Patients’ and health professionals’ understanding of and preferences for graphical presentation styles for individual-level EORTC QLQ-C30 scores

Purpose

To investigate patients’ and health professionals’ understanding of and preferences for different graphical presentation styles for individual-level EORTC QLQ-C30 scores.

Methods

We recruited cancer patients (any treatment and diagnosis) in four European countries and health professionals in the Netherlands. Using a questionnaire, we assessed objective and self-rated understanding of QLQ-C30 scores and preferences for five presentation styles (bar and line charts, with or without color coding, and a heat map).

Results

In total, 548 patients and 227 health professionals participated. Eighty-three percent of patients and 85 % of professionals self-rated the graphs as very or quite easy to understand; this did not differ between graphical presentation styles. The mean percentage of correct answers to questions objectively assessing understanding was 59 % in patients, 78 % in medical specialists, and 74 % in other health professionals. Objective understanding did not differ between graphical formats in patients. For non-colored charts, 49.8 % of patients did not have a preference. Colored bar charts (39 %) were preferred over heat maps (20 %) and colored line charts (12 %). Medical specialists preferred heat maps (46 %) followed by non-colored bar charts (19 %), whereas these charts were equally valued by other health professionals (both 32 %).

Conclusion

The substantial discrepancy between participants’ high self-rated and relatively low objective understanding of graphical presentation of PRO results highlights the need to provide sufficient guidance when presenting such results. It may be appropriate to adapt the presentation of PRO results to individual preferences. This could be facilitated when PROs are administered and presented to patients and health professionals electronically.

     

Effect of room temperature on tests for diagnosing vibration-induced white finger: finger rewarming times and finger systolic blood pressures

Purpose

This study investigates the effects of room temperature on two standard tests used to assist the diagnosis of vibration-induced white finger (VWF): finger rewarming times and finger systolic blood pressures.

Methods

Twelve healthy males and twelve healthy females participated in four sessions to obtain either finger skin temperatures (FSTs) during cooling and rewarming of the hand or finger systolic blood pressures (FSBPs) after local cooling of the fingers to 15 and 10 °C. The measures were obtained with the room temperature at either 20 or 28 °C.

Results

There were lower baseline finger skin temperatures, longer finger rewarming times, and lower finger systolic blood pressures with the room temperature at 20 than 28?°C. However, percentage reductions in FSBP at 15 and 10?°C relative to 30?°C (i.e. %FSBP) did not differ between the two room temperatures. Females had lower baseline FSTs, longer rewarming times, and lower FSBPs than males, but %FSBPs were similar in males and females.

Conclusions

Finger rewarming times after cold provocation are heavily influenced by room temperature and gender. For evaluating peripheral circulatory function using finger rewarming times, the room temperature must be strictly controlled, and a different diagnostic criterion is required for females. The calculation of percentage changes in finger systolic blood pressure at 15 and 10?°C relative to 30?°C reduces effects of both room temperature and gender, and the test may be used in conditions where the ±1?°C tolerance on room temperature required by the current standard cannot be achieved.

     

Psychological distress between chronic hemodialysis patients with and without low back pain

Objective

The aim of this study was to compare psychological distress between patients on chronic hemodialysis with and without chronic low back pain (CLBP).

Subjects and methods

A total of 72 patients on chronic hemodialysis, aged 72.9 ± 10.8 years, were enrolled in this cross-sectional study. Psychological distress using the K6, questionnaire for CLBP, and physical activity using the tri-accelerometer were evaluated.

Results

Twenty-nine patients (40.3 %) were having CLBP. The K6 scores were 4.0 ± 4.6 and physical activity (n = 55) was 1.0 ± 1.0 METs h/day. K6 scores in patients on chronic hemodialysis with CLBP were significantly higher than those in patients on chronic hemodialysis without CLBP even after adjusting for sex, age, duration of hemodialysis and physical activity.

Conclusion

These results suggest that higher psychological distress was a fundamental feature in patients on chronic hemodialysis with CLBP.

