Background: Depression has been recognized has one of the most critical psychological issues following a Myocardial Infarction (MI), its presence associated with readmissions and death, augments healthcare costs and increases utilisation of services. For theoretical and clinical reasons, Post-traumatic Stress Disorder (PTSD) should be considered as a predisposing psychological condition for depression. However, its impact on depression’s intensity and presence 6 months after a MI has not been clearly assess.
Methods: Out of the 870 eligible patients in three Canadian hospitals, 339 completed the research protocol. Patients completed a depression (BDI-II) and a PTSD (MPSS-SR) inventory 48 hours to 14 days post MI to assess the prevalence both disorders. They again completed the BDI-II six months after their MI to investigate the predisposing effect of PTSD on depression.
Results: Based on the symptomatology cut-off point of their respective measurement instruments, the prevalence of comorbid PTSD-depression was 11.5%. Patients with PTSD symptomatology one month post-MI report high level of depression symptomatology 6 months after the MI. The level of depression at 6 months for comorbid patients was not different from the depressed or traumatized patients’ level at 1 month.
Conclusion: The results suggest that the presence of PTSD symptomatology at 1 month is a predisposing condition for the development of depression and its evaluation in a post MI investigation routine is recommended.
AbstractWe examined the psychometric properties of a quality of life measure, the WHOQOL-BREF, in male treatment-seeking veterans. A sample of 131 veterans at an outpatient clinic completed a mail-in survey that included the WHOQOL-BREF as well as measures of posttraumatic stress, depression, anxiety symptoms, and functional health status. The WHOQOL-BREF showed evidence of good internal consistency and strong test-retest reliability. In addition, analysis of results demonstrated evidence of construct, convergent, and discriminant validity. The results suggest that the WHOQOL-BREF is a reliable and valid measure that can be used in the planning of psychological services provided to veterans with mental health problems.KeywordsvalidationWHOQOL-BREFmental health problems
Introduction. Les soins des brûlures chez les enfants occasionnent beaucoup de douleur et d'appréhension. Le confort, un concept référant autant à l'absence de douleur physique qu'au bien-être, est important pour évaluer la qualité des soins prodigués par les infirmières aux jeunes enfants brûlés. À notre connaissance, aucun instrument n'existe actuellement pour mesurer le confort lors de procédures douloureuses chez les enfants ayant subi des brûlures. Objectif. Développer et valider une échelle de mesure du confort, lors de procédures douloureuses, chez les jeunes enfants ayant subi des brûlures. Méthodes. Une revue de la littérature a permis de générer 38 énoncés dont le nombre a été réduit à 14 par un panel composé de 13 professionnels de la santé. Les énoncés ont été ensuite regroupés sous quatre sous-échelles comportementales principales : visage, pleurs, mouvements et attitude. L'instrument développé (OCCEB-BECCO) a été ensuite pré-testé auprès de 16 enfants âgés de moins de 5 ans ayant subi des brûlures. Résultats. L'instrument était clair, concis et simple à utiliser selon les experts. L'alpha de Cronbach était de 0,82. La corrélation était élevée entre l'OCCEB-BECCO et l'échelle Face Legs Activity Cry Consolability (FLACC) (r≥0,95) à tous les temps de mesure. Discussion et conclusion. L'OCCEB-BECCO, première échelle visant à évaluer le confort d'enfants brûlés lors de procédures douloureuses, est une mesure fiable et valide. Cependant, d'autres études devront être effectuées, auprès de plus grands échantillons, pour compléter la validation de l'échelle.
