Detraining period of the PILATES method on functional capacity of elderly women with type 2 diabetes: A randomized clinical trial

IntroductionThe aim of this study was to verify the effects of a 4-week detraining period on the functional capacity of elderly women with type-2 diabetes (T2D) after 12 weeks of a PILATES training program.MethodsTwenty-two individuals with T2D were randomly allocated into two groups: CONTROL (n = 11; 67.5 ± 6.3 years; 154.7 ± 6.1 cm; 73.5 ± 6.1 kg; calorie intake: 1487.5 ± 360.6 kcal/day) and PILATES (n = 11; 65.5 ± 5.5 years; 155.0 ± 4.5 cm; 66.2 ± 5.4 kg; calorie intake: 1289.3 ± 385.0 kcal/day). The PILATES group participated at a 12-week PILATES program at moderate intensity, 3x/week with each session lasting 60-min. The functional capacity was evaluated in the baseline (PRE), after 12-weeks (POST) and 4-week detraining period (4W_DT). The general index of functional capacity (GI_FC) was calculated for all participants.ResultsIn the PILATES group there was a reduction in performance (increased test time) for the GI_FC after 4W_DT in relation to POST (p < 0.05), however, GI_FC showing maintenance of performance gain in relation to the PRE (p > 0.05) (PRE: 36.0 ± 5.5 s vs. POST: 27.2 ± 4.0 s vs. 4W_DT: 29.0 ± 4.2 s). The CONTROL group had worse performance than the GI_FC POST (35.3 ± 4.6 s) and 4W_DT (35.4 ± 4.6 s) when compared to the PILATES group (F = 106.967; np2 = 0.842; p < 0.001).ConclusionA period of 4W_DT was not able to reduce the functional gains of elderly women with T2D after 12 weeks of PILATES training. These results have a practical application for training professionals, enabling better control and planning of training interruptions on the PILATES method for elderly women with T2D.     

Relationship between mood disturbance and sleep quality in oncology outpatients at the initiation of radiation therapy

Purpose of the researchThe purpose of this study was to describe the occurrence of significant mood disturbance and evaluate for differences in sleep quality among four mood groups (i.e., neither anxiety nor depression, only anxiety, only depression, anxiety and depression) prior to the initiation of radiation therapy (RT).Methods and samplePatients (n = 179) with breast, prostate, lung, and brain cancer were evaluated prior to the initiation of RT using the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiological Studies Depression Scale, and the Spielberger State Anxiety Inventory. Differences in sleep disturbance among the four mood groups were evaluated using analyses of variance.Key resultsWhile 38% of the patients reported some type of mood disturbance, 57% of the patients reported sleep disturbance. Patients with clinically significant levels of anxiety and depression reported the highest levels of sleep disturbance.ConclusionsOverall, oncology patients with mood disturbances reported more sleep disturbance than those without mood disturbance. Findings suggest that oncology patients need to be assessed for mood and sleep disturbances.     

Behavioral Symptom Clusters,Inflammation, and Quality of Life in Chronic Low Back Pain

BackgroundChronic low back pain is a prevalent condition, often involving an inflammatory process. Behavioral symptoms, including depressed mood, fatigue, and sleep disturbance, intensifies pain and reduces quality of life.AimsThe objectives of this pilot study were to identify behavioral symptom clusters (depressive mood, fatigue, poor sleep) in individuals with chronic low back pain, and to determine whether there are differences in pain, quality of life and inflammation (plasma IL-6) based on cluster membership.Design and SettingsA cross-sectional study was conducted in a pain clinic.Participants/ SubjectsParticipants between ages 21 to 70 years (N=69) were enrolled if they had chronic low back pain for at least six months.MethodsParticipants completed instruments measuring, pain, depressive mood, fatigue, sleep, and demographic form. Blood (10ml) was obtained. Latent class analysis was used to identify clusters.Results and ConclusionsFindings revealed a two-class model, with Class 1 characterized by more depressive mood, fatigue, and sleep disturbance compared to Class 2. Class 1 participants reported worse quality of life than those in Class 2. Pain severity and pain interference were not significantly different between the classes. Levels of IL-6 were significantly greater in Class 1 participants compared to Class 2 with higher levels of IL-6 correlating with greater pain severity and sleep disturbances. Logistic regression revealed higher levels of IL-6 predicted Class 1 membership. Behavioral symptoms cluster exist in chronic low back pain patients and impact quality of life. Inflammation may contribute to relationship between behavioral symptoms and pain severity.     

