Assessing the quality of sleep in Greek primary caregivers of patients with secondary progressive multiple sclerosis: a cross-sectional study

Context

Several studies have investigated the prevalence of sleep disorders in patients suffering from multiple sclerosis (MS) and have shown that up to 54% of patients may have significantly more sleep problems than the general population. To our knowledge, however, no data are available about the quality of sleep of the primary caregivers of patients with MS.

Objectives

The objectives of the current cross-sectional study were to assess the quality of sleep in Greek primary caregivers of patients with MS and to investigate its relationship with the degree of caregivers' emotional distress.

Methods

Twenty-two male and 13 female primary caregivers (mean age 47.3 ± 12.4 years) of an equal number of patients with MS, who consented to participate, completed the validated Greek version of the Pittsburgh Sleep Quality Index (PSQI) and the validated Greek version of the Hospital Anxiety and Depression Scale (HADS). Thirty-five age-, gender-, and education-matched healthy controls were used for comparisons.

Results

Caregivers experienced a higher degree of anxiety than depression. The mean score in the seven-item HADS-A subscale was 9.5 ± 4 (range 3-15) and the mean score in the seven-item HADS-D subscale was 7.1 ± 3.1 (range 2-14). The mean scores of caregivers on both HADS-A and HADS-D were significantly higher than those of controls (P < 0.001). The PSQI scoring demonstrated that 19 (54.3%) caregivers had poor sleep quality (cut-off value of >5). The mean values of caregivers for the PSQI were 6.0 ± 2.8 (range 2-12) compared with controls, who scored at a significantly lower level (1.5 ± 0.8; P < 0.001). Poor quality of sleep was significantly correlated with increased levels of anxiety (r = 0.392; P = 0.02) and depression (r = 0.424; P = 0.01). Among the PSQI components, the sleep duration and sleep latency were mostly influenced by the degree of emotional distress.

Conclusion

A significant proportion of primary caregivers of MS patients experience poor sleep quality. The degree of their emotional distress appears to significantly influence their quality of sleep. Appropriate psychopharmacological interventions may be required for those individuals.     

The bidirectional temporal relationship between headache and affective disorders: longitudinal data from the HUNT studies

BackgroundFew prospective population-based studies have evaluated the bidirectional relationship between headache and affective disorder. The aim of this large-scale population-based follow-up study was to investigate whether tension-type headache (TTH) and migraine had increased risk of developing anxiety and depression after 11 years, and vice-versa.MethodsData from the Trøndelag Health Study (HUNT) conducted in 2006-2008 (baseline) and 2017-2019 (follow-up) were used to evaluate the bidirectional relationship between migraine and TTH and anxiety and depression measured by Hospital Anxiety and depression Scale (HADS). The population at risk at baseline consisted of respectively 18,380 persons with HADS score ≤ 7 and 13,893 without headache, and the prospective data was analyzed by Poisson regression.ResultsIn the multi-adjusted model, individuals with HADS anxiety (HADS-A) and depression scores (HADS-D) of ≥8 at baseline nearly doubled the risk of migraine (Risk rations (RR) between 1.8 and 2.2) at follow-up whereas a 40% increased risk (RR 1.4) was found for TTH. Vice versa, the risk of having HADS-A and HADS-D scores of ≥8 at follow-up were increased for TTH (RR 1.3) and migraine (RR 1.3-1.6) at baseline. Migraine with aura was associated with 81% (RR 1.81, 95% 1.52-2.14) increased risk of HADS-A score of ≥8.ConclusionsIn this large-scale population-based follow-up study we found a bidirectional relationship between anxiety and depression and migraine and TTH. For anxiety, this bidirectional association was slightly more evident for migraine than TTH.     

