scholarly journals Evaluating the feasibility and effectiveness of a mindfulness-based intervention on stress and anxiety of family caregivers managing peritoneal dialysis

2021 ◽  
pp. 201010582110549
Author(s):  
Fazila Aloweni ◽  
Kinjal Doshi ◽  
Nurliyana Agus ◽  
Stephanie Fook-Chong ◽  
Sin Yan Wu ◽  
...  

Background Mindfulness-based intervention (MBI) has not been evaluated for its feasibility and effectiveness in reducing stress and anxiety among family caregivers of patients on peritoneal dialysis (PD). Objectives (1) To evaluate the feasibility to include MBI during PD training for family caregivers. (2) To determine the effect of MBI on the caregivers’ levels of stress (perceived stress scale, PSS), anxiety state-trait anxiety inventory, STAI), QOL (short-form 36) and reactions to caregiving (caregiver reaction assessment, CRA). (3) To determine differences in the health-related QOL (Kidney Disease Quality of Life Instrument-Short Form, KDQOL PCS and SF-36 MCS) of care recipients with caregivers receiving MBI at 1 month, 3 months and 6 months when compared to those with caregivers receiving routine training. (4) To gather the caregiver’s feedback on the MBI. Methods This feasibility study recruited family caregivers to receive either mindfulness training (MT) or treatment-as-usual (TAU) group. Both groups received 4.5-days of structured PD training, but only caregivers in the MT group received 4 days of MT sessions, audio-guided mindfulness practice at home and weekly telephone follow-up. Results Forty-four family caregivers participated in this study. Including MBI as part of the PD training was feasible. There was a trend towards lower scores for PSS and T-STAI in the MT group compared to the TAU group. The baseline score of both PSS and T-STAI were positively correlated with post-intervention outcome scores. Conclusions Mindfulness-based intervention has the potential to improve psychological symptoms among caregivers of patients with PD.

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 200-205 ◽  
Author(s):  
Setsuko Shimoyama ◽  
Orie Hirakawa ◽  
Keiko Yahiro ◽  
Toshimi Mizumachi ◽  
Andrea Schreiner ◽  
...  

Objective Recent studies have found that patients with chronic renal failure suffer from depression and other symptoms of decreased mental health. However, little is know about caregiver burden and mental health among patients’ families. In the present study, we examined the relationship in Japan between peritoneal dialysis (PD) patients and caregivers with regard to health-related quality of life (HRQOL) and caregiver burden. Method In March of 2002, we recruited 60 subjects—26 patients on continuous ambulatory peritoneal dialysis (CAPD), and 34 caregivers—from a PD patient support group in southern Japan. We used the Kidney Disease Quality of Life Short Form (KDQOL-SF) and the Medical Outcomes Study Short Form 36 (SF-36) to measure HRQOL. We used the Zarit Burden Interview (ZBI) to measure caregiver burden. Data was also collected on each patient's duration of illness, treatment modality, age, sex, and medical history. All data were collected by mail surveys. Results Mean age of the PD patients was 48.2; mean age of the caregivers was 46.6. Mean caregiver burden on the ZBI was 14.1, which is considerably lower than that reported among caregivers for patients with dementia or stroke. Caregivers and patients both rated their general health and vitality among the lowest of the eight dimensions on the KDQOL-SF. In addition, patients scored lower than a normative population in all dimensions and significantly lower than caregivers in the dimensions of role physical functioning, role emotional functioning, and social functioning. Compared to national normative data for their age group, caregivers scored substantially lower in general health, vitality, and mental health. Conclusions Patients on CAPD are at risk for social role dysfunction, and their caregivers are at risk for decreased mental health. Further research is needed to identify interventions that can improve the HRQOL of CAPD patients and their family caregivers.


CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S112
Author(s):  
S. Patrick ◽  
P. Duke ◽  
K. Lobay ◽  
M. Haager ◽  
B. Deane ◽  
...  

