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Journal of Family Medicine and Primary... Apr 2024To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19).
OBJECTIVES
To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19).
STUDY DESIGN
A cross-sectional study in selected municipal hospitals.
METHODS
Connor-Davidson Resilience Scale was used to assess the resilience of the 245 HCWs, including the nurses and paramedics working in Pune Municipal Corporation (PMC) hospitals in Pune City. Data were analysed using the Chi-square test, one-way analysis of variance (ANOVA), independent-samples -test and correlational analysis using the Statistical Package for the Social Sciences (SPSS) version 28.
RESULTS
The mean resilience score of the HCWs in PMC hospitals post-COVID-19 was 75.09 (±9.25). The score for hardiness, optimism, resourcefulness and purpose was 20.15 (±3.87), 21.22 (±3.39), 17.24 (±2.76) and 16.40 (±2.17), respectively. Seven factors were significantly associated with the resilience of nurses and paramedics, namely age ( < 0.001), work experience ( < 0.001), monthly income ( < 0.001), having faced financial problems during COVID-19 ( < 0.001), hospital setting ( < 0.05), marital status ( < 0.01) and professional category ( < 0.001). In addition, 60% of the participants reported mental health issues due to routine workloads such as irritation/anger, frustration and tension/worry, fatigue and work-related stress, and sadness and anxiety. Suggestions for improvement were mainly increasing human resources, proper management, skilled staff, improved facilities and funding, and cooperation among staff.
CONCLUSION
The resilience of primary HCWs in Pune post-COVID-19 was higher than HCWs in other countries assessed during COVID-19. Further, resilience was found more among nurses than paramedics. Modifiable factors affecting resilience must be addressed to improve the resilience of HCWs to build everyday resilience and strengthen health systems for public health emergencies.
PubMed: 38827730
DOI: 10.4103/jfmpc.jfmpc_947_23 -
Cureus May 2024Perioperative neurocognitive disorders (PNDs) affect a large percentage of people who undergo surgeries that need general anesthesia. There is an increased risk of... (Review)
Review
Perioperative neurocognitive disorders (PNDs) affect a large percentage of people who undergo surgeries that need general anesthesia. There is an increased risk of death and a major disruption to postoperative self-care as a result of this. This study compiles all the relevant materials that the authors have found to investigate postnatal depression and its causes, as well as the methods used to determine the probability and severity of PNDs and how to reduce their risk before surgery. Postnatal depression can have many causes, and this text explores some of them. These include a history of alcohol or opiate use, immunological dysregulation, advanced age, educational background, infections, neurocognitive impairment, and pre-existing chronic inflammatory disorders. It also delves into various methods used to gauge the likelihood and severity of postpartum depression. The following assessment tools were covered: the Clock Drawing Test, Domain-Specific Tests, the Mini-Mental State Examination, and the Montreal Cognitive Assessment. In addition to biochemical markers, neuroimaging techniques play an important role in diagnosis. The Frailty Fried assessment, which measures inertia, sluggishness, lack of physical activity, fatigue, and unintentional weight loss, is a key prognostic sign that is highlighted. There is strong evidence that the index, which is derived from these five characteristics, may accurately predict the likelihood of PNDs. Risk mitigation strategies are also covered in this research. Preoperative brain plasticity-based therapies, such as physical exercise and intensive cognitive training, can significantly reduce the incidence and severity of postoperative neurocognitive disorders. A peripheral nerve block, monitoring cerebral oxygen saturation, dexmedetomidine, and a reduction in anesthesia depth are all ways to improve anesthetic procedures. Methods that lower blood pressure should be avoided, the body temperature should be kept down during surgery, or the time without liquids should be lengthened; all of these raise the risk of postoperative nausea and vomiting and make it worse. Potential approaches include a Mediterranean diet, physical activity, cognitive stimulation, smoking cessation, alcohol reduction, avoidance of anticholinergic medications, and non-steroidal anti-inflammatory drug stewardship, although there is no definitive evidence for successful postoperative neurocognitive rehabilitation procedures. More standardized diagnostic criteria, evaluation methods, and PND classification are urgently needed, according to this study. Different cases of PNDs are characterized by different combinations of tests, cutoff values, and methods because there is a broad variety of diagnostic tests used to make the diagnosis. Until now, PNDs and pre-existing neurocognitive disorders have been diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). With an aging population comes an increase in the occurrence and prevalence of PNDs, which calls for a specific way to classify and describe the condition.