Effects of massage therapy on anxiety,depression, hyperventilation and quality of life in HIV infected patients: A randomized controlled trial

IntroductionHIV infection is often preceded or accompanied by psychiatric comorbidities. These disorders improve with complementary therapies. The aim of this study was to measure the effect of massage therapy on anxiety, depression, hyperventilation and quality of life in HIV infected patients.MethodAdult HIV-infected patients were randomized (n = 29) in massage therapy group (one hour a week during four weeks) and control group. Anxiety and depression (HADS-A and HADS-D), hyperventilation (Nijmegen questionnaire) and quality of life (WHOQOL-HIV) were evaluated at inclusion and after 4 weeks.ResultsAt inclusion, 51% and 17% of the patients had a positive HADS-A and HADS-D score respectively. Two facets from WHOQOL-HIV (“Home environment” and “Death and dying” (p = 0.04)) were different between groups. After the four week massage therapy, a significant improvement was observed only for Nijmegen questionnaire (p = 0.01) and HADS-A (p = 0.04) contrarily to WHOQOL-HIV and HADS-D. Domains of the WHOQOL-HIV did not improve following the massage therapy. Only “Pain and discomfort” facet improved after massage therapy (p = 0.04).ConclusionThis study highlights the positive impact of a four week massage therapy on anxiety and hyperventilation in HIV infected patients. However, neither benefit of this program was observed on depression and quality of life.     

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.     

Turkish Translation of the Patterns of Activity Measure-Pain in Patients with Chronic Low Back and Neck Pain: Validity and Reliability

ObjectiveTo translate the Patterns of Activity Measure-Pain (POAM-P) into Turkish and test its validity and reliability.MethodsA total of 252 patients with chronic low back and neck pain were included. The Turkish translation of the POAM-P (POAMP/T), which has subgroups of Avoidance, Overdoing, and Pacing, was performed in accordance with international recommendations. The POAMP/T was administered twice. Physical activity level was assessed with the International Physical Activity Questionnaire-7 (IPAQ-7), and psychologic status was assessed with the Hospital Anxiety (HADS-A) and Depression Scales (HADS-D). The internal and external construct validity, internal consistency, and test-retest reliability were analyzed.ResultsThree related factorial structures were defined in Confirmatory Factor Analysis. Indexes and factor loads were found to be sufficient. A negative relationship was observed between avoidance and IPAQ-7 (rho = –0.328, p < .001), HADS-D (ρ = ?0.163, p = .009), and HADS-A scores (ρ = ?0.164, p = .009); whereas, a positive relationship was observed between overdoing and IPAQ-7 (ρ = 0.362, p < .001), HADS-D (ρ = 0.309, p < .001), and HADS-A scores (ρ = 0.325, p < .001). A negative correlation was found between pacing and IPAQ-7 (ρ = ?0.200, p = .001), HADS-D (ρ = ?0.507, p < .001), and HADS-A scores (ρ = ?0.509, p < .001). The Cronbach alpha values for avoidance, overdoing, and pacing were obtained as 0.941, 0.917, and 0.940, respectively. The intraclass correlation coefficient for avoidance, overdoing, and pacing was found as 0.972, 0.973, and 0.972, respectively. Test and retest scores were similar (p > .05).ConclusionsThe Turkish version of the POAM-P is a valid and reliable scale for the assessment of pain-related activity patterns in patients with chronic low back or neck pain.     

Sleep quality and its impact on glycaemic control in patients with type 2 diabetes mellitus

PurposeTo investigate the sleep quality of patients with type 2 diabetes (T2D) and its impact on glycaemic control.MethodsUsing a convenience sampling method, 220 patients with T2D were recruited. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality with threshold at PSQI ≥ 8. The glycosylated haemoglobin A1c (HbA1c) test was used to measure the glycaemic control with threshold at HbA1c < 7%.ResultsThe PSQI score was 8.30 ± 4.12. The sleep disorder incidence rate was 47.1%. Patients with HbA1c ≥ 7% had significantly lower PSQI global and factor scores (p < 0.01) versus the control group. Sleep latency, sleep disturbance, and daytime dysfunction were the risk factors for poor glycaemic control.ConclusionPatients with T2D have high sleep disorder rate negatively impacting glycaemic control. Health care providers should pay close attention to the sleep quality of T2D patients, and provide them with appropriate educational material.     