Association Between Anxiety and Depressive Symptoms During Prehospitalization Waiting Period and Quality of Recovery at Postoperative Day 3 in Perioperative Cancer Patients

PurposePerioperative depressive symptoms are associated with poor postoperative quality of life (QOL), leading to prolonged hospital stays, and delayed return to society. Previous studies show that physical and mental states change on the third day after surgery, and there is a correlation between quality of recovery (QoR) on this day and QOL at 3 months after surgery. QoR after surgery is an important indicator of postoperative QOL. However, there are no reports on the association between depressive symptoms, and postoperative QoR. Therefore, the study purpose was to clarify the relationship between depressive symptoms in perioperative cancer patients during the prehospitalization waiting period, and QoR on the third postoperative day.DesignThis was a prospective cohort study.MethodsWe examined whether depressive symptoms during the prehospitalization waiting period were related to QoR on day 3 after surgery in perioperative cancer patients. Subjects were patients with primary tumors who underwent surgery under general anesthesia. Subjects completed self-administered questionnaires during the prehospitalization waiting period and on postoperative day 3. The presence and/or absence of depressive symptoms was measured using the Hospital Anxiety and Depression Scale. Subjects were divided into two groups: depressive symptoms or non–depressive symptoms. Postoperative QoR was determined using the QoR-40 questionnaire and we calculated the rate of change in QoR-40 global and dimension scores from preoperation to postoperation.Findings231 individuals met the inclusion criteria and agreed to participate in the study. Of these, 173 were included in the analysis. Only the rate of change in emotional state differed significantly between groups (P = .022). Both global and dimension QoR-40 scores were lower in the depressive symptoms group than in the non–depressive symptoms group.ConclusionsThese findings demonstrate the need to provide both psychological and physical support continuously from the preoperative to early postoperative stage for cancer patients with depressive symptoms in the prehospitalization waiting period.     

Course of Changes in Emotional Preparedness for Death and Its Associations With Caregiving Outcomes for Family Caregivers of Terminally Ill Cancer Patients Over Their Last Year of Life

BackgroundPreparing family caregivers for a patient's death is an integral component of quality end-of-life care, but temporal changes in emotional preparedness for death and its associations with caregivers' psychological well-being or quality of life (QOL) while providing end-of-life caregiving are under-researched. Our study was conducted to fill this gap.MethodsFor this prospective, longitudinal study, the course of changes in adequate emotional preparedness for death and its associations with severe depressive symptoms and QOL were examined on 309 consecutive caregivers of terminally ill cancer patients by univariate and multivariate generalized estimating equation analyses, respectively.ResultsPrevalence of adequate emotional preparedness for death was 57.2%, 61.3%, 54.4%, and 46.0% at 181-365, 91-180, 31-90, and 1-30 days before the patient's death, respectively, without significant changes as the patient's death approached. Adequate emotional preparedness for death was associated with caregivers' lower likelihood of severe depressive symptoms (adjusted odds ratio [95% CI]: 0.23 [0.16, 0.32], P < 0.001) but with their better QOL (adjusted β [95% CI]: 7.65 [6.38, 8.92], P < 0.001) in the patient's last year.ConclusionsWithout active, effective clinical interventions to promote caregivers' emotional preparedness for death, they cannot automatically become more prepared for the patient's death over time. Adequate emotional preparedness for the patient's death benefits caregivers by its associations with a lower likelihood of depressive symptoms and better QOL. Supportive programs for caregivers of terminally ill cancer patients should focus on not only enhancing caregiving skills but also cultivating emotional preparedness for their relative's death to promote their psychological well-being and QOL.     

Effects of mindfulness-based psychological care on mood and sleep of leukemia patients in chemotherapy

PurposeThe aim of this research was to explore the benefits of mindfulness-based psychological care (MBPC) and assess whether the intervention would be beneficial in reducing insomnia and emotional symptoms of leukemia patients receiving chemotherapy.MethodsA randomized control design study was applied in two hematology departments in a hospital in Zhengzhou. Patients in the experimental group received mindfulness-based psychological care(MBPC), and those in the control group received conventional care. Anxiety, depression, and sleeping problems were measured using the Self-Rating Anxiety Scale, Self-Rating Depression Scale, and the Pittsburgh Sleep Quality Index.ResultsStatistically significant differences were observed among anxiety, depression, and sleeping problems between the two groups in the post-test (P < 0.05). A significant decrease in anxiety and depression and an improvement in sleep were observed between pre- and post-interventions (P < 0.05) in the experimental group.ConclusionsMBPC significantly improved sleep quality and mood of the experimental group. It is an effective complementary therapy for leukemia treatment that is inexpensive, noninvasive, and associated with relaxation and pain reduction.     

