Tag: nevin manimala

Eur J Phys Rehabil Med. 2023 Oct 18. doi: 10.23736/S1973-9087.23.07970-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Stroke causes disability that makes its survivors depend on caregivers for help. The caregivers offer help during lifting and transferring patients from one place to another. However, such activities result in the caregivers sustaining musculoskeletal injuries such as the low back pain (LBP). The aim of this study was to carry out a systematic review and meta-analysis to determine the prevalence of LBP and its risk factors among these caregivers.

EVIDENCE ACQUISITION: PubMED, Embase, Web of Science (WoS) and CINAHL were searched until January 2023, and cross-sectional studies were included. Data on prevalence of LBP due to caregiving activities and participants’ characteristics such as sex and nature of caregiving were extracted.

EVIDENCE SYNTHESIS: Risks of bias of the included studies were assessed using Agency for healthcare Research and Quality (AHRQ) tool. The data were analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, random effect model meta-analysis of the prevalence and odd of developing LBP between men and women; and between partial and complete caregivers was used. Fives studies (N.=644) were included. The results showed that the prevalence of LBP was 53.9%, with 96% CI from 50.0% to 57.8%. In addition, there was no statistically significant difference in the risk of developing LBP between men and women (OR=1.58, 95% CI=0.27 to 9.27, P=0.61); and between partial and complete caregivers (OR=1.33, 95% CI=0.32 to 5.61, P=0.70).

CONCLUSIONS: About half of caregivers of stroke survivors may experience LBP. Therefore, this should be considered during rehabilitation.

PMID:37851375 | DOI:10.23736/S1973-9087.23.07970-4

Diabetes Care. 2023 Oct 18:dc230931. doi: 10.2337/dc23-0931. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the associations between concurrent atrial fibrillation and diabetes-related complications among patients with diabetes.

RESEARCH DESIGN AND METHODS: This nationwide observational cohort study used the health checkup database from the Korean National Health Insurance Service. Patients diagnosed with diabetes who underwent health checkups between 2009 and 2012 were investigated. The patients with atrial fibrillation were matched in a 1:5 ratio with those without atrial fibrillation using propensity scores. Study outcomes included macrovascular, microvascular (diabetic retinopathy and diabetic nephropathy), and diabetic foot complications. The risks of clinical outcomes were measured using hazard ratios (HRs) with 95% CIs.

RESULTS: A total of 65,760 patients with diabetes were analyzed (54,800 without atrial fibrillation and 10,960 with atrial fibrillation). After well-balanced propensity score matching, atrial fibrillation was associated with significantly higher risks of macrovascular complications (HR 1.12, 95% CI 1.09-1.16), diabetic nephropathy (HR 1.23, 95% CI 1.16-1.30), and diabetic foot complications (HR 1.13, 95% CI 1.09-1.17) compared with no atrial fibrillation, while the risk of diabetic retinopathy was comparable (HR 0.99, 95% CI 0.96-1.03). Patients with atrial fibrillation had a significantly higher risk of diabetic foot amputation (HR 4.12, 95% CI 1.98-8.56).

CONCLUSIONS: Among patients with diabetes, concurrent atrial fibrillation was associated with increased risks for diabetes-related macrovascular complications, diabetic nephropathy, and diabetic foot. Such patients require holistic management to reduce the risk of adverse outcomes.

PMID:37851370 | DOI:10.2337/dc23-0931

Pain. 2023 Oct 18. doi: 10.1097/j.pain.0000000000003078. Online ahead of print.