Predictors of breastfeeding self-efficacy during the covid-19 pandemic

BackgroundBreastfeeding self-efficacy (BSE) is a strong predictor of the duration of breastfeeding. The aim of this study is to determine the predictors of BSE in breastfeeding mothers during the Covid-19 pandemic.MethodsA cross-sectional study was conducted with 300 breastfeeding mothers who breastfed during the Covid-19 pandemic. Convenience sampling was used to recruit participants. A battery of online questionnaires measured sociodemographic and obstetric characteristics, breastfeeding self-efficacy, spouse postpartum social support, perceived social support, anxiety and depression, and fear of Covid-19. Data were analyzed using Pearson correlation coefficients, one-way ANOVA, and multivariable linear regression via stepwise method. The significance level in this study was α = 0.05.ResultsThe mean BSE score among participants was 58.19 ± 10.48 (out of 70). Spouse postpartum social support (β = 0.732, p = 0.04), intention to breastfeed (β = 0.17, p = 0.001), use of formula while breastfeeding (β = ?0.09, p < 0.001), and depression (β = - 0.11, p < 0.001) were significant predictors of BSE. However, fear of Covid-19 was not significantly correlated with BSE (p = 0.514).ConclusionThe results of the present study showed that fear of Covid-19 was not a significant predictor of BSE, while spouse postpartum social support and having the intention of breastfeeding were positively associated with BSE. Depression and simultaneous use of formula in feeding the infant was negatively associated with BSE during Covid-19. Overall, breastfeeding can be encouraged through counseling to improve receiving spousal support, increasing breastfeeding intent, and reducing depression.     

Impact of the coronavirus disease 2019 pandemic on critical care healthcare workers' depression,anxiety, and stress levels

AimThe aim of the study was to determine levels of depression, anxiety, and stress symptoms and factors associated with psychological burden amongst critical care healthcare workers in the early stages of the coronavirus disease 2019 pandemic.MethodsAn anonymous Web-based survey distributed in April 2020. All healthcare workers employed in a critical care setting were eligible to participate. Invitations to the survey were distributed through Australian and New Zealand critical care societies and social media platforms. The primary outcome was the proportion of healthcare workers who reported moderate to extremely severe scores on the Depression, Anxiety, and Stress Scale-21 (DASS-21).ResultsOf the 3770 complete responses, 3039 (80.6%) were from Australia. A total of 2871 respondents (76.2%) were women; the median age was 41 years. Nurses made up 2269 (60.2%) of respondents, with most (2029 [53.8%]) working in intensive care units. Overall, 813 (21.6%) respondents reported moderate to extremely severe depression, 1078 (28.6%) reported moderate to extremely severe anxiety, and 1057 (28.0%) reported moderate to extremely severe stress scores. Mean ± standard deviation values of DASS-21 depression, anxiety, and stress scores amongst woman vs men was as follows: 8.0 ± 8.2 vs 7.1 ± 8.2 (p = 0.003), 7.2 ± 7.5 vs 5.0 ± 6.7 (p < 0.001), and 14.4 ± 9.6 vs 12.5 ± 9.4 (p < 0.001), respectively. After adjusting for significant confounders, clinical concerns associated with higher DASS-21 scores included not being clinically prepared (β = 4.2, p < 0.001), an inadequate workforce (β = 2.4, p = 0.001), having to triage patients owing to lack of beds and/or equipment (β = 2.6, p = 0.001), virus transmission to friends and family (β = 2.1, p = 0.009), contracting coronavirus disease 2019 (β = 2.8, p = 0.011), being responsible for other staff members (β = 3.1, p < 0.001), and being asked to work in an area that was not in the respondents' expertise (β = 5.7, p < 0.001).ConclusionIn this survey of critical care healthcare workers, between 22 and 29% of respondents reported moderate to extremely severe depression, anxiety, and stress symptoms, with women reporting higher scores than men. Although female gender appears to play a role, modifiable factors also contribute to psychological burden and should be studied further.     