     

Long-term effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure: a randomized controlled trial

Background

Partners of patients with heart failure provide both practical and emotional support. Many partners assume caregiving responsibilities without being aware of the burden related with this role.

Objective

Our work has established that a psycho-educational intervention has benefits at 3, but not at 12 months for patients with heart failure. Further we had not described the long-term effects in caregivers. This study aimed to determine the 24-months effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure and study factors associated with a change in caregiver burden.

Design

A randomized controlled study design, with a follow-up assessment after 24 months.

Setting and participants

Partners to patients with heart failure were recruited from two hospitals in the southeast of Sweden.

Intervention

A three session nurse-led psycho-educational program was tested and included psychosocial support to maintain the partners’ physical and mental functions, and perceived control. Several instrument were used to measure caregiver burden, perceived control, physical and mental health, depression and morbidity.

Results

One hundred fifty-five partners were included. There were no significant differences in any index of caregiver burden or morbidity among the partners in the intervention and control groups after 24 months. Overall, the mean total caregiver burden was found to be significantly increased compared to baseline (36 ± 12 vs 38 ± 14, p < 0.05). A younger partner, less comorbidity, higher levels of perceived control, better physical health and less symptoms of depression in patients, and better mental health in the partners were factors associated with absence of increased caregiver burden over time.

Discussion and conclusion

Our intervention did not significantly decrease caregiver burden or morbidity. Over time, several aspects of burden increased in both groups. To improve outcomes, individualized and targeted interventions might be beneficial.

Registered on ClinicalTrials.gov Identifier

NCT02398799.

     

Application of the eight-item modified medical outcomes study social support survey in Japan: a national representative cross-sectional study

Purpose

This study aimed to create a Japanese version of the eight-item version of modified medical outcomes study social support survey (mMOS-SS), investigate psychometric property, and determine the standard values for Japanese citizens by using a nationally representative sample from the general population.

Methods

A stratified two-stage sampling was conducted with 4000 Japanese men and women who were in the age group of 25–74 as of January 01, 2014. From February to March 2014, placement method was conducted using self-administered questionnaire. Consequently, 2067 questionnaires were gathered (a collection rate of 51.7 %). Thus, the target of analysis was 952 males and 1100 females.

Results

The results of factor analysis showed that each of the samples exhibited two types of factors, i.e., emotional and instrumental, just as was the case with the original version. The Cronbach’s alpha ranged from 0.90 to 0.95 for each of the samples for both total score and the subscales. On comparing the groups by married versus unmarried and living alone versus not living alone, those not living alone and married people had significantly higher scores (p < 0.05) for each group except for married females less than 50 years. There was a significant positive correlation among mental health, life satisfaction, and self-rated health.

Conclusion

This study revealed that the eight-item Japanese version of the mMOS-SS had the same psychometric properties as those found in the research results of the English version.

     

Welche gesundheitsbezogenen Informationen brauchen Geflüchtete?

Background

The inclusion of refugees into the German health system is fraught with challenges. Besides need-based health services, refugees need information that enables them to appropriately use the German health care system and to increase their health literacy.

Objectives

The aim of the study was to analyze the demands and needs for further health information for refugees from the views of medical experts and refugees.

Materials and methods

In a mixed-methods design, 10 experts (medical staff) were interviewed. Based on the results of this qualitative research, a standardized questionnaire was developed. A total of 100 refugees (76.3% men; mean age 30.5 years; 84.7% came from Syria) answered the questionnaire.

Results

The medical experts identified information needs for refugees about structures, access, and characteristics of the German health system. Concerning health knowledge, the experts miss appropriate information about prevention, health behavior, medication management as well as psyche and somatization. For the refugees, information about expenses, contact points in case of emergency and diagnostic screening seemed to be remarkably relevant.

Conclusions

The results of this study illustrate health-related information needs of refugees. The results serve as a basis for target health information and health promotion. They can alert health care staff to the health information needs of refugees. Important topics for more understandable information seem to be the access to health system and additional costs for health services.