ABSTRACT

To assess postoperative pain intensity in adults, the numeric rating scale (NRS) is used. This scale has shown acceptable psychometric features, although its scale properties need further examination. We aimed to evaluate scale properties of the NRS using an item response theory (IRT) approach. Data from an international postoperative pain registry (QUIPS) was analyzed retrospectively. Overall, 346,892 adult patients (age groups: 18-20 years: 1.6%, 21-30 years: 6.7%, 31-40 years: 8.3%, 41-50 years: 13.2%, 51-60 years: 17.1%, 61-70 years: 17.3%, 71-80 years: 16.4%, 81-90 years: 3.9%, >90: 0.2%) were included. Among the patients, 55.7% are female and 38% had preoperative pain. Three pain items (movement pain, worst pain, least pain) were analyzed using 4 different IRT models: partial credit model (PCM), generalized partial credit model (GPCM), rating scale model (RSM), and graded response model (GRM). Fit indices were compared to decide the best fitting model (lower fit indices indicate a better model fit). Subgroup analyses were done for sex and age groups. After collapsing the highest and the second highest response category, the GRM outperformed other models (lowest Bayesian information criterion) in all subgroups. Overlapping categories were found in category boundary curves for worst and minimum pain and particularly for higher pain ratings. Response category widths differed depending on pain intensity. For female, male, and age groups, similar results were obtained. Response categories on the NRS are ordered but have different widths. The interval scale properties of the NRS should be questioned. In dealing with missing linearity in pain intensity ratings using the NRS, IRT methods may be helpful.

PMID:37851363 | DOI:10.1097/j.pain.0000000000003078

Appl Neuropsychol Child. 2023 Oct 18:1-20. doi: 10.1080/21622965.2023.2268776. Online ahead of print.

ABSTRACT

Continued advancements in the treatment of pediatric brain tumors have resulted in a growing proportion of children surviving previously incurable diagnoses. However, survivors of pediatric brain tumors show reduced Health-Related Quality of Life (HRQoL) compared to healthy populations and non-CNS childhood cancer survivors. This review systematically evaluates the existing literature on the influence of supratentorial and infratentorial brain tumor locations on Health-Related Quality of Life outcomes in survivors of pediatric brain tumors. Five electronic databases were searched for relevant articles published between their inception and January 2022. A purpose-developed evaluative tool was constructed to assess the quality of eligible studies. 16 of the 5270 identified articles were included in this review (n = 1391). This review found little evidence relating to the impact of brain tumor location on HRQoL, with only one study finding a significant difference between supratentorial and infratentorial tumor survivors. Key limitations of the current evidence include poor statistical reporting, ambiguous construct definitions, and insufficient adjustment for confounds. Findings from this review show that recovery from a pediatric brain tumor extends beyond recovery post-treatment and that further study into the factors influencing survivor HRQoL, including the influence of tumor location, is necessary.

PMID:37851360 | DOI:10.1080/21622965.2023.2268776

JBI Evid Synth. 2023 Oct 19. doi: 10.11124/JBIES-22-00409. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive behaviors toward staff perpetrated by patients, families, and/or visitors.

INTRODUCTION: Health care staff working within acute- and tertiary-level hospitals are at high risk of exposure to aggressive behaviors by patients, their family, and/or visitors. Negative staff and organizational impacts reported in the literature include individual psychological or emotional distress and severe harm, increased absenteeism, high staff turnover, and awarded compensation. Reports of this kind of occupational violence are increasing globally, therefore, strategies to address prevention and/or management are needed to mitigate the risk of harm to staff and the wider hospital service. Various educational activities have been implemented to address the issue, but the overall effect of these is unclear.

INCLUSION CRITERIA: Experimental and quasi-experimental studies were considered for inclusion if they reported on an educational program or intervention for staff working within an acute hospital setting and aimed at managing or preventing occupational violence perpetrated by patients, family, or visitors. Reports of implemented programs to address occupational violence, whether verbal or physical, were included. Studies were excluded if they reported on lateral upward violence or bullying, patients in psychiatric or dementia facilities, and pediatric patients, due to the specific care needs of these cohorts.

METHODS: The following databases were searched: PubMed, CINAHL, PsycINFO, Embase, ERIC, Cochrane Controlled Trials, and Scopus. Unpublished studies were sought from ProQuest Dissertations and Theses. To obtain a wider perspective of the issue, studies published in Chinese were also searched for in WanFang Database, China National Knowledge Infrastructure, and Chongqing VIP. A date filter of 2008-2023 was applied in a deliberate effort to expand from previous work. No language filters were applied. The review was conducted in accordance with JBI methodology for systematic reviews of effectiveness and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analaysis (PRISMA) guidelines.

