Health Related Quality of Life and Mental Health in ICU Survivors: Post-Intensive Care Syndrome Follow-Up and Correlations between the 36-Item Short Form Health Survey (SF-36) and the General Health Questionnaire (GHQ-28)

We investigated the relationship between health-related quality of life (HRQOL) and psychological distress in intensive care unit (ICU) survivors 12 months after ICU discharge. The purpose of this study, conducted and completed before the onset of the COVID-19 pandemic, was to find correlations among psychiatric symptoms detected by a screening tool as the General Health Questionnaire-28 (GHQ-28) and the different domains of HRQOL measured with the SF-36 health survey (SF-36), in order to identify ICU survivors with Post-Intensive Care Syndrome (PICS) who need a specific psychiatric intervention to improve their HRQOL. Among 298 ICU survivors who stayed in the ICU for at least 72 hours, 48 patients were enrolled one year after discharge undergoing a clinical interview to assess their functional impairment (Barthel index), mental health (GHQ-28), and health-related quality of life (SF-36). 19% of those subjects had a GHQ-28 ≥ 5 and were identified as “psychiatric cases”, and they were older and experienced a greater impairment in HRQOL. Anxiety, insomnia, and depressive symptoms seemed to be particularly involved in the impairment of HRQOL. A negative correlation between GHQ-28 total scores and subscales and SF-36 subscales was found. Our findings highlighted that psychological distress in ICU survivors may negatively impact physical health recovery and quality of life;conversely, physical impairment and functional disability may trigger the onset of psychiatric symptoms after discharge. The present study is firstly to investigate the correlations between HRQOL and psychological distress in ICU survivors through the GHQ-28, and then affirms the need to carry out follow-up checks for psychiatric symptoms in ICU survivors.

Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome

Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work productivity,emotional changes,sleep,sexual dysfunction,and mobility.Many metrics of quality of life(QoL)in this patient population have been developed;however,a unified,standardized approach to QoL in these patients has not been determined.The effects of IC/BPS and co-morbid conditions on QoL are described using current validated metrics.Next,data regarding successful treatment of IC/BPS in terms of QoL improvement are reviewed.While QoL is the single most important clinical measure of success in the treatment of patients suffering from IC/BPS,addressing QoL in this patient population remains a significant challenge,as its effects on QoL are highly variable and unable to be differentiated from the effects of comorbid conditions on QoL,including depression,poor sleep,and inability to work.Future studies will need to address treatment efficacy on the basis of IC/BPS specific QoL metrics,and multi-modal assessment and therapy to address comorbid disease will also play an important role in the future to ensure comprehensive management of these patients.

Frequency of Depression and Anxiety among Tuberculosis Patients

Objective: The aim of present study was to determine the frequency of depression and anxiety among tuberculosis patients. Methods: It was a descriptive study that had investigated the co-morbidity of depression and anxiety among tuberculosis patients with reference to gender. This study was conducted in Jinnah Post Graduate Medical Centre—Chest ward (TB clinic) from July 2014 to September 2014. Hundred diagnosed patients of tuberculosis (50 males and 50 females) were randomly selected. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) were used to assess the level of anxiety and depression. Results: Findings indicated that 56% tuberculosis (TB) patients had moderate to severe level of depression, whereas 65% TB patients had moderate to severe level of anxiety. Female patients had significantly high prevalence of depression as compared to males (t = –2.173, P –3.468, P Conclusion: Likelihood of depression and anxiety was frequent in tuberculosis patients. However, better management of these psychiatric morbidities may improve treatment adherence, illness perception and patient coping skills.