PubMed: 38826940
DOI: 10.7759/cureus.59436 -
Cancer Medicine Jun 2024Symptoms of cancer-related fatigue (CRF) can have a significant impact on patients' quality of life and treatment adherence. We aimed to investigate the relationship...
INTRODUCTION
Symptoms of cancer-related fatigue (CRF) can have a significant impact on patients' quality of life and treatment adherence. We aimed to investigate the relationship between CRF and multiple psychosocial and somatic indicators within a large mixed cancer sample.
METHODS
In this cross-sectional study, N = 1787 outpatients with cancer were assessed for CRF, pain, anxiety, and depression using validated screening instruments. We further obtained clinical parameters (Hb, CRP, creatinine, leukocytes, ASAT, and ALAT), sociodemographic data (age, gender, income, education level, marital status, parenthood, and living area), and lifestyle factors. Multivariate linear regression models were applied to estimate the impact of each indicator on CRF.
RESULTS
Overall, 90.6% of patients experienced some CRF, with 14.8% experiencing severe CRF. No gender difference was found in the prevalence of CRF. Patients with higher levels of pain, depressive symptoms, and lower Hb levels had significantly higher levels of CRF (p <0.001). Lower levels of CRF were observed in patients who had children (p = 0.03), had less education (p < 0.001), and were physically active for more than 2 h per week before their oncological diagnosis (p = 0.014). The latter was only a significant indicator in the male subsample.
CONCLUSION
The present results demonstrate a high prevalence of CRF and highlight that not only somatic and psychosocial factors, but also lifestyle factors prior to diagnosis appear to be associated with the etiology and persistence of CRF. To effectively treat CRF, a biopsychosocial, personalized approach is recommended.
Topics: Humans; Male; Female; Neoplasms; Fatigue; Middle Aged; Cross-Sectional Studies; Prevalence; Aged; Depression; Quality of Life; Adult; Anxiety
PubMed: 38819432
DOI: 10.1002/cam4.7293 -
European Journal of Translational... May 2024Gastroesophageal reflux disease (GERD) is a gastrointestinal tract disorder associated with regurgitation of gastric acid into the oesophagus. It can present itself as...
Gastroesophageal reflux disease (GERD) is a gastrointestinal tract disorder associated with regurgitation of gastric acid into the oesophagus. It can present itself as non-erosive reflux condition or erosive esophagitis. Our main objective was to evaluate the impact of oesophageal reflux disease on muscle fatigue among patients. The prospective study design was adopted using surveys performed at the South West China Medical University. All patients who were subjected to screening endoscopy at the South West China Medical University were prospectively enrolled in the study. Our study was conducted according to ethical guidelines involving animal and human subjects. Our study used Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), and the Multidimensional Fatigue Inventory (MFI) questionnaires to perform data collection on the levels of fatigue, depression, daytime hypersomnolence and anxiety. In the (HADS, Anxiety (β = 0.657, p < .001) and Depression (β = 2.927, p < .001) exhibited significant positive associations with the predicted fatigue. The Epworth Sleepiness Scale (ESS) showed no significant difference between individuals with and without reflux esophagitis (p = 0.787, power = 0.071). However, a significant difference was observed based on the presence of GERD symptoms (p = 0.003, power = 0.789), with higher mean scores for those with GERD symptoms (6.1±3.5) compared to those without (4.9±2.9). In MFI, significant differences were observed between the two groups for General and Physical Fatigue (p = 0.040, power = 0.823), Mental Fatigue (p = 0.002, power = 0.767), and MFI Total Score (p = 0.002, power = 0.981). In conclusion, GERD symptoms exhibited stronger associations with fatigue and daytime sleepiness than endoscopic findings, emphasizing the impact of symptomatic experiences on well-being.
PubMed: 38818777
DOI: 10.4081/ejtm.2024.12243 -
Translational Psychiatry May 2024Psychiatric syndromes are common following recovery from Coronavirus Disease 2019 (COVID-19) infection. This study investigated the prevalence and the network structure...