RESULTS: The search process retrieved 4681 citations with a total of 32 studies representing 3246 health staff. The studies were either before and after or pre-test-post-test study designs. Methodological quality of studies was varied, with the main issues being absence of CIs within statistical analysis, limited detail on participant selection or attrition/non-response, and under-reporting of confounding factors. Educational programs varied in content and duration. Content delivery across the studies also varied, with a variety of didactic, role play, debriefing, group work, and simulation exercises reported. While studies reported some improvement in self-reported confidence levels, results were mixed for other outcomes. Determining overall effect of included studies is challenging due to heterogeneity within and across studies in intervention types, populations, measurement tools, and outcomes.

CONCLUSIONS: This review is unable to determine which workplace educational programs were most effective on staff outcomes or on the number of occupational violence incidents. In future, educators and researchers could use the findings of this review to guide the design of educational programs and employ measures that are comparable to their settings.

REVIEW REGISTRATION: PROSPERO CRD42020190538.

SUPPLEMENTAL DIGITAL CONTENT: A Chinese-language version of the abstract of this review is available [http://links.lww.com/SRX/A33].

PMID:37851359 | DOI:10.11124/JBIES-22-00409

Holist Nurs Pract. 2023 Nov-Dec 01;37(6):E83-E91. doi: 10.1097/HNP.0000000000000609.

ABSTRACT

Job burnout is highly prevalent among health care workers. This study determined the effect of job burnout on decision-making and coping with stress among nurses. Two hundred seventy-seven nurses in Xijing Hospital were investigated using the Job Burnout Scale, Decision Scale, and Simple Stress Coping Style Scale. The total score of job burnout was 107.8 ± 16.479 (severe burnout) and clinical decision-making consciousness was 123.75 ± 16.094 (moderate decision-making consciousness). No statistical differences existed in different gender samples (P > .05). Burnout and clinical decision-making awareness of clinical nurses were stronger than nursing interns and regular trainee nurses, but the occupational pressure of nursing interns was the highest (P < .05). Marital status also showed significant differences in job burnout; unmarried nurses were more prone to burnout (P < .05). In conclusions, burnout is a serious issue among nurses, which is closely related with clinical decision-making awareness, negative coping, and occupational stress. Nurse identity and marital status had significant effects on burnout.

PMID:37851354 | DOI:10.1097/HNP.0000000000000609

Holist Nurs Pract. 2023 Nov-Dec 01;37(6):330-336. doi: 10.1097/HNP.0000000000000612.

ABSTRACT

This study evaluated the effectiveness of traditional Chinese medicine-based therapeutic acupuncture (TA) in reducing the severity of hot flashes (HFs) in breast cancer patients and compared the effectiveness of TA to “sham” placebo acupuncture (SA). Subjects experiencing more than 10 episodes of HF/week were randomly assigned to TA or SA. The response was assessed by the Menopause-specific Quality of Life (MenQoL) scale, scoring the subject’s perception of the severity of HFs. HFs were scored at baseline, after treatment, and 1-month follow-up. A total of 54 subjects enrolled (28 TA and 26 SA). Seven women withdrew from the study. A hot flash diary documented the number of HFs a subject experienced. Analysis included 47 subjects (27 TA and 20 SA). A statistically significant response in HF scores was noted in the TA group compared with the SA group (P = .0064.) On average HF scores dropped by 1.89 with TA, and only 0.16 with SA. At follow-up, TA subjects had a sustained response. TA is effective in reducing the intensity and severity of HF. With SA, no relative response/change in HF scores was noted. Larger studies and longer follow-up to assess durability of response to TA are needed.

PMID:37851349 | DOI:10.1097/HNP.0000000000000612

Holist Nurs Pract. 2023 Nov-Dec 01;37(6):318-329. doi: 10.1097/HNP.0000000000000613.

