Effects of single session music therapy on hospitalized patients recovering from a bone marrow transplant: Two studies

The purpose of these studies was to determine the effects of single session music therapy on inpatients in an adult bone marrow transplant unit. In Study 1, the researchers examined the effects of patient-preferred live music on anxiety, nausea, fatigue, pain, and relaxation for hospitalized patients (N = 50) recovering from a bone marrow transplant utilizing a pretest, posttest, and follow-up design with Likert-Type Scales. In Study 2, the researchers utilized a randomized controlled trial with pre and posttests to determine how music therapy might effect fatigue (N = 18). In Study 1, results were significant for relaxation, anxiety, and fatigue from pre to posttest. Although ratings tended to worsen slightly from posttest to follow-up, follow-up measurements maintained an improvement when compared with pretest scores. Results of Study 2 indicated no significant differences between- or within-group differences concerning fatigue. However, analyses of mean fatigue data indicated a slight decrease from pre to posttest for experimental participants and a slight increase from pre to posttest for control participants. Results of both studies indicate that a single music therapy session can have a positive effect on inpatients recovering from bone marrow transplants. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.     

ICU患者替代决策者决策疲劳现状及影响因素分析

目的 调查ICU患者替代决策者决策疲劳现状并分析其影响因素。方法 采用便利抽样法,2022年1月—10月,选取山东省某三级甲等医院314名ICU患者的替代决策者为调查对象。使用一般资料调查表、决策疲劳量表、决策准备量表、家庭成员决策自我效能量表、社会支持评定量表进行调查。结果 ICU患者的替代决策者决策疲劳量表得分为（12.33±4.88）分。多重线性回归分析结果显示,患者入住ICU天数、家庭人均月收入、替代决策者性别、文化程度、职业状态、是否了解该疾病、决策准备度、决策自我效能及主观支持是决策疲劳的影响因素。结论 ICU患者替代决策者决策疲劳处于中等水平;患者入住ICU天数较长、家庭人均月收入低、女性、文化程度高、在职、不了解该疾病的替代决策者的决策疲劳水平较高,提高决策准备度、决策自我效能感及主观支持水平有利于减轻替代决策者决策疲劳,改善其决策质量。     

造血干细胞移植患者疲乏管理的最佳证据总结

目的 检索、评价并总结国内外关于造血干细胞移植患者疲乏管理的最佳证据,为临床开展相关循证护理实践提供参考。方法 系统检索国内外计算机决策支持系统、指南网站、数据库、相关专业协会网站中关于造血干细胞移植患者疲乏管理的证据,包括指南、临床决策、推荐实践、证据总结、系统评价及专家共识。检索时间为建库至2022年2月10日。由2名研究者独立对文献质量进行评价,并结合专业判断进行资料提取、整合。结果 共纳入24篇文献,其中指南4篇、专家共识1篇、证据总结2篇、系统评价17篇。总结的最佳证据包括疲乏的评估、运动管理、心理社会干预、健康教育、营养管理、补充和替代疗法、合理用药、共同决策和多学科合作8个方面,共24条。结论 临床护理人员需要重视造血干细胞移植患者的疲乏管理,应根据临床实际情况和患者意愿,以规范、有效、安全的方式管理疲乏,以改善其预后和生活质量。     

某区军人疲劳状况及影响因素

目的调查南方某区部队军人的疲劳状况及影响因素,为评估官兵疲劳和采取干预措施提供参考。方法采用疲劳量表(Fatigue Scale-14,FS-14)、症状自评量表(symptoms checklist-90,SCL-90)和匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)对某区6580名军人进行调查。结果该区军人的体力疲劳、脑力疲劳得分和疲劳总分分别为3.79±2.38、2.00±1.58、5.76±3.33,明显高于国内健康人群(3.71±2.29,1.79±1.47,5.50±3.09),差异有显著性(P0.01);但是他们的体力疲劳、脑力疲劳得分和疲劳总分明显低于海军官兵和医护人员,差异具有统计学意义(P0.01);这些军人的体力疲劳、脑力疲劳得分和疲劳总分与SCL-90各项因子分值及睡眠指数、睡眠质量、入睡时间、睡眠时间、睡眠障碍、睡眠药物、日间功能障碍分值呈显著正相关(P0.01)。结论该区军人疲劳状况与心理健康及睡眠状况密切相关,因此改善官兵疲劳状况时,应注意缓解训练压力和改善生活环境,并结合心理健康教育、心理干预和睡眠干预。     