新冠疫情常态化防控期精神科医务人员睡眠情况调查及其影响因素分析

目的:了解新型冠状病毒肺炎疫情常态化防控期,精神科医护人员睡眠状况及其影响因素.方法:选取228例精神科医护人员,采用一般情况调查表、匹兹堡睡眠质量量表(PSQI)、抑郁自评量表(SDS)和焦虑自评量表(SAS)进行调查,使用非条件二分类Logistic回归分析其影响因素.结果:228例医护人员中,睡眠质量问题发生率为...     

Factor Analysis of the Pittsburgh Sleep Quality Index in Breast Cancer Survivors

ContextSleep is a significant problem in breast cancer survivors (BCS) and measured frequently using the Pittsburgh Sleep Quality Index (PSQI). Thus, it is important to evaluate its factor structure. The two-process model of sleep regulation was the theoretical framework for this study.ObjectivesTo perform a confirmatory factor analysis of the PSQI in BCS and compare results between African-American and Caucasian BCS.MethodsThis was a secondary analysis of cross-sectional data using local and regional health care facilities and Eastern Cooperative Oncology Group referrals. The study included 1174 nondepressed BCS (90% Caucasian), with a mean age of 57 years and median PSQI global scores at the cutoff for poor sleep (median = 6.00, interquartile range = 4.00–9.00). Measurements included self-reported demographics, medical history, depression, and sleep.ResultsAcceptable fit was not reached for the traditional one-factor model that would be consistent with current PSQI scoring or for alternative models in the published literature from other populations. A new two-factor model (i.e., sleep efficiency and perceived sleep quality) best fit the data but nested-model comparisons by race showed different relationships by race for 1) sleep quality-sleep latency and 2) sleep efficiency-sleep quality.ConclusionResults were inconsistent with current PSQI scoring that assumes a single global factor and with previously published literature. Although a new two-factor model best fit the data, further quantitative and qualitative analyses are warranted to validate our results in other populations before revising PSQI scoring recommendations. Additional recommendations are described for research.     

Coronavirus disease 2019 crisis in Paris: A differential psychological impact between regular intensive care unit staff members and reinforcement workers

BackgroundIntensive care unit (ICU) healthcare workers (HCWs) are at the forefront of the coronavirus disease 2019 pandemic. To overcome the lack of human resources during this crisis, some ICUs had to mobilise staff from a reinforcement pool, with no or outdated ICU experience. This study aimed to investigate and to compare the psychological impact of the pandemic on regular ICU staff members and reinforcement workers.Material and methodsSelf-assessment questionnaires were completed by HCWs who worked from March 1 to April 30, 2020, in our 16-bed neurological ICU at La Pitié-Salpêtrière Hospital in Paris, France, which was converted to a COVID ICU. The Hospital Anxiety and Depression Scale, the Post-traumatic Stress Disorder Checklist for DSM-5, McGill Quality of Life Questionnaire-Revised, and 10-item Connor-Davidson Resilience Scale were used to assess anxiety, depression and post-traumatic stress disorder, quality of life, and resilience, respectively.ResultsSixty-nine ICU HCWs completed the survey (37 from the team of regular staff members, i.e., from the public health service, and 32 from a reinforcement pool, either from non-ICU public health service or from private healthcare interim employment agencies). Prevalence of anxiety, depression, and post-traumatic stress disorder symptoms was high, at 19%, 9%, and 16%, respectively, with limited impairment in quality of life or resilience scores. Depression symptoms were observed more in regular staff members than in welcomed reinforcement workers, at 16% and 0%, respectively.ConclusionsThese results revealed that during the pandemic, HCWs from the team of regular staff members were at greater risk of developing psychological disorder compared with reinforcement workers, with higher levels of depressive symptoms.     

