Psychosomatic aspects of chronic low back pain syndrome

The purpose of the study was to determine the relationships between emotional distress and pain syndrome, its characteristic parameters and impact on the quality of life in patients with chronic low back pain. The study included 110 patients, mean age 44.2 ± 8.0 years, with clinical diagnosis of lumbar spine disk pathology with chronic low back pain syndrome. The results showed that the studied patients differed by their emotional state. Emotional distress was associated with high intensity and specific symptoms of low back pain syndrome. Musculoskeletal dysfunction was associated with both physical and psychoemotional factors. The interaction of chronic low back pain syndrome complexity and biopsyhosocial factors is shown by a correlation between cytokines IL- 10 and IL-8 level in blood serum and both pain intensity and duration, characteristics of emotional and physical status, and level of physical activities.publishersversionPeer reviewe

Opinions of Postpartum Women about the Impact of Pregnancy and Childbirth on Sexual Life

Abstract Introduction: Sexual life is often a very sensitive topic, but it may be especially delicate subject for pregnant women. Women are worried about possible impact of pregnancy and childbirth on their sexual life. Aim: The aim was to collect and analyze information given by patients in postpartum units about their opinions of impact of pregnancy, childbirth and partner’s presence during delivery on their sexual life. Materials and methods: Cross-sectional study was carried out involving 351 women in postpartum period. Data were collected from August 2016 until December 2016 in the Maternity Hospital using patient questionnaires. Results: Mean age was 30.3 years (SD 5.1; range, 18 - 43 years). 52.1% (n=183) participants were primiparous and 47.9% (n=168) were multiparous. 92.0% (n=323) had coitus during pregnancy and 8.0% (n=28) did not have. In 41.6% sexual desire decreased during pregnancy. 29.6% (n=104) were worried about impact of childbirth on sexual life, 35.3% (n=124) were worried if letting partner to participate in childbirth would change partners opinion about their sexual life. 49.6% (n=174) got advice from gynecologist about their sexual life during pregnancy, 26.2% (n=92) would like to talk about sexual life with gynecologist. Conclusions: Most of the women are sexually active during pregnancy. Primiparous compared to multiparous are more often worried that childbirth and partner’s presence during delivery may influence their sexual life. Those who admit sexual life as important for them more often are worried about possible impact and want to talk about sexuality with their gynecologist.publishersversionPeer reviewe

Quality of female sexual function after conventional abdominal hysterectomy - three months' observation

Introduction. Many medical and conservative surgical treatment options are available but still hysterectomy remains the most common gynecological procedure performed worldwide. These procedures are performed because of actual and possible malignant diseases, and benign conditions including pelvic pain, dyspareunia, uterine myomas, adenomyosis, endometriosis, and menometrorrhagia. The impact of hysterectomy on sexual function has always been a great concern to women and is a major source of preoperative anxiety. Data regarding the impact of hysterectomy on women’s sexual functioning are not clear and consistent, many women report improvement of sexual functioning after hysterectomy, which may be due to relief of symptoms, while others complain of sexual dysfunction as a result of hysterectomy. Also discussion about advantages of cervix sparing operations is still controversial. Aim of the study. Aim was to assess and compare pre- and post-operative quality of sexual life of gynecological patients undergoing planned hysterectomy, and to find out opinions of patients and their partners about expected impact of operation and changes after surgery. Material and methods. Questionnaire method was used to survey gynecologic patients undergoing planned subtotal / total hysterectomy due to benign indication. Sexual Quality of Life Questionnaire – Female (SQoL-F) was used to assess quality of sexual life before and after surgery. Questions about other influencing factors and patients’ opinions before and after operation were added. 38 completed questionnaires were used for data analysis. Results. Only 55% of subtotal hysterectomy group and 38.9% of total hysterectomy group told their partners completely about planned surgery. Mean period of beginning sexual activities after operation was 5.15 weeks after surgery in subtotal hysterectomy and 5.78 weeks in total hysterectomy group. SQoL-F after three months post-operation period was 6.50 points less in total hysterectomy group, which was not statistically significant. There was a slight statistically insignificant decrease of SQoL-F points within each group after three months observation period: -0.44 points in subtotal hysterectomy group and -2.47 points in total hysterectomy group. Although patients of total hysterectomy more frequently (22.2% vs. 5%) indicated negative impact on sexual function after operation, differences were not statistically significant. There were no differences in co-morbidities, concomitant medications, hormone use history and post-operative complications between groups. Conclusions. Patients before hysterectomy are worried about possible negative impact of surgery on their sexual function, they do not talk to their partners candidly about planned surgery. There were no statistically significant changes of sexual quality of life found after subtotal and total abdominal hysterectomy operation after three months observation period.publishersversionPeer reviewe

Self-Esteem and Occupational Factors as Predictors of the Incidence of Anxiety and Depression among Healthcare Workers during the COVID-19 Pandemic in Latvia