Prospective Longitudinal Evaluation of a Symptom Cluster in Breast Cancer

ContextSymptom cluster research expands cancer investigations beyond a focus on individual symptoms in isolation.ObjectivesWe conducted a prospective longitudinal study of sleep, fatigue, depression, anxiety, and perceived cognitive impairment in patients with breast cancer undergoing chemotherapy.MethodsPatient-reported outcome measures were administered prior to chemotherapy, at Cycle 4 Day 1, and six months after initiating chemotherapy. Participants were divided into four groups and assigned a symptom cluster index (SCI) score based on the number/severity of symptoms reported at enrollment.ResultsParticipants (N = 80) were mostly women (97.5%) with Stage II (69.0%) breast cancer, 29–71 years of age. Scores on all measures were moderately-highly correlated across all time points. There were time effects for all symptoms, except sleep quality (nonsignificant trend), with most symptoms worsening during chemotherapy, although anxiety improved. There were no significant group × time interactions; all four SCI groups showed a similar trajectory of symptoms over time. Worse performance status and quality of life were associated with higher SCI score over time.ConclusionWith the exception of anxiety, the coherence of the symptom cluster was supported by similar patterns of severity and change over time in these symptoms (trend for sleep quality). Participants with higher SCI scores prior to chemotherapy continued to experience greater symptom burden during and after chemotherapy. Early assessment and intervention addressing this symptom cluster (vs. individual symptoms) may have a greater impact on patient performance status and quality of life for patients with higher SCIs.     

The effect of applying pressure to the LIV3 and LI4 on the symptoms of premenstrual syndrome: A randomized clinical trial

ObjectiveTo evaluate the effect of simple acupressure protocol in LIV3, LI4 and placebo points on the quality of life (QOL) in women with premenstrual syndrome (PMS).MethodThis paper reports a randomized, single blinded clinical trial. 97 participants (students in of Hormozgan University of Medical Sciences, Iran) with PMS were allocated to three groups to receive 20 min acupressure on different acupoints for 14 days before menstruation for three consecutive menstrual cycles (training and then two cycles self applied acupressure). The acupoints were LIV3 and LI4; one group received acupressure at a placebo point. Each participant completed the PSST scale (to determine PMS severity), HADS scale (for depression and anxiety), and quality of life SF12.ResultsThe number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group (p < 0.04).Moreover, depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the placebo group (p < 0.05).Analyzing the score of SF12 fields in the second and third cycles showed a significant difference in all dimensions between the intervention and placebo groups. There was no significant difference between LIV3 and LI4 acupressure groups in decrease of PMS symptoms, anxiety and depression and improving SF12scores (p < 0.05).ConclusionPerforming the simple acupressure protocol at LIV3 and LI4 is an effective method to decrease the severity of PMS symptoms, anxiety and depression, and to improve the QOL. Pressure at LIV3 and LI4 appears to be equally effective.     

affron® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind,parallel, randomized,placebo-controlled clinical trial

BackgroundIn recent years phytotherapy has been explored as a source for alternative treatments for mood disorders. One potential candidate is saffron (Crocus sativus L.), whose main bioactive components are crocins and safranal.ObjectivesThe aim of this study was to investigate the efficacy of affron^®, a standardised stigmas extract from Crocus sativus L. for improving mood, stress, anxiety and sleep quality in healthy adults.MethodsIn this 3 arm study, 128 participants self-reporting low mood but not diagnosed with depression, were given affron^® at 28 mg/day, 22 mg/day, or a placebo treatment in a randomized, double-blind, placebo-controlled trial for 4 weeks. Mood was measured at baseline and at the end of the study, using the POMS (primary outcome measure) and PANAS questionnaires, and the DASS-21 scale. Sleep was monitored using Sleep Quality Index (PSQI).ResultsAnalysis indicated a significant decrease in negative mood and symptoms related to stress and anxiety at a 28 mg/day dose (with a significant difference between 28 mg/day and placebo on the POMS Total Mood Disturbance scale, p < 0.001, d = −1.10), but no treatment effect at the 22 mg/day dose.LimitationsThe main weaknesses of this investigation were found in the self-reporting nature of both the screening and the testing.Conclusionsaffron^® increased mood, reduced anxiety and managed stress without side effects, offering a natural alternative to standard treatments.     