Evaluation of factors affecting psychological morbidity in emergency medicine practitioners

BACKGROUND: Assessing and evaluating mental health status can provide educational planners valuable information to predict the quality of physicians' performance at work. These data can help physicians to practice in the most desired way. The study aimed to evaluate factors affecting psychological morbidity in Iranian emergency medicine practitioners at educational hospitals of Tehran.METHODS: In this cross sectional study 204 participants(emergency medicine residents and specialists) from educational hospitals of Tehran were recruited and their psychological morbidity was assessed by using a 28-question Goldberg General Health Questionnaire(GHQ-28). Somatization, anxiety and sleep disorders, social dysfunction and depression were evaluated among practitioners and compared to demographic and job related variables.RESULTS: Two hundreds and four participants consisting of 146(71.6%) males and 58(28.4%) females were evaluated. Of all participants, 55(27%) were single and 149(73%) were married. Most of our participants(40.2%) were between 30–35 years old. By using GHQ-28, 129(63.2%) were recognized as normal and 75(36.8%) suffered some mental health disorders. There was a signifi cant gender difference between normal practitioners and practitioners with disorder(P=0.02) while marital status had no significant difference(P=0.2). Only 19(9.3%) declared having some major mental health issue in the previous month.CONCLUSION: Females encountered more mental health disorders than male(P=0.02) and the most common disorder observed was somatization(P=0.006).

Cross-Sectional Survey on Complementary and Alternative Medicine Awareness among Health Care Professionals and Students Using CHBQ Questionnaire in a Balkan Country

Objective： To conduct a study on attitudes, knowledge, and use of complementary and altemative medicine （CAM） therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies. Methods： The questionnaire used was based on previously validated CAM Health Belief Questionnaire （CHBQ）, formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010-July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals （50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses）. Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude. Restdts： Students of dentistry （54.65 ± 6.07） were better informed on CAM therapies than medicine students （50.26 ± 7.92）. Pharmacy students （51.16 ± 7.10） accepted low-scientific CAM. Pharmacists scored better than university professors （55.12±6.55 vs. 50.29± 9.50）. Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy. Conclusion： These pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.

Development and evaluation of a Traditional Chinese Medicine syndrome questionnaire for measuring sub-optimal health status in China

OBJECTIVE:Sub-optimal health status(SHS),in which a person's mind and body exists in a low-quality state of being between disease and health,has become a public health problem that cannot be ignored in China.SHS measurement presents a challenge to the academic fields.We developed and evaluated a questionnaire from the perspective of traditional Chinese medicine(TCM) that embodies the features of TCM syndrome diagnosis for measuring SHS in China.METHODS:The construction of the theoretical framework of the questionnaire was based on a literature review,an expert questionnaire survey and group interviews.The subscales and questionnaire items were screened through a pilot study using statistical means and qualitative analysis.Reliability tests that were used included test-retest reliability,Cronbach's α coefficient,split-half reliability;validity tests included content validity,criterion validity,discrimination validity and construct validity.RESULTS:The final questionnaire,the SHSQ-50,included 50 five-class quantifiable items that encompassed nine subscales:liver stagnation syndrome,liver-Qi deficiency syndrome,spleen-Qi deficiency syndrome,liver-fire syndrome,heart-fire syndrome,stomach-fire syndrome,heart-Qi deficiency syndrome,lung-Qi deficiency syndrome and dampness syndrome.Questionnaires were completed by 268 of the 288 SHS subjects(93.0%) and by 86 of the 94 healthy subjects(91.5%).The Cronbach α coefficients,split-half coefficients and stability coefficients ranged from 0.70 to 0.95,0.67 to 0.87 and 0.88 to 0.98,respectively,for the overall scores and subscales.The Wilcoxon rank test showed statistically significant differences in the subscales and overall scores between the SHS group and the healthy group(P<0.01).Twelve factors with an eigenvalue greater than one were extracted by factor analysis and merged into nine factors,for which the cumulative contribution rate was 63.63%.The nine factors were corresponded to the overall structure of the questionnaire.CONCLUSION:The SHSQ-50 is a reliable and valid instrument for measuring TCM syndrome diagnosis of SHS in China.