Psychiatric syndromes are common following recovery from Coronavirus Disease 2019 (COVID-19) infection. This study investigated the prevalence and the network structure of depression, insomnia, and suicidality among mental health professionals (MHPs) who recovered from COVID-19. Depression and insomnia were assessed with the Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index questionnaire (ISI7) respectively. Suicidality items comprising suicidal ideation, suicidal plan and suicidal attempt were evaluated with binary response (no/yes) items. Network analyses with Ising model were conducted to identify the central symptoms of the network and their links to suicidality. A total of 9858 COVID-19 survivors were enrolled in a survey of MHPs. The prevalence of depression and insomnia were 47.10% (95% confidence interval (CI) = 46.09-48.06%) and 36.2% (95%CI = 35.35-37.21%), respectively, while the overall prevalence of suicidality was 7.8% (95%CI = 7.31-8.37%). The key central nodes included "Distress caused by the sleep difficulties" (ISI7) (EI = 1.34), "Interference with daytime functioning" (ISI5) (EI = 1.08), and "Sleep dissatisfaction" (ISI4) (EI = 0.74). "Fatigue" (PHQ4) (Bridge EI = 1.98), "Distress caused by sleep difficulties" (ISI7) (Bridge EI = 1.71), and "Motor Disturbances" (PHQ8) (Bridge EI = 1.67) were important bridge symptoms. The flow network indicated that the edge between the nodes of "Suicidality" (SU) and "Guilt" (PHQ6) showed the strongest connection (Edge Weight= 1.17, followed by "Suicidality" (SU) - "Sad mood" (PHQ2) (Edge Weight = 0.68)). The network analysis results suggest that insomnia symptoms play a critical role in the activation of the insomnia-depression-suicidality network model of COVID-19 survivors, while suicidality is more susceptible to the influence of depressive symptoms. These findings may have implications for developing prevention and intervention strategies for mental health conditions following recovery from COVID-19.
Topics: Humans; COVID-19; Sleep Initiation and Maintenance Disorders; Female; Male; China; Adult; Prevalence; Suicidal Ideation; Depression; Middle Aged; Health Personnel; Surveys and Questionnaires; SARS-CoV-2; Suicide, Attempted
PubMed: 38816419
DOI: 10.1038/s41398-024-02918-8 -
BMC Nursing May 2024Palliative care schemes, which include pain management, symptom control, psychosocial support and rehabilitation, aim to boost patients' quality of life, ease the burden...
Impact of a comprehensive rehabilitation palliative care program on the quality of life of patients with terminal cancer and their informal caregivers: a quasi-experimental study.
BACKGROUND
Palliative care schemes, which include pain management, symptom control, psychosocial support and rehabilitation, aim to boost patients' quality of life, ease the burden and anxiety of informal caregivers, and ultimately provide a comprehensive approach to enhance well-being during this challenging and sensitive period. This study aims to evaluate the impact of a comprehensive rehabilitation palliative care program on the quality of life of patients with terminal cancer and their informal caregivers.
METHODS
This quasi-experimental study, conducted from August 2023 to January 2024 at outpatient clinics affiliated with the Oncology Center at Mansoura University, Egypt, focused on cancer patients and their caregivers in the palliative care department. Employing pre- and post-test phases, data were gathered using a questionnaire, EORTC QLQ C30, Hospital Anxiety and Depression Scale, Short Form Health Survey, Caregiver Burden Inventory, and Beck Anxiety Inventory. The investigation evaluated a 16-week rehabilitation program comprising exercise, psychoeducation, individual counselling, and spiritual support. Exercises, led by a physiotherapist, targeted fatigue and stress through tailored aerobic and resistance training. Psychoeducation sessions aimed to bolster coping abilities, covering fatigue management and nutrition. Trained counsellors addressed spiritual and existential concerns. Personal advisory sessions were available for individual support. Caregivers received education on rehabilitation and palliative care protocols, ensuring comprehensive patient care.