Introduction: Following an emergency department (ED) presentation for acute atrial fibrillation and/or flutter (AF/AFL), patients often experience anxiety, depression and impaired health-related quality of life (QoL). Emergency physicians may prescribe appropriate thrombo-embolic (TE) prophylaxis upon discharge; however, the QoL of these patients is unclear. This study measured the QoL of patients with AF/AFL following discharge to determine the factors associated with QoL. Methods: Patients ≥18 years of age identified by the attending physician as having a diagnosis of acute AF/AFL confirmed by ECG were prospectively enrolled from three Edmonton, AB EDs. Using standardized enrollment forms, trained research assistants collected data on patient demographics factors and management both in the ED and at discharge. Patients’ health-related QoL was assessed up to 20 days after their initial ED visit by a telephone interview based on six domains of the short-form 8 health survey. Results: From a total of 196 enrolled patients, 121 (62%) were male and the mean age was 63 years (standard deviation ±14). Most patients had previous history of AF/AFL (71%), and emergency physicians had the opportunity to treat or revise TE prevention therapy in 19% of the patients. The majority (89%) were discharged with prescriptions for antiplatelet or anticoagulant agents, and 188 (96%) were contacted by telephone at a median of 7 days. Most patients rated their overall health between good and excellent (70%); however, 30% assessed their health as fair or very poor. Many also reported having physical limitations (54%), difficulties completing their daily work (42%), bodily pain (32%) and limitations in social activities (32%). Finally, some patients reported having low energy (25%). At follow up, patients receiving adequate TE prevention rated their health to be similar to those without adequate TE prevention (30% vs 23%; p=0.534). Conclusion: Overall, patients with acute, symptomatic AF/AFL seen in the ED have impairments in health-related QoL following discharge from the ED. Many factors contribute to this impairment; however, providing patients with appropriate TE prophylaxis at discharge did not explain these findings. Further research is required to explore the impact of AF/AFL on patient’s health-related QoL after discharge from the ED.


2014 ◽  
Vol 32 (14) ◽  
pp. 1427-1436 ◽  
Author(s):  
Elizabeth Maunsell ◽  
Paul E. Goss ◽  
Rowan T. Chlebowski ◽  
James N. Ingle ◽  
José E. Alés-Martínez ◽  
...  

Purpose Exemestane, a steroidal aromatase inhibitor, reduced invasive breast cancer incidence by 65% among 4,560 postmenopausal women randomly assigned to exemestane (25 mg per day) compared with placebo in the National Cancer Institute of Canada (NCIC) Clinical Trials Group MAP.3 (Mammary Prevention 3) trial, but effects on quality of life (QOL) were not fully described. Patients and Methods Menopause-specific and health-related QOL were assessed by using the four Menopause-Specific Quality of Life Questionnaire (MENQOL) domains and the eight Medical Outcomes Study Short Form Health Survey (SF-36) scales at baseline, 6 months, and yearly thereafter. MENQOL questionnaire completion was high (88% to 98%) in both groups at each follow-up visit. Change scores for each MENQOL and SF-36 scale, calculated at each assessment time relative to baseline, were compared by using the Wilcoxon rank-sum test. Clinically important worsened QOL was defined as a MENQOL change score increase of more than 0.5 (of 8) points and an SF-36 change score decrease of more than 5 (of 100) points from baseline. Results Exemestane had small negative effects on women's self-reported vasomotor symptoms, sexual symptoms, and pain, which occurred mainly in the first 6 months to 2 years after random assignment. However, these changes represented only a small excess number of women being given exemestane with clinically important worsening of QOL at one time or another; specifically, 8% more in the vasomotor domain and 4% more each in the sexual domain and for pain. No other between-group differences were observed. Overall, slightly more women in the exemestane arm (32%) than in the placebo arm (28%) discontinued assigned treatment. Conclusion Exemestane given for prevention has limited negative impact on menopause-specific and health-related QOL in healthy postmenopausal women at risk for breast cancer.


2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Marília Pilotto de Oliveira ◽  
Luciana Kusumota ◽  
Vanderlei José Haas ◽  
Rita de Cássia Helú Mendonça Ribeiro ◽  
Sueli Marques ◽  
...  

Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.


Author(s):  
Anna-Maija Itkonen Freitas ◽  
Tomi S. Mikkola ◽  
Päivi Rahkola-Soisalo ◽  
Sari Tulokas ◽  
Maarit Mentula

Abstract Introduction and hypothesis To assess changes in quality of life (QoL) and sexual function outcomes at 1 year after tension-free vaginal tape (TVT) versus polyacrylamide hydrogel injection (PAHG). Methods In a randomized trial comparing TVT (n = 111) and PAHG (n = 113) treatments of stress urinary incontinence (SUI), we compared urinary incontinence and health-related QoL using the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire, Short Form (IIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and RAND-36 Item Health Survey (RAND-36) at baseline and 1 year. Results UDI-6 and IIQ-7 showed improved incontinence-related QoL (p = 0.001) from baseline in both groups except for difficulty emptying the bladder and pain/discomfort. At 1 year, TVT patients experienced less urinary symptom-related distress compared to PAHG (p < 0.001). Sexual function improved in both groups (p < 0.001 for TVT and p = 0.01 for PAHG) with higher scores for the physical section subscale (p < 0.001) for TVT. Health-related QoL (RAND-36) improved from baseline in both groups in physical and social functioning (p < 0.001) with better outcome in the TVT group for physical functioning (p < 0.001). Increase in pain from baseline (p = 0.02) was detected for TVT, but not for PAHG. However, there was no difference between the groups (p = 0.78). Conclusions In primary SUI, TVT and PAHG treatments both improved QoL and sexual function at 1 year. However, incontinence and health-related QoL scores were better in the TVT group. More pain compared to the baseline was reported after TVT, although there was no difference between groups. Clinical significance needs to be evaluated in long-term follow-up.


2020 ◽  
Author(s):  
Takakazu Oka

Abstract Background: Our previous study demonstrated that 42% of yoga class participants in Japan had chronic diseases that required medication. This raises the question as to whether those with chronic diseases could benefit from practicing yoga or if they are at higher risk for specific adverse events compared to healthy individuals receiving the same instruction. Methods: To address these questions, 328 adults who started practicing yoga for the first time were asked to complete the Profile of Mood States (POMS), Perceived Stress Scale (PSS), and Medical Outcomes Study Short Form 8, standard version (SF-8TM) and to record any adverse events on the first day of the yoga class and again three months later. The participants consisted of three groups: a healthy (H) group (n=70), a poor health (PH) group (n=117), and a chronic disease (CD) group (n=141). The severity of subjective symptoms was also compared between the pre- and post-intervention period in the PH and CD groups.Results: Typically, yoga classes were held once a week for 60-90 min. The programs included asanas, pranayamas, meditation, isometric yoga and sukshma vyayama. In the PH and CD groups, the POMS tension-anxiety and fatigue scores decreased and the vigor score increased significantly after the first class. Furthermore, PSS scores decreased and the SF-8TM scores increased significantly three months later. The severity of subjective symptoms such as easy fatigability, shoulder stiffness, and insomnia also decreased over three months. Individuals in these groups experienced more frequent adverse events than those in the H group. The PH and CD groups also experienced a greater variety of symptoms, including psychological ones, not reported by the H group. Adverse events were not so serious that subjects stopped practicing yoga during the class. About 60% of all participants were highly satisfied with participating in yoga classes.Conclusions: If yoga classes are conducted with attention to possible adverse events, yoga practice in a studio may have beneficial effects for people with functional somatic symptoms and chronic diseases, as well as healthy subjects. These benefits include reductions in perceived stress and uncomfortable symptoms as well as improved mood and quality of life.