Data mining-based study on sub-mentally healthy state among residents in eight provinces and cities in China

OBJECTIVE: To apply data mining methods to research on the state of sub-mental health among residents in eight provinces and cities in China and to mine latent knowledge about many conditions through data mining and analysis of data on 3970 sub-mentally healthy individuals selected from 13385 relevant question naires.METHODS: The strategic tree algorithm was used to identify the main mani festations of the state of sub-mental health. The backpropogation artificial neural network was used to analyze the main mani festations of sub-healthy mental states of three different degrees. A sub-mental health evaluation model was then established to achieve predictive evaluationresults.RESULTS: Using classifications from the Scale of Chinese Sub-healthy State, the main manifestations of sub-mental health selected using the strate gictree were F1101(Do you lack peace of mind?),F1102(Are you easily nervous when something comes up?), and F1002(Do you often sigh?). The relative intensity of manifestations of sub-mental health was highest for F1101, followed by F1102,and then F1002. Through study of the neural network, better differentiation could be made between moderate and severe and between mild and severe states of sub-mental health. The differentiation between mild and moderate sub-mental health states was less apparent. Additionally, the sub-mental health state evaluation model, which could be used to predict states of sub-mental health of different individuals, was established using F1101, F1102, F1002, and the mental self-assessment totals core.CONCLUSION: The main manifestations of the state of sub-mental health can be discovered using data mining methods to research and analyze the latent laws and knowledge hidden in research evidence on the state of sub-mental health. The state of sub-mental health of different individuals can be rapidly predicted using the model established here.This can provide a basis for assessment and intervention for sub-mental health. It can also replace the relatively outdated approaches to research on sub-health in the technical era of information and digitization by combining the study of states of sub-mental health with information techniques and by further quantifying the relevant information.

Evaluation of Depression and Quality of Life in Patients With Psoriasis

Objective:To measure the prevalence of depression in patients with psoriasis and to evaluate the relationship between the severity of psoriasis and depression and its effect on patients’quality of life.Methods:A total of 154 patients with a confirmed diagnosis of psoriasis were assessed to determine the severity of psoriasis based on the psoriasis area and severity index score,presence,and severity of depression using the patient health questionnaire 9,and quality of life using the dermatology life quality index 10.Pearson correlation coefficient was used to demonstrate the relationship between continuous variables with 95%confidence intervals(CIs);P<0.00001 was taken to indicate statistical significance.Results:The severity of psoriasis was mild in 36.36%of patients,moderate in 25.97%,severe in 32.47%,and very severe in 5.20%.Of the 154 patients,139(90.3%)had depression;the severity of depression was mild in most affected patients(46.7%)and severe in 2.6%of patients.Psoriasis had a moderate effect on the quality of life in 37.01%of patients and a very large effect in 33.77%of patients.The severity of psoriasis was positively correlated with depression(Pearson correlation coefficient,r=0.42,P<0.00001,95%CI:0.28–0.54)and quality of life(r=0.43,P<0.00001,95%CI:0.29–0.55).Conclusion:Depression is a common comorbidity in patients with psoriasis.The severity of psoriasis is positively correlated with the severity of depression and is associated with poor quality of life.

Determination of symptoms associated with hiesho among young females using hie rating surveys

Objective： Hie （cold sensation） is one of the most well-known health complaints in Japan and elsewhere in East Asia. Those who suffer from severe hie are considered to have hiesho （cold disorder）. This study was conducted to determine symptoms associated with hie in young females using a survey consisting of the hie scale and hie diary. Methods： Two hundred and seventy-one participants were included for the analysis. Survey forms were distributed to the participants. Diagnosis of hiesho was determined by using the hie scale. A discriminant score of over -0.38 was considered hiesho. The Short Form-8 Health Survey Standard Version （SF-8） was used to measure health-related quality of life （QOL）. The participants were also asked to respond to the questionnaire evaluating 14 physical and emotional symptoms, utilizing a six-level Likert scale item. Results： The 1st factor （hie factor） was correlated with hie （r= 0.546）, dry mouth （r= 0.332）, lower- extremity edema （r = 0.450）, headrushes （r=0.470）, shoulder stiffness （r = 0.311 ）, headrushes with chills （r = 0.726）, and fatigue （r= 0.359）. Cronbach＇s α of the 1st factor was 0.748, which indicated reliability between the items. When hie factor was the dependent variable, standardized partial regression coefficient was β=-0.387 for physical component score （P 〈 0.001） and β=-0.243 for mental component score （P 〈 0.001 ）. Conclusion： This study indicated that hiesho symptoms among young female adults were associated with bodily pain and general health perceptions of the SF-8 QOL survey.