Development and Testing of a Computerized Pain Body Map in Patients With Advanced Cancer

ContextPain localization is an important part of pain assessment. Development of pain tools for self-report should include expert and patient input, and patient testing in large samples.ObjectivesTo develop a computerized pain body map (CPBM) for use in patients with advanced cancer.MethodsThree studies were conducted: 1) an international expert survey and a pilot study guiding the contents and layout of the CPBM, 2) clinical testing in an international symptom assessment study in eight countries and 17 centers (N = 533), and 3) comparing patient pain markings on computer and paper body maps (N = 92).ResultsStudy 1: 22 pain experts and 28 patients participated. A CPBM with anterior and posterior whole body views was developed for marking pain locations, supplemented by pain intensity ratings for each location. Study 2: 533 patients (286 male, 247 female, mean age 62 years) participated; 80% received pain medication and 81% had metastatic disease. Eighty-five percent completed CPBM as intended. Mean ± SD number of marked pain locations was 1.8 ± 1.2. Aberrant markings (15%) were mostly related to software problems. No differences were found regarding age, gender, cognitive/physical performance, or previous computer experience. Study 3: 70% of the patients had identical markings on the computer and paper maps. Only four patients had completely different markings on the two maps.ConclusionThis first version of CPBM was well accepted by patients with advanced cancer. However, several areas for improvement were revealed, providing a basis for the development of the next version, which is subject to further international testing.     

Excessive daytime sleepiness in temporomandibular disorder patients

ABSTRACT

Objective: To investigate the relationship between excessive daytime sleepiness (EDS) and associated factors in temporomandibular disorder (TMD) patients.

Methods: Medical records of 350 TMD patients were collected. The EDS status was measured by Epworth Sleepiness Scale (ESS). TMD patients were classified according to ESS scores into TMD patients with EDS (ESS ≥10) and without EDS (ESS <10). The relationship between EDS status and associated factors, such as demographic, TMD symptom severity, and psychological status was analyzed using chi-square and t-test. The level of statistical significance was set at 0.05.

Results: Approximately 28.57% of TMD patients presented with EDS. These patients possessed a significantly higher level of TMD symptom severity, stress, anxiety, and depression, compared to TMD patients without EDS.

Discussion: TMD patients with EDS distinctively suffer both physically and psychologically. This warrants further investigation for the causes and effects as well as underlying mechanisms of EDS in TMD.     

热敏灸治疗脾胃虚弱型糖尿病胃轻瘫疗效观察

目的:观察热敏灸治疗脾胃虚弱型糖尿病胃轻瘫的疗效及相关机制。方法:将70例脾胃虚弱型糖尿病胃轻瘫患者随机分为对照组和观察组各35例。对照组予多潘立酮片,观察组在此基础上予热敏灸治疗,疗程为1个月。治疗前后测定胃轻瘫症状严重指数量表(GCSI)评分、胃排空率,测定患者静脉血血红素加氧酶-1(HO-1)、胰岛素样生长因子-1(IGF-1)水平,于治疗结束后进行疗效评价。结果:观察组总有效率明显高于对照组(P<0.05);治疗后,两组早饱、恶心呕吐、腹胀评分及GCSI总分明显降低(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组胃排空率均明显提升,观察组胃排空率明显高于对照组(P<0.05);观察组HO-1、IGF-1水平在治疗后明显升高,且与对照组有统计学差异(P<0.05)。结论:热敏灸治疗脾胃虚弱型糖尿病胃轻瘫疗效确切,能显著降低GCSI量表评分,改善胃排空率,这可能与其纠正HO-1、IGF-1水平相关。     