Author(s):  
Emma L. M. Jennings ◽  
Denis O’Mahony ◽  
Paul F. Gallagher

Abstract Purpose To assess medication-related quality-of-life (MRQoL) in multi-morbid older adults with polypharmacy and correlations with medications, frailty and health-related QoL. Methods With a cross sectional study of multi-morbid geriatric medicine outpatients, we assessed MRQoL (MRQol-LSv1), frailty status, potentially inappropriate medications, Medication Adherence Rating Scale (MARS), health-related-QoL (Short-Form 12, SF12) and medication burden (Living with Medicines Questionnaire, LMQv2). Results One-in-four (n = 59) of 234 outpatient attendees met inclusion criteria. Almost half (n = 106, 45%) were excluded due to cognition (MMSE < 26). Included participants (n = 27, mean age 80.2 years) experienced a median of 11 (IQR 9–13.5) co-morbidities and were prescribed a median of 10 (IQR 8–12.25) medications. Overall, MRQoL-LS.v.1 scores were low, suggesting good medication-related quality of life (median MRQoL-LS.v.1 score of 14, IQR 14–22). Correlations between MRQoL, number of daily medications, co-morbidity burden, LMQv2 score, SF12 scores and number of PIMs were non-significant. Conclusion MRQoL-LSv.1 is unsuitable for most patients attending geriatric ambulatory services.


2021 ◽  
pp. 1-10
Author(s):  
Keisuke Suzuki ◽  
Ayaka Numao ◽  
Tomoko Komagamine ◽  
Yasuo Haruyama ◽  
Akiko Kawasaki ◽  
...  

Background: The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the mental health of the general population. Objective: We investigated the determinants of quality of life (QOL) in Parkinson’s disease (PD) patients during the COVID-19 pandemic. Methods: Impacts of lifestyle changes due to the COVID-19 pandemic on 100 patients with PD and their caregivers/spouses were assessed. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. The physical component summary (PCS) and mental component summary (MCS) scores of the short form (SF)-8 were used to evaluate health-related QOL. Results: Regarding health-related QOL, physical function, role physical, general health, vitality and the PCS score were significantly worse in PD patients than in caregivers. Worsening of PD-related symptoms, increased stress, and decreased physical activity were observed in 29.0%, 37.0% and 44.0% of PD patients, respectively. Sixteen patients (16.0%) experienced problems with hospital access, but none reported medication shortages. Strong concerns about COVID-19 were reported by 47.0% of caregivers and 50.0% of PD patients. In PD patients, increased gait disturbance and rigidity, disease severity, smoking, the levodopa equivalent dose and decreased body weight predicted a worse PCS score; anxiety, depression, female sex, stress and long disease duration predicted a worse MCS score. In caregivers, age and smoking contributed to a worse PCS score; depression, stress and worsening patient mood contributed to a worse MCS score. Conclusion: We report the negative impacts of the COVID-19 pandemic on health-related QOL and its determinants in PD patients and their caregivers.


2008 ◽  
Vol 13 (5) ◽  
pp. 407-411 ◽  
Author(s):  
Adam van Dijk ◽  
Patricia A McGrath ◽  
William Pickett ◽  
Elizabeth G Van Den Kerkhof

BACKGROUND: Despite increasing attention to the epidemiology of pain, relatively little is known about the association between pain and health in children. In particular, no studies have examined this relationship in the general population of children in Canada.OBJECTIVES: To assess the association between self-reported pain experiences and health in school children in southeastern Ontario. Health measures included perceived health status, psychological complaints and satisfaction with school.METHODS: A total of 495 nine-to 13-year-old school children completed the Pain Experience Interview – Short Form and health-related questions from the Health Behaviour in School-aged Children questionnaire.RESULTS: Of the 495 children in the present study, 8% rated their health as ‘fair’ to ‘poor’, 56% reported experiencing at least one of four psychological symptoms more than once a week and 24% said they disliked school. The strongest associations existed between headaches and poor self-rated health (OR=10.1; 95% CI 1.3 to 78.3), recurrent pain and psychological outcomes (OR=3.6; 95% CI 2.0 to 6.3), and recurrent pain and disliking school (OR=3.6; 95% CI 1.9 to 6.7).DISCUSSION: These findings indicate that common childhood pains are associated with childhood health. Further studies are needed to assess the causal relationship between pain and health in children, to obtain a more comprehensive understanding of the personal and economic impact of childhood pain, and to monitor changes in the lives of children living with chronic pain.


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