ABSTRACT

The present study was conducted to examine the effects of Pranayama applied to hemodialysis patients on fatigue. The study was completed with 91 patients, including Pranayama (n = 30), Relaxation (n = 30), and Control groups (n = 31). The patients in the Pranayama group applied the interventions 15 to 20 minutes every day, once a day, for a total of 3 months, and the patients in the relaxation practice group applied the interventions 15 to 20 minutes every day, once a day, for a total of 3 months. Before the study commenced, permission was obtained from health care institutions, the ethics committee, and the patients. The data were collected with a Questionnaire, Piper Fatigue Scale (PFS), visual analog scale, and Vital Findings Form. Piper Fatigue Scale consists of 4 subdimensions, the total score obtained from the scale varies between 0 and 10, and as the score increases, the level of fatigue also increases. It was found that the patients in the Pranayama Group had decreased PFS total and subdimension mean scores after the procedure (P < .05); however, no significant changes were detected in the PFS total and subdimension mean scores of the patients in the Relaxation and Control groups (P > .05). Although the decrease in the daily fatigue severity of the patients in the Pranayama group was at a statistically significant level (P < .05), no statistically significant changes were detected in the fatigue severity of the patients in the Relaxation and Control groups (P > .05). It was also found that the blood pressure values of the patients in the Pranayama and Relaxation groups decreased (P < .05). It was found in the present study that Pranayama reduced the fatigue levels of hemodialysis patients. In this respect, it is recommended to teach and apply Pranayama techniques to patients with the support of nurses.

PMID:37851348 | DOI:10.1097/HNP.0000000000000613

Pain. 2023 Oct 17. doi: 10.1097/j.pain.0000000000003052. Online ahead of print.

ABSTRACT

Habituation to pain is a fundamental learning process and important adaption. Yet, a comprehensive review of the current state of the field is lacking. Through a systematic search, 63 studies were included. Results address habituation to pain in healthy individuals based on self-report, electroencephalography, or functional magnetic resonance imaging. Our findings indicate a large variety in methods, experimental settings, and contexts, making habituation a ubiquitous phenomenon. Habituation to pain based on self-report studies shows a large influence of expectations, as well as the presence of individual differences. Furthermore, widespread neural effects, with sometimes opposing effects in self-report measures, are noted. Electroencephalography studies showed habituation of the N2-P2 amplitude, whereas functional magnetic resonance imaging studies showed decreasing activity during painful repeated stimulation in several identified brain areas (cingulate cortex and somatosensory cortices). Important considerations for the use of terminology, methodology, statistics, and individual differences are discussed. This review will aid our understanding of habituation to pain in healthy individuals and may lead the way to improving methods and designs for personalized treatment approaches in chronic pain patients.

PMID:37851343 | DOI:10.1097/j.pain.0000000000003052

Eur J Gastroenterol Hepatol. 2023 Oct 18. doi: 10.1097/MEG.0000000000002674. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate rectal sensitivity and associated factors in patients with different subtypes of functional defecation disorder (FDD).

METHODS: We segregated individuals diagnosed with FDD into two groups based on their defecation patterns: those with dyssynergic defecation and those with inadequate defecatory propulsion. We gathered general information through questionnaires and assessed rectal sensitivity using anorectal manometry. The rectal sensitivity performances of the two groups were compared; the factors related to rectal sensitivity were analyzed to determine the factors associated with rectal sensitivity, and the effect of biofeedback therapy on rectal sensitivity was clarified.

RESULTS: Rectal sensitivity in different subtypes of FDD decreased, and the difference between the two groups was not statistically significant (P > 0.05). There were no statistically significant differences in the first constant sensation volume, defecatory desire volume, and maximum tolerable volume between the different subtypes of FDD (P > 0.05). Multi-factor binary logistic regression analysis showed that age, constipation symptom score, and diabetes were all independent risk factors for decreased rectal sensitivity (P < 0.05). There were no statistically significant differences between the prior- and post-biofeedback therapy in the first constant sensation volume, defecatory desire volume, and maximum tolerable volume (P > 0.05).

CONCLUSION: Rectal sensitivity in different subtypes of FDD decreased. Age, constipation symptom score, and diabetes were independent risk factors for decreased rectal sensitivity. Short-term biofeedback therapy did not improve rectal hyposensitivity in patients with FDD.

PMID:37851333 | DOI:10.1097/MEG.0000000000002674