RESULTS
The mean age for cancer patients was 65.79 ± 13.85. In contrast, the mean age for primary carers was 42.05 ± 11.15. The QOL for cancer patients during the pre-test phase was 77.8 ± 7.16 and rose to 87.34 ± 14.56 during the post-test phase. Additionally, the total anxiety level of patients before the rehabilitation palliative care program was conducted was 15.45 ± 3.05 compared to 6.12 ± 3.21 after the post test phase. Furthermore, the total depression levels of the patients during the pre-test phase were 20.89 ± 9.21. However, after implementing the rehabilitation palliative care program, it decreased to 15.5 ± 6.86. In regards to the total quality of life of informal caregivers, it was measured at 67.28 ± 32.09 before conducting the program. Nevertheless, it increased to 25.95 ± 40.29 after conducting it. Additionally, the total Caregiver Burden Inventory before implementing the program was 37.45 ± 25.7, and it decreased to 29.36 ± 16.4 after conducting it. Additionally, the total score on the Beck Anxiety Inventory decreased from 45.7 ± 4.3 during the initial testing phase to 17.35 ± 23.67.
CONCLUSION
The program for rehabilitation palliative care successfully achieved its goals by enhancing the overall quality of life for cancer patients and their caregivers. Additionally, it reduced the anxiety and depression levels among the patients, as well as the anxiety and caregiver burden among the caregivers. Continue research into the effectiveness of rehabilitation palliative care programs to identify best practices, improve existing programs, and expand access to these services.
PubMed: 38812027
DOI: 10.1186/s12912-024-02028-2 -
Kidney360 May 2024Fatigue is a devastating symptom experienced by adults with chronic kidney disease (CKD), but less is known about the prevalence of fatigue and factors associated with...
BACKGROUND
Fatigue is a devastating symptom experienced by adults with chronic kidney disease (CKD), but less is known about the prevalence of fatigue and factors associated with fatigue in a general population of adults with CKD. Therefore, we examined the prevalence of fatigue and identified factors associated with fatigue amongst a national cohort of US adults with CKD.
METHODS
We utilized cross-sectional data from 1,079 adults from the National Health and Nutrition Examination Survey (NHANES) 2007-2012 and included participants aged 18 and over with CKD Stage 3 and 4 (eGFR between 15 and 60 ml/min/1.73m2) who had available data evaluating fatigue. Unadjusted and adjusted logistic regression models were used to evaluate the odds of having fatigue in the context of physiological, sociodemographic, psychological, and behavioral factors.
RESULTS
We estimated that 48% of those with CKD had fatigue. Among the risk factors examined, the factors with the strongest evidence of association in multivariable analyses were female sex (OR 1.49, 95% CI: 1.02, 2.17), pain (OR 2.49, 95% CI: 1.57, 3.93), poor mental health (OR 1.97, 95% CI: 1.05, 3.72), anxiety (OR 1.95, 95% CI: 1.14, 3.34), and depressive symptoms (OR 2.58, 95% CI: 1.17, 5.66).
CONCLUSIONS
Fatigue is a common symptom experienced by adults with CKD in the US. Physiological, sociodemographic, psychological, and behavioral factors are associated with fatigue, with psychological factors being most strongly associated. Future work is needed to identify interventions to mitigate fatigue and risk factors for fatigue in adults with CKD.
PubMed: 38809609
DOI: 10.34067/KID.0000000000000481 -
Journal of Medical Internet Research May 2024The overall pandemic created enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. Despite this, most of the...
BACKGROUND
The overall pandemic created enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. Despite this, most of the available evidence on professional well-being during COVID-19 has exclusively focused on frontline health care workers.
OBJECTIVE
This study aimed to identify the long-term psychological needs of LTCWs derived from the COVID-19 pandemic and to explore barriers and facilitators related to digital mental health tools. This is part of a project that seeks to develop a digital mental health intervention to reduce psychological distress in this population group.
METHODS
We performed a qualitative study with a rapid research approach. Participants were LTCWs of the autonomous community of Catalonia. We conducted 30 semistructured interviews between April and September 2022. We used a qualitative content analysis method with an inductive-deductive approach.
RESULTS
The period of the pandemic with the highest mental health burden was the COVID-19 outbreak, with almost all workers having experienced some form of emotional distress. Emotional distress persisted over time in more than half of the participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, the feeling that pandemic times are not over, and poor working conditions that have remained since then have been the most frequently expressed determinants of such emotions. Potential barriers and facilitators to engagement with digital tools were also identified in terms of previous experience and beliefs of the target population, possibilities for the integration of a digital tool into daily life, preferences regarding the level of guidance, the possibility of social connectedness through the tool, and privacy and confidentiality. The identified factors may become especially relevant in the context of the pandemic remission phase.