     

Körperliche Aktivität zur Stärkung kognitiver Ressourcen

Background

Nursing care insurance funds are supposed to deliver preventive services in nursing homes. The strengthening of cognitive resources is considered as one field of action.

Aim

The preventive effectiveness of physical activity on cognitive performance in nursing home residents shall be evaluated.

Methods

A systematic search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL, PsycINFO and PEDro. Results were combined in random-effects meta-analyses.

Results

Taking into account 13 primary studies, it was shown that those participating in physical activity showed statistically significant greater cognitive performance compared to controls (SMD = 0.43, 95% CI 0.20–0.66, p = 00002). Subgroup analyses suggest that nursing home residents with different cognitive impairments might benefit from long-lasting physical activity interventions. Due to the high risk of bias in included studies, the results must be interpreted with caution.

Conclusion

Physical activity might be effective in the inpatient care setting. Further studies with longer intervention periods are required.

     

Sickness absence and return to work rates in women with breast cancer

Purpose

Most women are diagnosed with breast cancer when they are of working age. How long are breast cancer patients absent? How many of them return to work?

Methods

ArboNed Occupational Health Services documents sickness absence data of 1 million workers of whom 40% were women. Between 2001 and 2005, 2,259 women had 2,361 episodes of sickness absence due to breast cancer. These absence episodes were followed for 2 years using Kaplan–Meier analysis.

Results

The mean ± standard error of mean duration of absence due to breast cancer was 349 ± 5 days. Thirty-seven percent of absences lasted longer than one year and 12% of absences lasted longer than 2 years particularly in women aged 25–34 years.

Conclusions

The mean duration of sickness absence due to breast cancer was nearly a year, but most women returned to work. The results of the study can be used as a reference for return to work of women following breast cancer.

     

Correlation of emotional labor and cortisol concentration in hair among female kindergarten teachers

Objectives

The purpose of this study was to explore whether two types of emotional labor, surface acting and deep acting, are related to hair cortisol concentration among kindergarten teachers.

Methods

Surface acting and deep acting over the last month were measured with the Chinese version of the emotional labor scale in 43 kindergarten teachers. Hair samples with 1 cm in length were cut from their posterior vertex region to represent cortisol excretion over one month. Cortisol concentrations were analyzed with high-performance liquid chromatography–tandem mass spectrometry.

Results

Positive association of emotion labor with hair cortisol concentration was significant for surface acting (r = 0.34, p < 0.05) and not significant for deep acting (r = 0.14, p > 0.05).

Conclusions

More surface acting showed to be associated stronger with stress responses or higher HPA axis activity.

     

Kenntnis des Impfstatus,Impfraten und Impfakzeptanz

Background

Vaccination coverage among medical students is often insufficient. Regarding vaccination coverage of students of other fields, there are no currently published data for Germany. Based on high international mobility, an insufficient or unknown vaccination status increases the health risk among students.

Objective

What is the vaccination status among students of different subjects? Are there group-based differences concerning knowledge of ones own vaccination status? Are there differences concerning attitudes towards vaccination?

Material and methods

The survey was conducted at the Technische Universität Dresden during the summer semester 2012 using a semi-standardized questionnaire. Data from 428 students (subjects: medicine, sociology, architecture and physics) were analyzed.

Results

Significantly less medical students reported an unknown vaccination status regarding all the nine vaccinations analyzed compared to students of sociology or technical subjects. Significantly more medical students reported complete vaccination status compared to students of other subjects (χ²-test: p ≤ 0.001; Z?test p ≤ 0.05). Significantly more medical students had the opinion that vaccinations were absolutely necessary compared to students of other subjects (χ²-test: p ≤ 0.001; Z?test p ≤ 0.05).

Conclusion

University students often have insufficient vaccination coverage. Students of subjects other than medicine are often not aware of their own vaccination status. Low-threshold opportunities to check vaccination status and to be vaccinated if necessary should be established, e.?g. at university and the workplace.

     

Normal values for finger systolic blood pressures in males and females

Objective

To compare finger systolic blood pressures in males and females and in younger and older persons and provide normal values for all four fingers in younger and older males and females.