不同地区助产士共情疲劳现状及其影响因素的研究

目的 调查中国东部、中部、西部地区不同级别医院助产士共情疲劳现状并分析其影响因素。 方法 采用随机抽样法抽取中国东部、中部、西部地区中的12个省份,便利抽取52所不同级别医院,并采用目的抽样法根据纳入排除标准抽取助产士作为研究对象,采用一般资料问卷、共情疲劳量表及社会支持评定量表进行横断面调查,通过多水平统计模型分析助产士共情疲劳的影响因素。 结果 共回收489份问卷,有效问卷477份,有效回收率为97.8%。调查对象共情疲劳各维度得分为共情满意（31.64±6.47）分、职业倦怠（27.87±5.01）分、继发性创伤应激（26.21±5.70）分,其中82.6%的助产士为中度及以上共情疲劳,社会支持水平总得分（37.93±6.44）分,多水平Logistic回归分析结果显示,医院级别、子女情况、地区、是否喜欢工作氛围、经历分娩创伤事件次数、睡眠质量、社会支持程度对助产士共情疲劳程度有影响（P<0.05）。 结论 助产士的共情疲劳程度较重,社会支持水平低、睡眠质量差、工作氛围不和谐、离异或有婴幼儿的助产士共情疲劳程度较严重,西部地区及二级、三级医院助产士共情疲劳程度较重,护理管理者应根据其影响因素,采取有效措施,降低助产士共情疲劳发生率和程度。     

Experimental characterisation for micromechanical modelling of CoCr stent fatigue

Fatigue of CoCr alloy stents has become a major concern in recent times, owing to cases of premature fracture, often driven by microstructural phenomena. This work presents the development of a micromechanical framework for fatigue design, based on experimental characterisation of a biomedical grade CoCr alloy, including both microscopy and mechanical testing. Fatigue indicator parameters (FIPs) within the micromechanical framework are calibrated for the prediction of microstructure-sensitive fatigue crack initiation (FCI). A multi-scale CoCr stent model is developed, including a 3D global J₂ continuum stent-artery model and a 2D micromechanical sub-model. Several microstructure realizations for the stent sub-model allow assessment of the effect of crystallographic orientations on stent fatigue crack initiation predictions. Predictions of FCI are compared with traditional Basquin-Goodman total life predictions, revealing more realistic scatter of data for the microstructure-based FIP approach. Comparison of stent predictions with performance of a 316L stent for the same generic design exposes the design as over-conservative for the CoCr alloy. In response, the micromechanical framework is used to modify the stent design for the CoCr alloy, improving design efficiency.     

Fatigue in Peritoneal Dialysis Patients and an Exploration of Contributing Factors: A Cross-Sectional Study

