnosed with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), thereby offering insights into the efficacy of such interventions in improving the quality of life and clinical outcomes for these individuals.
METHODS
We extracted patient demographic, comorbidity, and outcome data from Allegheny Health Network's electronic medical records. Functionality test results were compared before and after PR, including 6-minute walk test (6MWT), chair rise repetitions (CR reps), timed up and go test (TUG), gait speed (Rehab gait), modified medical research council scale (MMRC), shortness of breath questionnaire (SOBQ), hospital anxiety and depression scale (HADS) and chronic obstructive pulmonary disease assessment test (CAT) scores. Multiple regression analysis was done to evaluate the effect of comorbidities and patient factors on patient responses to PR.
RESULTS
The 55 patients included in this study had a mean time of 4 months between the initial COVID-19 diagnosis and the subsequent PASC diagnosis. Following pulmonary rehabilitation (PR), significant improvements were observed across various metrics. The distance covered in the 6-minute walk test (6MWT) increased markedly from a pre-rehabilitation average of 895 feet (SD 290) to 1,300 feet (SD 335) post-rehabilitation, with a mean change of 405 feet (95% CI [333, 477]). Chair rise repetitions (CR reps) saw an increase from 9 (SD 3) reps to 13 (SD 3) reps, with a change of 4 reps (95% CI [3.7, 4.9]). The timed up and go test (TUG) time decreased significantly from 13 s (SD 5) to 10 s (SD 2), reflecting a mean reduction of 3 s (95% CI [-4.5, -2.5]). Rehabilitation gait speed improved from 1.0 m/s to 1.3 m/s, changing by 0.3 m/s (95% CI [0.2, 0.3]). The Modified Medical Research Council (MMRC) dyspnea scale showed a notable decrease from a mean of 2 (SD 1) to 1 (SD 1), a change of -1 (95% CI [-1.5, -1]). The Shortness of Breath Questionnaire (SOBQ) scores reduced significantly from 51 (SD 21) to 22 (SD 18), with a change of -29 (95% CI [-34, -23]). The Hospital Anxiety and Depression Scale (HADS) scores decreased from 11 (SD 7) to 8 (SD 7), a reduction of -4 (95% CI [-5, -2]). Lastly, the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) scores significantly dropped from 18 (SD 7) to 9 (SD 7), changing by -10 (95% CI [-11, -8]). However, the presence of hypertension, diabetes, chronic lung diseases, outpatient status, and receipt of specific pharmacologic treatments (decadron, decadron + remdesivir, and decadron + remdesivir + tocilizumab) were identified as factors associated with a poor response to PR.
CONCLUSION
Our study supports PR as an integrated model of care for PASC patients to improve several physical and mental health indices. The long-term effects of PR on patients' functional status should be investigated in the future.
Topics: Humans; COVID-19; Male; Female; Middle Aged; Post-Acute COVID-19 Syndrome; Quality of Life; Aged; SARS-CoV-2; Walk Test; Dyspnea; Retrospective Studies
PubMed: 38745298
DOI: 10.1186/s12890-024-03047-0 -
BMC Psychiatry May 2024A concentrated transdiagnostic and micro choice-based group treatment for patients with depression and anxiety has previously shown to yield significant reduction in...
Concentrated transdiagnostic and cross-disciplinary micro-choice based group treatment for patients with depression and with anxiety leads to lasting improvements after 12 months: a pilot study.
BACKGROUND
A concentrated transdiagnostic and micro choice-based group treatment for patients with depression and anxiety has previously shown to yield significant reduction in symptoms and increased level of functioning from pre to 3-month follow-up. In the present study, we report the results after 12 months follow-up.
METHODS
This was a non-randomized clinical intervention pilot study, conducted in line with a published protocol. Sixty-seven consecutively referred patients, aged 19-47 (mean age 32.5, SD = 8.0) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age at onset of symptoms was 17.6 (SD = 7.9) years. Mean number of prior treatment courses was 3.5 (SD = 3.3; range 0-20). The main objective was to assess the treatment effectiveness by questionnaires measuring relevant symptoms at pre-treatment, 7 days-, 3 months-, 6 months- and at 12-months follow-up.
RESULTS
Validated measures of functional impairment (WSAS), depression (PHQ9), anxiety (GAD7), worry (PSWQ), fatigue (CFQ), insomnia (BIS) and illness perception (BIPQ) improved significantly (p < .0005) from before treatment to 12 months follow-up, yielding mostly large to extremely large effect sizes (0.89-3.68), whereas some moderate (0.60-0.76). After 12 months, 74% report an overall improvement in problems related to anxiety and depression. Utilization of specialist, public and private mental health care was reported as nonexistent or had decreased for 70% of the patients at 12-month follow up.
CONCLUSIONS
The concentrated, micro-choice based group treatment approach yielded a highly clinically significant reduction in a wide range of symptoms already one week after treatment, and the positive results persisted at 12-month follow-up.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05234281, first posted date 10/02/2022.
Topics: Humans; Pilot Projects; Adult; Male; Female; Middle Aged; Psychotherapy, Group; Young Adult; Treatment Outcome; Follow-Up Studies; Anxiety Disorders; Anxiety; Depression; Depressive Disorder
PubMed: 38745158
DOI: 10.1186/s12888-024-05786-0 -
EXCLI Journal 2024Participation in marathons has dramatically increased over the last few years. Marathon running has many proven beneficial effects, especially on cardiovascular health... (Review)
Review
Participation in marathons has dramatically increased over the last few years. Marathon running has many proven beneficial effects, especially on cardiovascular health and fitness. Most research has focused on physiologic and pathophysiologic adaptations in connection with endurance exercise. Nevertheless, marathon running also has a major impact on psychological aspects and positively influences mental health, which has only recently attracted research interest. The present narrative review aimed to review the personality traits of marathon runners with an emphasis on recent literature. Marathon runners show a distinct personality and highly characteristic personality traits needed to successfully finish such a demanding race, i.e., a strong sense of vigor, self-sufficiency, and intelligence as well as low scores in anger, fatigue, tension, and depression. Furthermore, personality differences are detectable between runners of different sexes, ages, and performance level groups. This has significant clinical implications for athletes, coaches and competition organizers, as these groups show different patterns of personality traits. Future studies should focus on changes in cognition and mood states pre-, during, and post-endurance events, as well as during training periods. Large-scale studies comparing personality differences by sex, age, and performance are also important for better clinical guidance. See also the graphical abstract(Fig. 1).
PubMed: 38741728
DOI: 10.17179/excli2024-6907