服刑病犯应激性/心因性精神障碍状况分析与心理干预

目的：探讨服刑期间病区病犯应激性／心因性精神障碍的发病因素及相应对策。方法选取我院服刑人员病区病犯106例，采用症状自评量表（SCL‐90）进行心理测试，与国内常模进行比较分析。应用（SCL‐90）对服刑病犯人员进行心理干预前后效果比较。结果服刑病犯10个心理症状情况因子测试结果均高于国内常模为心理健康状态障碍，P＜0．01。心理干预后，取得了较好的疗效（ P＜0．05或 P＜0．01）。结论服刑期间病犯存在应激性／心因性精神障碍因素，应根据病犯的四大心理特点给予相应的矫治对策，重塑健全人格。     

妊娠早期症状与经前期症状之间的相关性分析

目的通过对妊娠早期症状与经前期症状之间的相关性分析,评估经前期症状对妊娠早期症状的预测价值。方法对2014年9~12月在郑州大学第一附属医院产科就诊的305例妊娠期妇女进行问卷调查,采用配对t检验对经前期症状和妊娠早期症状进行差异性分析,分别采用简单线性回归模型、多重线性回归模型对经前期症状与妊娠早期症状进行相关性分析。结果妊娠早期症状出现的频数及严重程度与经前期症状比较,差异均有统计学意义(t=6.9、t=6.7,P0.001);妊娠早期与经前期各症状平均严重程度之间存在大量的相关性;妊娠早期症状的总体严重程度与经前期症状的总体严重程度呈显著性相关(b=0.4,95%CI=0.3~0.5,P0.001)。结论妊娠早期与经前期具有相似的症状模式,妊娠早期出现的某一精神心理症状可通过经前期症状预测,经前期易怒症状的严重程度是预测妊娠早期症状总体严重程度的最佳指标。     

Longitudinal association between neighborhood cohesion and depressive mood in old age: A Japanese prospective study

Despite increasing evidence of the relationship between neighborhood cohesion and depressive mood, little is known about this longitudinal association in old age. This study examined the association between perceived neighborhood cohesion and depressive mood and the stress-buffering effect of perceived neighborhood cohesion on depressive mood among older Japanese people using the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study datasets. We analyzed 655 participants aged 65–84 at baseline. Although perceived neighborhood cohesion at baseline was not associated with depressive mood at follow-up, high neighborhood cohesion partially offset the deleterious effect of anticipated daily stressors on depressive mood. This effect was stronger for long-term residents of the neighborhood. Interventions to strengthen neighborhood cohesion may help reduce the deleterious effect of stressors on older residents’ depressive mood.     

Web-Based Symptom Management for Women With Recurrent Ovarian Cancer: A Pilot Randomized Controlled Trial of the WRITE Symptoms Intervention

ContextLittle research has focused on symptom management among women with ovarian cancer. Written Representational Intervention To Ease Symptoms (WRITE Symptoms) is an educational intervention delivered through asynchronous web-based message boards between a study participant and a nurse.ObjectivesWe evaluated WRITE Symptoms for 1) feasibility of conducting the study via message boards, 2) system usability, 3) participant satisfaction, and 4) initial efficacy.MethodsParticipants were 65 women (mean age, 56.5; SD = 9.23) with recurrent ovarian cancer randomized using minimization with race/ethnicity (non-Hispanic white vs. minority) as the stratification factor. Measures were obtained at baseline and two and six weeks after intervention. Outcomes were feasibility of conducting the study, system usability, participant satisfaction, and efficacy (symptom severity, distress, consequences, and controllability).ResultsFifty-six (87.5%) participants were retained, and the mean usability score (range 1–7) was 6.18 (SD = 1.29). All satisfaction items were scored at 5 (of 7) or higher. There were significant between-group effects at T2 for symptom distress, with those in the WRITE Symptoms group reporting lower distress than those in the control group [t(88.4) = −2.57; P = 0.012], with a similar trend for symptom severity [t(40.4) = −1.95; P = 0.058]. Repeated measures analysis also supported a group effect, with those in the WRITE Symptoms group reporting lower symptom distress than those in the control condition [F(1, 56.7) = 4.59; P = 0.037].ConclusionParticipants found the intervention and assessment system easy to use and had high levels of satisfaction. Initial efficacy was supported by decreases in symptom severity and distress.