ContextFatigue is a common and detrimental symptom in dialysis patients; however, our understanding of it and investigation of its contributing factors is still very limited, especially in peritoneal dialysis (PD) patients.ObjectivesTo assess fatigue in PD patients and identify contributing factors.MethodsOne hundred eight PD patients in a comprehensive hospital in China were recruited. The fatigue severity of the participants was assessed using the Chalder Fatigue Scale 11. Demographic factors and results of physiological tests were collected. Quality of sleep, mental health, and social support were assessed with the Pittsburgh Sleep Quality Index, Symptom Checklist 90, and Social Support Rating Scale, respectively. Multiple linear regression models were conducted with candidate variables with a P-value of less than 0.1 on univariate analysis and variables that were clinically relevant to identify contributing factors for fatigue.ResultsThe fatigue level in PD patients was significantly higher than the community population, and 78.7% of them were suffering from fatigue. The factors that were significantly associated with fatigue were quality of sleep, normalized protein nitrogen appearance, transferrin, alkaline phosphatase, and total cholesterol (adjusted R squared 0.86). Among them, quality of sleep, transferrin, alkaline phosphatase, and total cholesterol were significant contributors for physical fatigue, whereas the quality of sleep and normalized protein nitrogen appearance were contributing factors for mental fatigue.ConclusionFatigue is a common symptom in PD patients, suggesting that increased awareness of this symptom is required. The identification of correlates by extensive exploration of multidimensional factors in this study may help practitioners to identify patients at higher risk and to develop a multidimensional and targeted intervention plan.     

Effects of vibration therapy on neuromuscular efficiency & features of the EMG signal based on endurance test

BackgroundVibration Therapy (VT) stimulate the muscle spindles, which in turn enhances its afferent activities.ObjectiveThe present study was designed to investigate the effect of VT at 23 and 35 Hz on muscle performance. The EMG features (six time-domain (TD) and four frequency-domain (FD)) and a new formula for computing neuromuscular performance were used as dependent variables to evaluate the effect of VT.MethodThe EMG recording was performed at 50% MVC during grip endurance test before and after VT. The EMG features were extracted out of raw EMG signals acquired from four forearm muscles, viz., flexor digitorum superficialis (FDS); flexor carpi ulnaris (FCU); extensor carpi radialis brevis (ECRB); and extensor carpi ulnaris (ECU) in supine position. Fatigue assessments were evaluated based on the pattern of TD and FD features.ResultsStatistical analysis showed a significant difference in the effect of vibration exposure frequency on IEMG (p < 0.001), MAV (p = 0.041), SSI (p = 0.032), and WL (p < 0.001) of FCU muscle. In addition, the greatest increase in neuromuscular efficiency (NME) was observed in the performance of ECRB after 35 Hz of VT and ECU muscles after 23 Hz of VT.ConclusionsThe features of EMG signals could be used for fatigue analysis. However, the slope based on the median frequency regression line may be the best feature for fatigue assessment.     

Feasibility and preliminary efficacy of a hypopressive exercise program on postmenopausal cancer survivors: A pilot study

BackgroundCancer-related fatigue (CRF) is a common symptom during and after cancer treatment that negatively affects the patient's quality of life. Exercise is one of the most effective non-pharmacological treatments for CRF. Multimodal exercise therapy programs that include hypopressive exercises, relaxation and myofascial release may be beneficial for CRF. The aim of this pilot study was to evaluate the feasibility and efficacy of a multimodal program on CRF and lower limb functional strength in postmenopausal women diagnosed with cancer.Methods7 postmenopausal women (age = 55.28 years; BMI = 26.05 kg/m2) who had a cancer diagnosis participated in a supervised and progressive 55-min class once per week for 12-weeks. CRF was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer Related Fatigue 12 and lower limb strength was assessed with the sit and stand test.ResultsNo adverse events were reported during the training period and all participants completed the exercise protocol. There was a significant increase (p = 0.01) in lower limb functional strength (pre: 19.60 (SD = 2.19) vs post: 24.60(SD = 2.19)) with an effect size of d = 2.28 and a decrease in CRF (p = 0.245) (pre: 29.36 ± 24.42; post: 17.85 ± 14.23) with a trivial effect size (d < 0.5).ConclusionsThese preliminary findings indicate that a supervised once per week multimodal program that includes hypopressive exercises for postmenopausal cancer survivors increased lower limb functional strength without exacerbating their CRF. These findings support further randomized trials of hypopressive training programs on patients with cancer.