Methods

Eighty healthy subjects participated in the study: 20 males and 20 females aged 20–30 years, and 20 males and 20 females aged 55–65 years. Finger systolic blood pressures (FSBPs) were measured using strain-gauge plethysmography following local cooling at 30 and 10°C in accord with International Standard 14835-2. The FSBPs were measured simultaneously in the thumb and the four fingers of the dominant hand and the percentage changes in finger systolic blood pressures (%FSBPs) due to the cold provocation were calculated.

Results

The median finger systolic blood pressures increased with increasing age in both females and males, with the increase highly significant at 30°C but not at 10°C. The %FSBPs were not significantly affected by the age of males, but were significantly lower in older females than younger females. The FSBPs were lower in females than in males at 30°C but there was no significant difference between genders at 10°C. The %FSBPs were higher in younger females than younger males, but only significantly higher in the middle finger and there were no significant differences between the genders in the older age group. There were only minor differences between the four fingers in the FSBPs at 30 and 10°C. The %FSBPs across the four fingers were similar in the younger subjects and in the older females, but varied with finger in the older males.

Conclusion

Although there are some differences in the %FSBPs associated with age, gender, and finger, the differences may be sufficiently small to use a single value criterion when deciding on abnormalities in FSBP associated with cold provocation for persons aged 20–65 years.

     

Profiles of Emergent Writing Skills Among Preschool Children

Background

Research suggests that considerable individual differences may exist among preschool children in terms of emergent writing performance. However, there is no study examining this variability.

Objective

This research explored the patterns of within-group individual differences in the emergent writing skills of preschool children.

Method

Cluster analysis was employed to identify profiles of emergent writing skills in two independent samples (children from middle-socioeconomic status backgrounds N = 36; children from socioeconomically and racial/ethnically diverse backgrounds N = 367).

Results

Cluster analysis identified three emergent writing profiles: (1) highest emergent writing-strength in letter writing and spelling; (2) average emergent writing-strength in name writing; and (3) lowest emergent writing across skills. Children’s letter name knowledge and phonological awareness significantly predicted profile membership when controlling for age.

Conclusion

These findings provide evidence regarding the heterogeneity of preschool children’s emergent writing skills and suggest that different profiles of emergent writing can be explained by children’s letter name knowledge, phonological awareness, and age.

     

Diagnosing soft tissue rheumatic disorders of the upper limb in epidemiological studies of vibration-exposed populations

Objectives

To investigate approaches adopted to diagnose soft tissue rheumatic disorders of the upper limb (ULDs) in vibration-exposed populations and in other settings, and to compare their methodological qualities.

Methods

Systematic searches were made of the Medline, Embase, and CINAHL electronic bibliographic databases, and of various supplementary sources (textbooks, reviews, conference and workshop proceedings, personal files). For vibration-exposed populations, qualifying papers were scored in terms of the provenance of their measuring instruments (adequacy of documentation, standardisation, reliability, criterion-related and content validity). Similar criteria were applied to general proposals for whole diagnostic schemes, and evidence was collated on the test–retest reliability of symptom histories and clinical signs.

Results

In total, 23 relevant reports were identified concerning vibration-exposed populations—21 involving symptoms and 9 involving examination/diagnosis. Most of the instruments employed scored poorly in terms of methodological quality. The search also identified, from the wider literature, more than a dozen schemes directed at classifying ULDs, and 18 studies of test–retest reliability of symptoms and physical signs in the upper limb. Findings support the use of the standardised Nordic questionnaire for symptom inquiry and suggest that a range of physical signs can be elicited with reasonable between-observer agreement. Four classification schemes rated well in terms of content validity. One of these had excellent documentation, and one had been tested for repeatability, agreement with an external reference standard, and utility in distinguishing groups that differed in disability, prognosis and associated risk factors.

Conclusions

Hitherto, most studies of ULDs in vibration-exposed populations have used custom-specified diagnostic methods, poorly documented, and non-stringent in terms of standardisation and supporting evidence of reliability and/or validity. The broader literature contains several question sets and procedures that improve upon this, and offer scope in vibration-exposed populations to diagnose ULDs more systematically.