矛盾意向训练在老年OSAS患者中的应用效果

目的探讨矛盾意向训练对老年OSAS患者睡眠质量、负性情绪及生活质量的影响。方法采用便利抽样法纳入2018年3月—2020年2月郑州大学第一附属医院收治的老年OSAS患者130例,随机分为对照组和观察组,每组65例。对照组实施常规护理干预,观察组基于常规护理干预前提下实施矛盾意向训练。干预前后采用匹兹堡睡眠质量指数(PSQI)、医院用焦虑抑郁量表(HADS)、Calgary睡眠呼吸暂停生活质量指数(SAQLI)比较两组睡眠质量、心理状况及生活质量。结果干预1周后,观察组患者PSQI评分(7.08±2.70)分、焦虑亚量表(HADS-A)评分(6.25±1.20)分、抑郁亚量表(HADS-D)评分(6.34±1.24)分,均低于对照组,差异有统计学意义(t值分别为4.871、9.439、8.754;P<0.01)。干预后,观察组患者SAQLI总分(4.87±0.35)分,对照组(4.22±0.25)分,差异有统计学意义(t=12.184,P<0.01)。结论矛盾意向训练有助于提升老年OSAS患者睡眠质量,改善心理状况,提高生活质量。     

Changes in health and sleep quality after anti-retroviral treatment modification in Japanese people living with HIV

BackgroundAnti-retroviral treatment (ART) modification for treatment simplification is performed in virologically controlled people living with Human Immunodeficiency Virus (PLWH). However, studies on the impact of these stable treatment modifications on health-related quality of life (HRQoL) measured using patient-reported outcomes (PROs) in clinical practice are scarce; this was the focus of this study.MethodsPLWH who visited Teikyo University Hospital between October 2019 and March 2021, and whose ART was changed to a newly recommended single-tablet regimen for treatment simplification, were included in the study. HRQoL and sleep quality were evaluated using the Short-Form (SF) 8 and Pittsburgh Sleep Quality Index (PSQI) global score, respectively, at two time points: before and after treatment modification. Comorbidities, duration of Human Immunodeficiency Virus diagnosis, ART initiation, ART regimens, and blood test data before and after treatment were assessed. The SF-8 was used to calculate the physical component summary (PCS) and mental component summary (MCS) scores.ResultsForty-nine patients (all male) were included into the study. There was no change in the PCS score before and after ART modification. The MCS score significantly improved from 48.50 ± 6.56 to 50.76 ± 4.37 (p = 0.0159). Thirteen patients' ARTs were changed to dolutegravir/lamivudine. Their HRQoL and sleep quality changes were further analyzed. Their MCS and PSQI scores had improved significantly. Thirty patients’ ARTs were changed to bictegravir/tenofovir alafenamide/emtricitabine; however, there were no significant changes in their HRQoL or PSQI score.ConclusionART modification for treatment simplification based on PROs may improve the HRQoL of PLWH.     

65～80岁老年患者睡眠质量与心理状况的相关性研究

目的 调查老年住院患者心理健康状况和睡眠质量情况,分析二者的相瓦关系.方法 纳入2005年10月-2007年10月在哈尔滨医科大学附属第四医院老年住院患者300例.采用匹兹堡睡眠质量评价老年住院患者的睡眠质量,以匹兹堡睡眠质量指数>8分作为睡眠障碍的标准,将300例患者按匹兹堡睡眠质量指数<5分,5～8分,>8分为3组.分别为70例、84例、146例;采用心理卫生自评量表(90项症状自评量表)评价患者心理状况.测试前向患者说明调查目的及意义,要求患者在1～2 h内独立完成答卷,各组间心理卫生自评量表得分比较采用方差分析,匹兹堡睡眠质量指数和心理卫生自评量表得分的相关性分析采用Spearman等级相关分析.结果 按意向处理分析,300例患者全部进入结果分析.(1)匹兹堡睡眠质量指数>8分的患者症状自评量表中躯体化、强迫、抑郁、焦虑、精神病性5个因子及总均分显著高于5～8分和<5分的患者,且匹兹堡睡眠质量指数得分越高,症状自评量表各因子及总得分越高.(2)症状自评量表躯体化、强迫、抑郁、焦虑、精神病性5个因子及总分与睡眠质昔呈显著正相关,其中其他、躯体化、强迫、3个因子与睡眠质量、入睡时间、睡眠时间、睡眠效率呈现非常显著正相关,郁抑郁、焦虑、和症状自评量表与睡眠效率呈显著正相关.结论 老年住院患者睡眠质量越差.焦虑分和抑郁分就愈高,呈显著正相关,并且促使焦虑,抑郁等多种情绪障碍的发生.说明住院老年人失眠不单单是一个睡眠生理紊乱,同时还有一个心理紊乱过程.     

