Short-Term Cognitive-Behavioral Treatment in Multicultural Primary Care of Patients With Longstanding Backache.

Short-term cognitive-behavioral treatment in multicultural primary care of patients with longstanding backache.

Scand J Psychol. 2013 Jun 6;
Taloyan M, Alinaghizadeh H, Löfvander M

The efficacy of cognitive-behavioral therapy in multi-cultural primary care patients with longstanding backache is not evaluated. The purpose of this study was to investigate the outcome of a four weekly-treatment given by primary care physicians regarding pain-related worry, depression and severe pain and to determine which social, clinical or gender factors were associated with outcome.The study group consisted of 245 patients in consecutive order from 19 countries, 18 to 45 years, entering rehabilitation program because of longstanding backache. Prevalences of pain-related worry and depression and severe pain was counted and compared before and after. Logistic regression was used to calculate the odds (OR; 95% CI) for persistent pain-related worry and/or persistent depression and severe pain (VAS ? 50). The prevalences of pain-related worry and depression were both significantly lower after treatment (pain-related worry 83% before vs. 38% after; depression 43% before vs. 31% after). Also the number of patients scoring ? 50 VAS was a little, but significantly, fewer (68% vs. 61%). Use of interpreter doubled the risk of having persistent pain-related worry (OR 2.1; 95% CI 1.1-4.1) but the risk was not significant regarding persistent depression (OR 1.8; 0.6-5.4). The rating of VAS rating ? 50 after treatment was twice as high, OR 2.3 (95% CI 1.1-4.6) in the 38-45 year old age group. To conclude, a focus on pain ideas reduced pain-related worry and depression in these patients with various sociocultural backgrounds and longstanding backache. HubMed – rehab

Stress Cardiomyopathy with an “Inverse” Takotsubo Pattern in a Patient with Acute Aneurysmal Subarachnoid Hemorrhage.

Echocardiography. 2013 Jun 6;
Waller CJ, Vandenberg B, Hasan D, Kumar AB

BACKGROUND: Subarachnoid hemorrhage (SAH) induced myocardial dysfunction (often labeled neurogenic stunned myocardium) encompasses a spectrum of clinical presentations ranging from an isolated elevation of cardiac enzymes to cardiogenic shock. OBJECTIVE: We describe a case of stress cardiomyopathy in a patient following acute aneurysmal subarachnoid hemorrhage that showed an “inverse” or reverse takotsubo pattern on echocardiography. CASE REPORT: The patient was a 46-year-old female who presented with acute cardiogenic shock following acute subarachnoid hemorrhage necessitating aggressive cardiorespiratory in the ICU. Her admission echo showed a depressed left ventricular ejection fraction of 25%. The basal 2/3 of the left ventricle (LV) was severely hypokinetic and the apical 1/3 of the LV was hypercontractile, i.e. the reverse or inverse takotsubo pattern of regional wall motion abnormality. With ongoing aggressive support her cardiovascular function steadily improved and on day 6 her follow up echo showed LV ejection fraction increased to 60-65% with resolution of the previous regional wall motion abnormality. The patient was discharged to a neuro-rehabilitation facility on day 16. SUMMARY: The “inverse” or “reverse” takotsubo pattern of regional wall motion abnormalities, i.e. with preserved apical LV contractility and hypokinesis of the basal walls of the LV is more common in patients following acute SAH. HubMed – rehab

Psychometric properties of the Brazilian Portuguese versions of the 29- and 13-item scales of the Antonovsky’s Sense of Coherence (SOC-29 and SOC-13) evaluated in Brazilian cardiac patients.

J Clin Nurs. 2013 Jun 7;
Spadoti Dantas RA, Silva FS, Ciol MA

AIM AND OBJECTIVES: To assess the construct validity and reliability of the Brazilian Portuguese versions of the 29- and 13-item scales of the Antonovsky’s Sense of Coherence Scale (SOC-29 and SOC-13). BACKGROUND: Antonovsky’s Sense of Coherence Questionnaire was developed to measure the main construct of the salutogenic theory, the sense of coherence. The use of the sense of coherence by health professionals might help identifying specific coping strategies used by person with chronic illness. DESIGN: Cross-sectional study. METHODS: The SOC-29 has been culturally adapted to Brazilian Portuguese language. In this study, we assessed its psychometric properties (construct validity and internal reliability) tested on 203 cardiac patients. The SOC-13 was tested on another 100 cardiac patients hospitalised in the same hospital. The construct validity of both versions was investigated through Pearson correlation between the measures of sense of coherence and of correlated constructs (self-esteem, depression and age), analysis of the principal components and comparison of distinct groups (male vs. female). The internal reliability for both versions was evaluated by Cronbach’s alpha. RESULTS: For both versions, the construct validity assessments showed strong positive correlations between sense of coherence and self-esteem and strong negative correlations between sense of coherence and depression (convergent validity), and weak correlation between sense of coherence and age (divergent validity). Principal component analysis supported in part the presence of a single component (unidimensionality). Differences in sense of coherence were found by sex with SOC-29, but not with SOC-13. Cronbach’s alpha coefficients showed satisfactory internal consistency in both versions. CONCLUSIONS: The Brazilian Portuguese versions of SOC-29 and SOC-13 can be considered valid and reliable for the populations studied. More studies need to be performed to assess these proprieties in other Brazilian populations. RELEVANCE TO CLINICAL PRACTICE: This scale can be used in research and clinical practice in Brazil to assess nursing interventions aimed at decreasing stress during cardiac rehabilitation. HubMed – rehab

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