     

The role of mindfulness in distress and quality of life for men with advanced prostate cancer

Objective

To examine the extent to which mindfulness skills influence psychological distress and health-related quality of life (HRQOL) in men with metastatic or castration-resistant biochemical progression of prostate cancer.

Patients and methods

A cross-sectional survey of 190 men (46 % response; mean age 71 years, SD = 8.7, range 40–91 years) with advanced prostate cancer, assessed psychological and cancer-specific distress, HRQOL. Mindfulness skills were assessed as potential predictors of adjustment outcomes.

Results

Overall, 39 % of men reported high psychological distress. One third had accessed psychological support previously although only 10 % were under current psychological care. One quarter had accessed a prostate cancer support group in the past six months.Higher HRQOL and lower cancer-specific and global psychological distress were related to non-judging of inner experience (p < 0.001).Higher HRQOL and lower psychological distress were related to acting with awareness (p < 0.001). Lower distress was also related to higher non-reactivity to inner experience and a lower level of observing (p < 0.05).

Conclusions

Men with advanced prostate cancer are at risk of poor psychological outcomes. Psychological flexibility may be a promising target for interventions to improve adjustment outcomes in this patient group.

Clinical Trial Registry

Trial Registration: ACTRN12612000306819

     

Familienhebammen im System Früher Hilfen

Background

During the last 10 years, family midwives have become increasingly integrated into the Early Intervention System in Germany. As representatives of the health care professions and based on a trusting relationship with vulnerable families, they use several strategies to promote positive health behavior and health conditions.

Objectives

The aim of the study was to obtain insight into subjective theories of family midwives, which influence their dealings with families and taking a guiding role for the families.

Methods

Following a qualitative research approach, 13 family midwives were interviewed. The interviews were interpreted according to methods recommendations by Witzel.

Results

Structural circumstances influence family midwives’ subjective theories of good quality. In spite of disclaiming controlling function, family midwives who work directly with representatives of child welfare services, by trend follow the aims of child welfare services. Family midwives working in conjunction with a private agency emphasize their strategies of health promotion.

Conclusion

Family midwives can be supported in their strategies of health promotion. Association with a private agency seems to be helpful for maintaining the salutogenetic perspective of midwives.

     

Rauchgewohnheiten von deutschen Medizinstudierenden in Deutschland und Ungarn

Background

Although many anti-tobacco measures have reduced the number of smokers in Germany, every fourth person still smokes and smoking is still an enormous burden for both the affected person and their relatives as well as for the healthcare system and society. Physicians have a key position in tobacco cessation, their health and smoking behavior is therefore of great importance.

Objective

To provide information about the distribution of tobacco consumption among medical students and to examine the influence of study site on tobacco consumption.

Material and methods

In a multicenter cross-sectional study, data on the health behavior of German medical students in two German and two Hungarian universities were collected in 2014 using a questionnaire.

Results

Of the 1384 students, 7.3% smoked daily, 9.1% occasionally and 11.9% were ex-smokers. The consumption of e?cigarettes was rare, whereas shisha smoking was more widespread among medical students. Among the study locations Munich had the lowest rates of occasional smoking for men and for women consuming shisha.

Conclusions

Medical students must be encouraged not to smoke. Our results highlight the need for smoking cessation programs at medical schools, including education about detrimental health effects of shisha use.

     

Health resource utilization associated with skeletal-related events: results from a retrospective European study

Background

Bone complications, also known as skeletal-related events (SREs), are common in patients with bone metastases secondary to advanced cancers.

Objective

To provide a detailed estimate of the health resource utilization (HRU) burden associated with SREs across eight European countries.

Methods

Eligible patients from centers in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden, and Switzerland with bone metastases or lesions secondary to breast cancer, prostate, or lung cancer or multiple myeloma who had experienced at least one SRE (defined as radiation to bone, long-bone pathologic fracture, other bone pathologic fracture, surgery to bone or spinal cord compression) were entered into this study. HRU data were extracted retrospectively from the patients’ charts from 3.5 months before the index SRE until 3 months after the index SRE (defined as an SRE preceded by an SRE-free period of at least 6.5 months).