The impact of the first COVID-19 surge on the mental well-being of ICU nurses: A nationwide survey study

ObjectivesTo determine the impact of the first COVID-19 surge (March through June 2020) on mental well-being and associated risk factors among intensive care unit nurses.Research methodologyIn September 2020, a nationwide cross-sectional survey study among Dutch intensive care nurses was carried out to measure prevalence rates of symptoms of anxiety, depression, posttraumatic stress disorder, and need for recovery (NFR), objectified by the HADS-A, HADS-D, IES-6 and NFR questionnaires, respectively. Associated risk factors were determined using multivariate logistic regression analyses.ResultsSymptoms of anxiety, depression, and post traumatic stress disorder were reported by 27.0%, 18.6% and 22.2% of the 726 respondents, respectively. The NFR was positive, meaning not being recovered from work, in 41.7%. Working in an academic hospital, being afraid of infecting relatives and experiencing insufficient numbers of colleagues were associated with more mental symptoms, while having been on holiday was associated with reduced depression symptoms and need for recovery.ConclusionThe first COVID-19 surge had a high impact on the mental well-being of intensive care nurses, increasing the risk for drop out and jeopardising the continuity of care. Effort should be made to optimize working conditions and decrease workload to guarantee care in the next months of the COVID-19 pandemic.     

Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep

Our goal was to evaluate pain severity, pain-related interference with function, sleep impairment, symptom levels of anxiety and depression, and quality of life among patients with painful diabetic peripheral neuropathy (DPN). Participants in a burden of illness survey (n = 255) completed the modified Brief Pain Inventory-DPN (BPI-DPN), MOS Sleep Scale, Hospital Anxiety and Depression Scale (HADS), Short Form Health Survey-12v2 (SF-12v2), and the EuroQoL (EQ-5D). Patients were 61 +/- 12.8 years old (51.4% female), had diabetes for 12 +/- 10.3 years and painful DPN for 6.4 +/- 6.4 years. Average and Worst Pain scores (BPI-DPN, 0-10 scales) were 5.0 +/- 2.5 and 5.6 +/- 2.8. Pain substantially interfered (>or=4 on 0-10 scales) with walking ability, normal work, sleep, enjoyment of life, mood, and general activity. Moderate to severe symptom levels of anxiety and depression (HADS-A and HADS-D scores >or=11 on 0-21 scales) occurred in 35% and 28% of patients, respectively. Patients reported greater sleep problems compared with the general U.S. population and significant impairment in both physical and mental functioning (SF-12v2) compared with subjects with diabetes. The mean EQ-5D utility score was 0.5 +/- 0.3. Greater pain levels in DPN (mild to moderate to severe) corresponded with higher symptom levels of anxiety and depression, more sleep problems, and lower utility ratings and physical and mental functioning, (all Ps < 0.01). Painful DPN is associated with decrements in many aspects of patients' lives: physical and emotional functioning, affective symptoms, and sleep problems. The negative impact is higher in patients with greater pain severity.     

