Disrupted Rhythmicity and Vegetative Functions Relate to PTSD and Gender in Earthquake Survivors

Application of health self-management intervention program for metabolic syndrome patients in the bereaved population following the Wenchuan earthquake

Background

The destructive Wenchuan earthquake has led to approximately 800,000 people being bereaved. In the previous cross-sectional study, we explored the long-term incidence of Metabolic Syndrome (MS) and studied its influencing factors among the bereaved population 12 years after the Wenchuan earthquake. Chronic disease self-management has become a recognized public health service. Studies have shown that demographic and genetic factors, stress, geographical environment, society, culture, dietary habits, lifestyle, and other aspects influence MS. Due to the Wenchuan earthquake being a serious stress event, the implementation of targeted interventions should be discussed further.

Objectives

To verify the effect of applying a self-management intervention program for patients with MS among the bereaved population following the Wenchuan earthquake.

Design

A randomized controlled trial (RCT) design was adopted.

Participants

A total of 132 bereaved patients with MS following the Wenchuan earthquake constituted the sample.

Methods

The study was based on the Cognitive-Phenomenological-Transaction, Chronic Disease Self-Management Program, and Patient Empowerment Conceptual Model, which combined with the latest evidence-based guidelines, were used to systematically evaluate cross-sectional results of this study that were used to construct a stress management-based health self-management intervention program and MS health self-management manual for bereaved patients with MS following the Wenchuan earthquake. In addition, we revised and completed a health self-management intervention program and health self-management manual for patients with MS by using the expert consultation method. General data were collected prior to intervention (T0). We collected the patients' MS disease-related physiological indicators before intervention (T0), after intervention (T1), and 2 months after intervention (T2). EipData3.1 software was used to input data in duplex and duplicate, and SPSS22.0 software was used for statistical analysis.

Results

The variance analysis showed that the total score of healthy self-management behavior and the score of diet management, exercise management, drug management, and emotional management have intergroup effects, time effects, and group-time interaction effects (p < 0.05). When the differences between groups were further compared, we found that the total score and the score of six dimensions (excluding disease self-monitoring management) were higher than those of the control groups at T1 and T2, and the differences were statistically significant (p < 0.05).

Conclusion

The intervention program of healthy self-management for patients with MS who come from bereaved families following the Wenchuan earthquake can effectively improve patients' health self-management behaviors.

Validation of the Spanish Version of the Trauma and Loss Spectrum Self-Report (TALS-SR): A Study on Healthcare Workers Facing the COVID-19 Pandemic

Background

The present study aimed at reporting about the validity and reliability of the Spanish version of the Trauma and Loss Spectrum-Self Report (TALS-SR), an instrument based on a multidimensional approach to Post-Traumatic Stress Disorder (PTSD) and Prolonged Grief Disorder (PGD), including a range of threatening or traumatic experiences and significant losses, besides the spectrum of peri-traumatic stress reactions and post-traumatic stress symptoms that may occur.

Methods

A sample of 87 Health Care Workers (HCWs) employed in the COVID-19 Emergency Department at the Virgen de la Arrixaca and Reina Sofia Hospitals (Murcia, Spain) during the pandemic, was consecutively recruited and fulfilled the TALS-SR. Assessments also included the Impact of Event Scale-Revised (IES-R), to examine post-traumatic stress symptoms and probable PTSD. Nineteen HCWs fulfilled the TALS-SR again after three weeks from baseline for test-retest reliability.

Results

This study provides evidence of good internal consistency and test-retest reliability of the Spanish version of the TALS-SR. Strong support for the internal validity structure was obtained, with positive and significant correlations between the five symptomatologic domains and the symptomatologic total score. Significant and good correlations between the TALS-SR symptomatologic domains and the IES-R total and single domains' scores were found. The Questionnaire also demonstrated to discriminate between subjects with and without PTSD, with subjects with PTSD showing significantly higher mean scores in each domain of the TALS-SR.

Conclusion

This study validates the Spanish version of TALS-SR, providing a useful instrument for a spectrum approach to PTSD and confirms the potential utility of this psychometric tool in both clinical practice and research settings.

A 3-Month Naturalistic Follow-Up Treatment With Selective Serotonin Reuptake Inhibitors in Frequent Attenders of General Medical Practice: What Correlates With a Good Response?

ABSTRACT

Frequent attenders (FAs), defined as patients repeatedly attending general practitioners, frequently exhibit underdiagnosed psychiatric comorbidities, leading to the hypothesis that frequent attendance may be related to an undetected psychiatric burden. This study explores the role of psychiatric comorbidities and psychopharmacological treatment on the clinical outcomes of a cohort of FAs of the general medical practice in Italy. The study included 75 FAs assessed by the Structured Clinical Interview for DSM-5, Clinical Global Impression, Global Assessment Functioning, and Illness Behavior Inventory, administered at baseline (T0) and after 3 months (T1). Data were analyzed on the bases of the presence of any mental disorder and selective serotonin reuptake inhibitor (SSRI) treatment, with respect to other psychopharmacological treatments. Results showed better outcomes among patients with a mental disorder, particularly anxiety, depression, and somatic symptoms disorders, and when under SSRI treatment. Our findings corroborate the role of psychiatric comorbidity on frequent attendance in the context of general clinical practice with a positive outcome when receiving appropriate treatment with SSRI.

Post-Traumatic Stress Reactions in Caregivers of Children and Adolescents/Young Adults with Severe Diseases: A Systematic Review of Risk and Protective Factors

Severe illnesses in children and adolescents/young adults (AYAs) may represent a complex burden for patients and their caregivers, including a wide range of mental disorders, particularly post-traumatic stress disorder (PTSD). Few events are as potentially traumatizing as having a son or a daughter diagnosed with a severe, life-threatening, or disabling disease. The presence of PTSD symptoms in caregivers may compromise their efficacy as caregivers and negatively affect the child’s well-being. This systematic review aims at outlining potential risk and protective factors for the development of PTSD symptoms in caregivers of children and AYAs affected by severe acute or chronic illnesses. Thirty-one studies on caregivers of children and AYAs affected by severe, acute, or chronic diseases were included. Socio-demographic and socio-economic characteristics, illness-related distress, psychiatric symptoms, support, and coping styles were found as potential risk/protective factors across studies. It is crucial to consider risk factors affecting caregivers of severely ill young patients, in order to plan focused interventions aimed at preventing an adverse clinical outcome in caregivers and at enhancing caregivers’ coping skills, in order to ultimately improve their quality of life.