Results

Overall, the mean number of inpatient stays per SRE increased from baseline by approximately 0.5–1.5 stays, with increases in the total duration of inpatient stays of approximately 6–37 days per event. All SREs were associated with substantial increases from baseline in the frequency of procedures and the number of outpatient and day-care visits.

Conclusions

SREs are associated with substantial HRU owing to considerable increases in the number and duration of inpatient stays, and in the number of procedures, outpatient visits, and day-care visits. These data collectively provide a valuable summary of the real-world SRE burden on European healthcare systems.

     

A pilot study of the relationship between diet and mental health in female university students enrolled in a training course for registered dietitians

Objective

The purpose of the present pilot study was to investigate the link between diet and mental health in female university students enrolled in a training course for registered dietitians.

Subjects and methods

A total of 62 female university students, with a mean age of 18.79 ± 0.45 years, participated in this cross-sectional study. Diet surveys were performed using the brief-type self-administered diet history questionnaire (BDHQ). Mental health was also evaluated using the general health questionnaire-12 (GHQ-12), which was the shortest form and clinically available. Lifestyles such as physical activity levels were also evaluated.

Results

The mean energy intake was 1379 ± 575 kcal and the mean GHQ score was 3.11 ± 2.41. Among nutrients, vegetable fat and sucrose showed a weak positive correlation with the GHQ scores. Among food groups, potatoes, fats and oils, and confectioneries also showed a weak positive correlation with the GHQ scores. A multiple regression analysis showed that the confectioneries were the determining factor for the GHQ scores.

Conclusion

Proper education concerning their diets and reducing confectioneries in their daily lives might be beneficial for the mental health of female university students.

     

Quality Rating and Improvement Systems and Children’s Cognitive Development

Background

Providing enriched learning environments is important to stimulating children’s development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children’s school readiness.

Objective

The purpose of this study was to examine associations between QRIS, a statewide government-funded early childhood care and education policy which integrates structural quality of child-care, and children’s cognitive skills.

Methods

A sample of randomly selected 313 children (mean age = 54.9 months, SD = 6.7) from 36 QRIS-participating early child-care programs was included in this study.

Results

Multilevel analysis with a latent variable (i.e., observed cognitive skills consisting of vocabulary, phonological awareness, and mathematical skills) revealed that children in the highest level of QRIS programs demonstrated better cognitive skills after controlling for child demographics, and home and neighborhood environments. In addition, QRIS moderated a negative association between family socioeconomic risk and children’s cognitive skills.

Conclusions

The results suggest that policymakers may expect positive returns on QRIS investments in terms of children’s early cognitive achievements that support their school readiness in later life.

     

Family and Parent Predictors of Anxiety Disorder Onset in Offspring of Anxious Parents

Background

Offspring of anxious parents are at increased risk for developing anxiety disorders. There is a need to identify which youth are at greatest risk for disorder onset in this population.

Objective

This study prospectively examined several theory-based family and parent characteristics (e.g., family conflict, parental over-control, parental psychopathology) as predictors of anxiety disorder onset in children whose parents were clinically anxious.

Methods

Families were enrolled in a randomized controlled trial evaluating a family-based preventative intervention, relative to an information monitoring control condition, for offspring of anxious parents (N = 136; child mean age 8.69 years; 55% female; 85% Caucasian). Family and parent measures were collected using multiple informants and an observational task at baseline, post-intervention, and at a 6 and 12 month follow-up. Child anxiety disorder diagnosis was determined by independent evaluators using the Anxiety Disorders Interview Schedule for Children.

Results

Results indicated that none of the baseline family or parent variables examined predicted the onset of an anxiety disorder in children over the 1 year follow-up period.

Conclusions

Findings raise questions about the short-term risk associated with family and parent factors in anxiety disorder development in this high risk population.