Effects of kettlebell training and detraining on mood status and sleep and life quality of healthy women

Background and purposeKettlebell exercise have become popular because of its ability to simultaneously train aerobic/anaerobic systems, low cost and easy access, and the great potential for physical fitness programs with a focus on public health. However, little is known about its effects on mood status, sleep, and quality of life (QOL) parameters. The aim of the present study was to examine the effects of kettlebell training/detraining on the prevention of depressive and anxiety symptoms and QOL and sleep quality.MethodsThe sample was composed of 17 healthy women (age: 26.0 ± 5.0 years; body mass: 60.9 ± 12.5 kg; height: 164.6 ± 5.5 cm). The study was organized into four consecutive phases: pre-intervention (PRE), intervention (kettlebell training, 12 weeks, three times/week), post-intervention (POST) and detraining (D, four weeks). The questionnaires SF-36 (QOL), Beck (depressive symptoms), State-Anxiety Inventory (acute anxiety symptoms), POMS (mood state) and the Pittsburgh Sleep Quality Index (sleep quality) were administered at PRE/POST/D phases.ResultsQOL, anxiety, sleep quality, and mood state exhibited no differences between PRE/POST/D. Levels of depressive symptoms significantly decreased (22.0%, p = 0.003) between PRE and POST phases, and remained low and similar to POST levels after D.ConclusionTwelve weeks of kettlebell training was able to reduce and prevent depressive/anxiety symptoms in healthy women and these results were maintained after short-term detraining. Thus, kettlebell training might be considered an alternative method on the promotion of mental health and prevention of mood disorders and consequently can improve QOL even in health people.     

Tailored educational supportive care programme on sleep quality and psychological distress in patients with heart failure: A randomised controlled trial

BackgroundUp to 74% of patients with heart failure report poor sleep in Taiwan. Poor symptom management or sleep hygiene may affect patients’ sleep quality. An effective educational programme was important to improve patients’ sleep quality and psychological distress. However, research related to sleep disturbance in patients with heart failure is limited in Taiwan.ObjectivesTo examine the effects of a tailored educational supportive care programme on sleep disturbance and psychological distress in patients with heart failure.Designrandomised controlled trial.Participants and settingEighty-four patients with heart failure were recruited from an outpatient department of a medical centre in Taipei, Taiwan. Patients were randomly assigned to the intervention group (n = 43) or the control group (n = 41).MethodsPatients in the intervention group received a 12-week tailored educational supportive care programme including individualised education on sleep hygiene, self-care, emotional support through a monthly nursing visit at home, and telephone follow-up counselling every 2 weeks. The control group received routine nursing care. Data were collected at baseline, the 4th, 8th, and 12th weeks after patients’ enrollment. Outcome measures included sleep quality, daytime sleepiness, anxiety, and depression.ResultsThe intervention group exhibited significant improvement in the level of sleep quality and daytime sleepiness after 12 weeks of the supportive nursing care programme, whereas the control group exhibited no significant differences. Anxiety and depression scores were increased significantly in the control group at the 12th week (p < .001). However, anxiety and depression scores in the intervention group remained unchanged after 12 weeks of the supportive nursing care programme (p > .05). Compared with the control group, the intervention group had significantly greater improvement in sleep quality (β = −2.22, p < .001), daytime sleepiness (β = −4.23, p < .001), anxiety (β = −1.94, p < .001), and depression (β = −3.05, p < .001) after 12 weeks of the intervention.ConclusionThis study confirmed that a supportive nursing care programme could effectively improve sleep quality and psychological distress in patients with heart failure. We suggested that this supportive nursing care programme should be applied to clinical practice in cardiovascular nursing.     

Are there gender differences in affective disturbance in schizophrenia?

There have been few investigations conducted into the relationship of gender to affective disturbance in clients with a primary diagnosis of schizophrenia. The current study sought to determine if there was a significant difference between male and female clients in this clinical group (N = 100) on self-report measures of anxiety and depression. No significant gender differences were observed on Hospital Anxiety and Depression Scale (HADS) scores; effect sizes were, however, small. Gender differences were observed in the proportion of clients classified as possible cases on HADS anxiety (HADS-A) and depression (HADS-D) sub-scale scores. Further research is recommended to investigate the role of gender in the presentation of affective disturbance in this often neglected and socially marginalised clinical group.