Prevalence,Severity, and Correlates of Sleep-Wake Disturbances in Long-Term Breast Cancer Survivors

ContextCurrent evidence shows that sleep-wake disturbances are a persistent problem linked to poor quality of life in women surviving breast cancer. Information regarding correlates of sleep-wake disturbances in long-term survivors is sparse.ObjectivesThe objective of this study was to refine knowledge regarding prevalence, severity, and correlates of sleep-wake disturbances in long-term breast cancer survivors (BCS) compared with age-matched women without breast cancer (WWC).MethodsThe cross-sectional convenience sample included 246 BCS and 246 WWC who completed a quality-of-life study and were matched within ±5 years of age.ResultsBCS were a mean of 5.6 years beyond completion of cancer treatment (range = 5.6–10.0 years). Based on Pittsburgh Sleep Quality Index (PSQI) scores, BCS had significantly more prevalent sleep-wake disturbances (65%) compared with WWC (55%) (P < 0.05). BCS also had significantly higher PSQI global scores indicating poorer sleep quality compared with WWC (P < 0.05). Significant correlates of prevalence of poor sleep for BCS included hot flashes, poor physical functioning, depressive symptoms, and distress, and for WWC, these included hot flashes, poor physical functioning, and depressive symptoms. Significant correlates (P < 0.05) of severity of poor sleep for BCS included presence of noncancer comorbidities, hot flashes, depressive symptoms, and residual effects of cancer treatment. For WWC, these included hot flashes, poor physical functioning, depressive symptoms, and impact of a life event.ConclusionKnowledge of prevalence, severity, and correlates of sleep-wake disturbances provides useful information to health care providers during clinical evaluations for treatment of sleep-wake disturbances in BCS.     

The Effectiveness of Wellness Coaching for Improving Quality of Life

ObjectiveTo learn more about the potential psychosocial benefits of wellness coaching. Although wellness coaching is increasing in popularity, there are few published outcome studies.Patients and MethodsIn a single-cohort study design, 100 employees who completed the 12-week wellness coaching program were of a mean age of 42 years, 90% were women, and most were overweight or obese. Three areas of psychosocial functioning were assessed: quality of life (QOL; 5 domains and overall), depressive symptoms (Patient Health Questionnaire-9), and perceived stress level (Perceived Stress Scale-10). Participants were recruited from January 1, 2011, through December 31, 2011; data were collected up to July 31, 2012, and were analyzed from August 1, 2012, through October 31, 2013.ResultsThese 100 wellness coaching completers exhibited significant improvements in all 5 domains of QOL and overall QOL (P<.0001), reduced their level of depressive symptoms (P<.0001), and reduced their perceived stress level (P<.001) after 12 weeks of in-person wellness coaching, and they maintained these improvements at the 24-week follow-up.ConclusionIn this single-arm cohort study (level 2b evidence), participating in wellness coaching was associated with improvement in 3 key areas of psychosocial functioning: QOL, mood, and perceived stress level. The results from this single prospective cohort study suggest that these areas of functioning improve after participating in wellness coaching; however, randomized clinical trials involving large samples of diverse individuals are needed to establish level 1 evidence for wellness coaching.     

Local vibration training improves the recovery of quadriceps strength in early rehabilitation after anterior cruciate ligament reconstruction: A feasibility randomised controlled trial

BackgroundAfter anterior cruciate ligament reconstruction (ACLR), quadriceps strength must be maximised as early as possible.ObjectivesWe tested whether local vibration training (LVT) during the early post-ACLR period (i.e., ～10 weeks) could improve strength recovery.MethodsThis was a multicentric, open, parallel-group, randomised controlled trial. Thirty individuals attending ACLR were randomised by use of a dedicated Web application to 2 groups: vibration (standardised rehabilitation plus LVT, n = 16) or control (standardised rehabilitation alone, n = 14). Experimenters, physiotherapists and participants were not blinded. Both groups received 24 sessions of standardised rehabilitation over ～10 weeks. In addition, the vibration group received 1 hour of vibration applied to the relaxed quadriceps of the injured leg at the end of each rehabilitation session. The primary outcome — maximal isometric strength of both injured and non-injured legs (i.e., allowing for limb asymmetry measurement) — was evaluated before ACLR (PRE) and after the 10-week rehabilitation (POST).ResultsSeven participants were lost to follow-up, so data for 23 participants were used in the complete-case analysis. For the injured leg, the mean (SD) decrease in maximal strength from PRE to POST was significantly lower for the vibration than control group (n = 11, ?16% [10] vs. n = 12, ?30% [11]; P = 0.0045, Cohen's d effect size = 1.33). Mean PRE–POST change in limb symmetry was lower for the vibration than control group (?19% [11] vs. ?29% [13]) but not significantly (P = 0.051, Cohen's d effect size = 0.85).ConclusionLVT improved strength recovery after ACLR. This feasibility study suggests that LVT applied to relaxed muscles is a promising modality of vibration therapy that could be implemented early in ACLR.Trial registrationClinicalTrials.gov: NCT02929004.     