CONCLUSIONS
More than 2 years after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees' well-being. Considering factors that act as barriers and facilitators for the use of digital mental health tools, it is important to develop tailored tools that could offer valuable support to this population during and after a pandemic.
Topics: Humans; COVID-19; Qualitative Research; Female; Male; Adult; Pandemics; Middle Aged; Long-Term Care; Health Personnel; Mental Health; Spain; SARS-CoV-2; Psychological Distress; Telemedicine
PubMed: 38809605
DOI: 10.2196/47546 -
BMJ Open May 2024It is well evidenced that healthcare professionals working in paediatric critical care experience high levels of burn-out, compassion fatigue and moral distress. This...
OBJECTIVES
It is well evidenced that healthcare professionals working in paediatric critical care experience high levels of burn-out, compassion fatigue and moral distress. This worsened during the COVID-19 pandemic. This work examines the nature of challenges to workplace well-being and explores what well-being means to staff. This evidence will inform the development of staff interventions to improve and maintain staff well-being.
DESIGN
Qualitative study.
SETTING
Paediatric critical care units in the UK.
PARTICIPANTS
30 nurses and allied health professionals took part in online interviews and were asked about well-being and challenges to well-being. Lived experiences of well-being were analysed using interpretative phenomenological analysis.
RESULTS
Themes generated were as follows: perception of self and identity; relationships and team morale; importance of control and balance and consequences of COVID-19. They focused on the impact of poor well-being on participants' sense of self; the significance of how or whether they feel able to relate well with their team and senior colleagues; the challenges associated with switching off, feeling unable to separate work from home life and the idealised goal of being able to do just that; and lessons learnt from working through the pandemic, in particular associated with redeployment to adult intensive care.
CONCLUSIONS
Our findings align closely with the self-determination theory which stipulates autonomy, belonging and competence are required for well-being. Participants' accounts supported existing literature demonstrating the importance of empowering individuals to become self-aware, to be skilled in self-reflection and to be proactive in managing one's own well-being. Change at the individual and staff group level may be possible with relatively low-intensity intervention, but significant change requires systemic shifts towards the genuine prioritisation of staff well-being as a prerequisite for high-quality patient care.
Topics: Humans; COVID-19; Qualitative Research; Female; Allied Health Personnel; Critical Care; Male; Adult; Burnout, Professional; United Kingdom; SARS-CoV-2; Intensive Care Units, Pediatric; Compassion Fatigue; Attitude of Health Personnel; Pandemics
PubMed: 38806418
DOI: 10.1136/bmjopen-2024-084926 -
Journal of Psychopharmacology (Oxford,... Jun 2024Processing speed is a task-independent construct underpinning more complex goal-related abilities. Processing speed is impaired in alcohol dependence (AD) and is linked...
BACKGROUND
Processing speed is a task-independent construct underpinning more complex goal-related abilities. Processing speed is impaired in alcohol dependence (AD) and is linked to relapse, as are the functions it underpins. Reliable measurement of processing speed may allow tracking of AD recovery trajectories and identify patients requiring additional support.
AIMS
To assess changes in reaction time (RT) from baseline (at the start of a detoxification programme) across early abstinence.
METHODS
Vibrotactile RT was assessed in early recovery between days 3 and 7 of treatment in 66 individuals with AD (25 females; aged 19-74, 44.60 ± 10.60 years) and against 35 controls tested on one occasion (19 females; 41.00 ± 13.60), using two multivariate multiple regressions. A mixed multivariate analysis of covariance (MANCOVA) of available AD data ( = 45) assessed change in RT between timepoints and between treatment settings (outpatient vs inpatient).
RESULTS
The group (AD vs control) significantly predicted choice RT at baseline and follow-up but did not significantly predict simple RT or RT variability, which is inconsistent with previous findings. At follow-up, mental fatigue was also predicted by the group, and MANCOVA indicated that this had worsened in inpatients but improved in outpatients.
CONCLUSIONS
Recovery of RT measures so early in the treatment journey was not in line with previous research which indicates persisting deficits. The interaction between setting and timepoint indicates that despite being typically less medically complex, outpatients require ongoing support and monitoring during their recovery.
Topics: Humans; Female; Male; Alcoholism; Adult; Reaction Time; Middle Aged; Alcohol Abstinence; Young Adult; Aged; Processing Speed
PubMed: 38804547
DOI: 10.1177/02698811241254830