lemay s., johnston c., choinière m., fortin c., hubert i., fréchette g., kudirka d. & murray l. (2010) Pain management interventions with parents in the emergency department: a randomized trial. Journal of Advanced Nursing 66 (11), 2442–2449. Abstract Aim. This paper is a report of the efficacy of a parental educational intervention on children’s pain intensity and experience of pain‐related unpleasantness at 24 hours post‐discharge from the emergency department, and on parents’ beliefs about pain. Background. Parents’ misbeliefs about pain management may inhibit them from managing their child’s pain appropriately. Educating parents about pain management may increase their knowledge, dispel myths and help decrease children’s pain intensity and unpleasantness related to pain following a visit to an emergency department. Method. A randomized design was adopted with samples of parent/child dyads. The experimental group received a bookmark, booklet on pain management and pain scale. The control group only received a pain scale. Pain intensity and unpleasantness were measured at triage and 24 hours after discharge from the emergency department. Parents’ beliefs were measured with the Pain Belief Questionnaire. Data were collected from November 2005 to May 2006. Results. Samples of 98 (experimental) and 97 (control) children/parents were recruited. No statistically significant differences were found between both groups regarding pain intensity and unpleasantness, at triage and 24 hours post‐discharge. Results for the Pain Belief Questionnaire were similar between the groups ( t = 1·751, P = 0·082). Conclusion. The interventions were not effective to reduce pain and unpleasantness related to pain, as well as to improve pain beliefs of parents. Other interventions, such as having parents participate actively in their child’s pain management, might be more effective than a passive educational intervention.
Victims of violent crime (VVC) are at risk of developing acute stress disorder (ASD) and subsequent posttraumatic stress disorder (PTSD). In addition, VVC are more likely to have low social support due to stigmatization and victim-blaming, and PTSD is frequently associated with depression, anxiety, and impaired quality of life (QoL). The present study aimed to determine the impact of ASD, PTSD, depressive symptoms, anxiety symptoms, and perceived social support in relation to four domains of QoL among VVC. Individuals were recruited as part of a longitudinal study assessing the efficacy of a brief cognitive behavioral treatment for ASD. Participants (N = 127) were interviewed and completed self-report measures within 30 days of experiencing a violent crime (T0 ) and at assessments 2 months (T1 ) and 6 months (T2 ) after the event. Depressive symptoms, ASD, and PTSD were found to be associated with lower QoL ratings in all four domains. Anxiety symptoms were found to be associated with lower ratings in the physical health and psychological QoL domains. Perceived social support was found to be associated with higher QoL ratings in all domains. The proportions of QoL variance explained by the combined fixed and random effects combined ranged from 70% to 79%. Future research considerations include an examination of how early interventions for VVC could prevent QoL deterioration by targeting ASD and PTSD development, depressive and anxiety symptoms, and social support.
In July 1996, the Saguenay-Lac-St-Jean region suffered one of the greatest natural disasters in Quebec's history. This article presents results of a study aiming at comparing, two years after the flood, the physical and psychological health condition of victims (n=177) to that of non-victims (n=168). The results indicate that victims, - regardless of their gender - present a psychological well-being as well as a post-disaster physical health that is different from non-victims. Disaster victims are much more numerous than non-victims in considering that their health is bad or average and in witnessing new health problems or the exacerbation of existing problems. Victims also present more manifestations of prosttraumatic stress and somatic complaints, have higher levels of depression, anxiety and social dysfunction than non-victims. However, no significant difference between subjects was revealed concerning severe depression. Results obtained corroborated that of other studies. After a natural or technological disaster involving important material damages to individual belongings, victims are more affected than non-victims concerning their psychological and physical health.
Objective: This paper examines the prevalence of chronic Post-Traumatic Stress Disorder (PTSD) after a Myocardial Infarction (MI) and the factors associated its early detection in a hospital setting.
Methods: Of 1344 MI patients admitted to three Canadian hospitals, 474 patients did not meet the inclusion criteria and 370 declined participation in the study; 500 patients consented to participate in the study. A structured clinical interview and questionnaires were administered to patients 48 hours to 14 days post-MI (M=4SD=2.7 days) and three months later to assess the prevalence of chronic PTSD and its risk factors.
Results: Respectively 4.4% and 11.1% of the patients met the full and partial diagnostic criteria of chronic PTSD, measured with the Interview from the DSM-IV-TR PTSD module. Using binary logistic regression, both the intensity of anxiety (Beck Anxiety Inventory) (OR=1.05 per unit increase; p<.05, 95% CI: 1.00-1.10) and acute stress disorder symptoms (Modified PTSD Symptom Scale) (OR=1.05 per unit increase; p<.001, 95% CI=1.03-1.08), measured while in-hospital were associated with the presence of symptoms of PTSD three-months after the MI.
Conclusion: Systematic in-hospital investigation of easily assessable risk factors is recommended in order to improve the detection of chronic PTSD and to prevent its detrimental effects on cardiovascular health.