The Role of Comorbid Mood Disorders in Cognitive Behavioral Therapy for Childhood Social Anxiety

Background

Children with a social anxiety disorder have worse treatment outcomes after Cognitive Behavior Therapy (CBT) than children with other anxiety disorders. Anxiety disorders and mood disorders are strongly related and especially social anxiety is related to high comorbidity rates with mood disorders. The aim of the study was to investigate how comorbid mood disorders are related to treatment outcomes after CBT and whether this can explain the worse outcomes for childhood social anxiety.

Methods

Participants were 152 referred clinically children (7–18 years) with either a social anxiety disorder (n?=?52) or another anxiety disorder (n?=?100) of whom 24.3% (n?=?37) had a comorbid mood disorder. Child anxiety, internalizing symptoms, and quality of life were measured pre-treatment, post-treatment, 3 months and 1 year after treatment, using child and both parents’ report.

Results

Children with a primary social anxiety disorder more often had a comorbid mood disorder than children with another primary anxiety disorder. Children with a mood disorder had more severe anxiety problems before treatment. Comorbid mood disorders were related to greater anxiety reductions after treatment. The worse outcomes for children with a primary social anxiety disorder remained after controlling for comorbid mood disorders.

Conclusions

Findings stress the importance of future studies examining why the presence of a comorbid mood disorder is associated with greater anxiety reductions, and other factors that explain the worse treatment outcomes found for childhood social anxiety disorder.

     

A systematic review and meta-analysis of the effect of whole body cryotherapy on mental health problems

ObjectiveTo give an overview of the nature and methodological quality of studies on whole body cryotherapy (WBC) as add-on intervention for mental health problems.MethodsA meta-analysis according to PRISMA guidelines was conducted (Prospero registration: CRD42020167443). Databases MEDLINE, PsycINFO and the Cochrane Library were searched. Risk of bias was scored according to the Cochrane ROBINS-I-tool to which an extra bias-dimension of allegiance bias was added. Within and between Hedges’ g pooled effect sizes were calculated for the main aspect of mental health measured. Treatment efficacy was examined using a random effects model. Heterogeneity was examined through identification of visual outliers and by I² statistics.ResultsOut of 196 articles coming up from the search, ten studies met all inclusion criteria, six of which were (randomized) controlled trials. Together these studies report on a total of 294 participants receiving WBC. The within-group pooled effect size for mental health problems is large (Hedges’ g = 1.63, CI: 1.05-2.21), with high heterogeneity (I² = 93%). Subgroup analyses on depressive symptoms and quality of life (QOL) showed a diminution of heterogeneity to moderate. Effect sizes for depressive symptoms are very large (Hedges’ g = 2.95, CI: 2.44-3.45) and for QOL medium (Hedges’ g = 0.70, CI: 0.15-1.24). The between-group pooled effect size is medium (Hedges’ g = 0.76, CI: 0.17-1.36).ConclusionsResults indicate preliminary evidence for WBC as efficacious add-on intervention for mental health problems, especially depressive symptoms. Further research in the form of RCTs with larger numbers of participants is needed.     

Effects of auricular acupressure on the quality of sleep and anxiety in patients undergoing cardiac surgery: A single-blind,randomized controlled trial

AimThis study aimed to evaluate the effects of auricular acupressure (AA), a non-invasive type of reflexotherapy, on sleep quality and anxiety in patients after cardiac surgery.BackgroundSleep disturbances and anxiety hinder the recovery of patients after cardiac surgery; thus, appropriate and adequate nursing interventions must be pursued. AA is a complementary therapy suitable for patients with limited pharmacological therapy options.MethodA single-blind, randomized controlled trial with a pretest-posttest control group design was applied. The study consisted of 42 patients, comprising an experimental group (n = 21) and a control group (n = 21). AA was applied for six days per trial for a total of 2 trials, while sleep (sleep score, sleep satisfaction) and anxiety (state, trait) were measured at three time points (pre-op, 7 days post-op, and 14 days post-op).ResultsThe sleep and sleep satisfaction scores of the experimental group were significantly higher than those of the control group. No significant difference was found in anxiety state/trait between the two groups.ConclusionsWe conclude that AA is a safe, effective, noninvasive, and low-risk nursing intervention that can improve sleep quality in patients after cardiac surgery.     

Modifiable correlates of physical symptoms and health-related quality of life in patients with heart failure: A cross-sectional study

BackgroundHeart failure is associated with high rates of hospitalization and mortality. The majority of patients with heart failure suffer from physical symptoms, and these symptoms are strongly associated with poor health-related quality of life. To improve physical symptoms and health-related quality of life, the modifiable factors associated with physical symptoms need to be examined.PurposeTo examine modifiable psychosocial and behavioral factors associated with physical symptoms and health-related quality of life, and the mediator effects of physical symptoms on the relationships between the modifiable factors and health-related quality of life in patients with heart failure.MethodsData on potential correlates of physical symptoms (i.e., depressive symptoms, perceived control, social support, medication adherence, sodium intake, and self-care management) were collected from 109 patients with heart failure (mean age 58 ± 14 years, 46% male, 89% New York Heart Association class II/III). Data on physical symptoms (Symptom Status Questionnaire-Heart Failure) and health-related quality of life (Minnesota Living with Heart Failure) also were collected. Simple and multiple regression analyses were used to analyze the data.ResultsAmong the potential correlates, depressive symptoms and sodium intake were associated with physical symptoms (F = 11.63, p < .001), and depressive symptoms and perceived control were associated with health-related quality of life (F = 9.917, p < .001). Physical symptoms mediated the relationship between depressive symptoms and health-related quality of life.ConclusionImproving depressive symptoms and eating the appropriate amount of sodium may be primary intervention targets to improve physical symptoms. To improve health-related quality of life, depressive symptoms as well as physical symptoms need to be managed appropriately.     

Anxiety,depression, and quality of life in mothers of newborns admitted to the neonatal intensive care unit: A follow-up study from birth to the first two years of life

AimThere is evidence that the Neonatal Intensive Care Unit (NICU) environment can have a negative impact on maternal psychological well-being, especially in low- and middle-income settings. However, most studies on distress and quality of life in mothers of newborns who needed intensive medical care have measured patient-centered outcomes at only one time-point. Here, we evaluated the levels of anxiety, depression, and quality of life in mothers of newborns admitted to the NICU with follow-up throughout the first 2 years of the child's life.MethodsWe performed a longitudinal study in a region with the worst socioeconomic indicators in Brazil. We included mothers who had newborns admitted to the NICU. Our primary outcome of interest was quality of life, as measured by the WHOQOL-BREF instrument. Secondary endpoints included anxiety levels (Spielberger's State-Trace Anxiety Inventory) and depressive symptoms (Beck Depression Inventory).ResultsFifty-four mothers were included. During the first 48 h after NICU admission, the median quality of life score was 62.5 (IQR 56.3–68.8), and severe levels of state anxiety were observed in 61.1% of mothers. A positive relationship was observed between levels of state anxiety (p = 0.003), depressive symptoms (p < 0.001), and length of stay in the NICU. A significant improvement in the mothers' global quality of life score was observed only 12 months after the child's birth, which remained unchanged at the 24-month assessment.ConclusionsOur findings suggested that the admission of newborns to the NICU may have a long-term impact on maternal mental health.     

The effects of an interprofessional patient-centered communication intervention for patients with communication disorders

Purpose of the studyThis small scale study examined the influence of an interprofessional (IP) evidence based patient-centered communication intervention (PCCI), delivered by trained nurses in collaboration with Speech Language Pathologists, on patient outcomes in an active stroke rehabilitation setting.Design and methodsThe setting constraints imposed the use of a single-group pretest and post-test design to determine the influence of the intervention on patient outcomes. Validated tools measured patient quality of life (QOL), depressive symptoms and satisfaction with care.ResultsPatients (n = 34) showed improvement in all outcomes from pretest to post-test, including quality of life, geriatric depressive symptoms, and satisfaction with care.ImplicationsThe findings indicate that a comprehensive person-centered communication intervention has the potential to enhance patient outcomes at discharge. Challenges to implementing and evaluating evidence-based interventions in practice are highlighted.