The prevalence of depression and anxiety among healthcare workers (HCWs) during the COVID-19 pandemic is high. The aim of the study is to identify the importance of self-esteem and occupational factors in association with the incidence of depression and anxiety among HCWs through a longitudinal cohort study during the COVID-19 pandemic in Latvia. Participants received seven questionnaires during the COVID-19 pandemic on demographic parameters, work-related information, and contact with COVID-19 patients, and three standardized questionnaires that evaluated symptoms of anxiety (GAD-7), depression (PHQ-9), and self-esteem (Rosenberg’s self-esteem scale). The Generalized Linear Mixed Model (GLMM) was used to identify factors associated with the incidence of depression and anxiety among HCWs. A total of 322 participants were included in the data analysis for depression and 352 for anxiety. HCWs with low self-esteem were 83% more likely to experience depression and 76% more likely to experience anxiety. Working at a general practitioner practice is associated with twice the risk of developing depression and anxiety. A 31% increase in the odds of depression is observed among HCWs with direct contact with COVID-19 patients. The organizational and government levels must look for opportunities to facilitate the mental health of HCWs to ensure better-quality healthcare.Peer reviewe

Symptoms of depression and anxiety among health care workers during COVID-19 pandemia in Latvia : A cohort study

publishersversionPeer reviewe

Microaggressions towards the LGBT population and lack of human rights, equity, and equality, resulting in LGBT domestic abuse in Latvia

Background. It is well known that equality and equity have asignificant meaning inhealthcare. InLatvia, there are no human rights for LGBT families. This case report looks at theproblem through theframe ofone LGBT person’s experience and a lack of support and knowledge, resulting in domestic abuse and neglect of children. Objectives. Toevaluate theshortcomings inLatvian legislation through one LGBT patient’s experience and perception of life inLatvia asanLGBT family member. Case report. The 44-year-old female patient has lived in Latvia since birth. At the doctor’s office, she presented with adisease history of abroken leg at3points of tibiae – thepatient had refused toundergo anoperation due to developed stigma towards medical care, feeling of exclusion; she presented with undiagnosed bronchial asthma, smoking, depression, low self-esteem, frequent suicidal thoughts, 5attempts ofsuicide, insomnia. Thepatient isapolice officer and social worker. Intheanamnesis she has had 3relationships with women and recognises herself as a lesbian. The patient faced discrimination at her workplace – was afraid to talk about her sexuality, had been humiliated by her colleagues at police station. All her relationships with women were highly toxic, asall partners abused her physically and emotionally; they also neglected and physically abused 5children, raised bythepatient for 15years. Thepatient was forced toend all relationships, and had no rights toraise kids even though they had parent–children bonding – they got into thefoster home, while having anon-biological LGBT family parent. Being discriminated against asanLGBT person, and with post-traumatic stress disorder, prevented thepatient, and her children, from seeking and receiving support, even while being apolice officer. Conclusions. Microaggressions towards theLGBT population, discrimination and inequality inLatvia lead toelevated morbidity and higher risk ofsuicide attempts; new legislation isneeded toprotect children’s and their non-biological parents’ needs and health.Peer reviewe

Mental Health and Associated Demographic and Occupational Factors among Health Care Workers during the COVID-19 Pandemic in Latvia

Background and Objectives: The COVID-19 pandemic has negatively impacted the health care system. Front-line health care workers (HCWs) are at a higher risk of mental health adverse outcomes. The aim of this study was to evaluate the frequency of the symptoms of depression and anxiety and associated demographic and occupational factors among front-line HCWs in Latvia. Materials and Methods: A cross-sectional quantitative study was performed in a population of HCWs during the first wave of the COVID-19 pandemic in Latvia. The participants were interviewed between 28 April 2020 and 2 June 2020. Answers from 864 HCWs were obtained. The participants reported their demographics, work-related information, contacts with COVID-19-positive patients and completed two standardised questionnaires that assessed the symptoms of anxiety (GAD-7) and depression (PHQ-9). The gathered data were analysed by a chi-squared test and binary logistic regression. The data analysis was performed using SPSS v25. Results: A total of 209 (24.8%) participants had depression symptoms and 145 (17.2%) had anxiety symptoms. Health care workers older than 50 had a lower risk of both depression (OR 0.422 (95% CI, 0.262-0.680)) and anxiety (OR 0.468 (95% CI, 0.270-0.813)). General practitioners had more frequent symptoms of depression and anxiety than participants who worked at hospitals (32.8% (n = 63) versus 19.4% (n = 73) and 27.1% (n = 52) versus 10.3% (n = 39), respectively (p = 0.037; p < 0.000)). Working more than 48 h during the week was associated with a higher risk of depression (OR 2.222 (95% CI, 1.315-3.753)) and anxiety (OR 2.416 (95% CI, 1.272-4.586)). Conclusions: The vulnerability of the health care system before the COVID-19 pandemic led to significant mental health adverse outcomes of HCWs during the COVID-19 pandemic in Latvia. A further cohort study is needed to evaluate the dynamics of mental health and other predisposing factors of HCWs.publishersversionPeer reviewe

Quality of Female Sexual Function After Conventional Abdominal Hysterectomy - Three Month' Observation

Introduction. Many medical and conservative surgical treatment options are available but still hysterectomy remains the most common gynecological procedure performed worldwide. These procedures are performed because of actual and possible malignant diseases, and benign conditions including pelvic pain, dyspareunia, uterine myomas, adenomyosis, endometriosis, and menometrorrhagia. The impact of hysterectomy on sexual function has always been a great concern to women and is a major source of preoperative anxiety. Data regarding the impact of hysterectomy on women’s sexual functioning are not clear and consistent, many women report improvement of sexual functioning after hysterectomy, which may be due to relief of symptoms, while others complain of sexual dysfunction as a result of hysterectomy. Also discussion about advantages of cervix sparing operations is still controversial. Aim of the study. Aim was to assess and compare pre- and post-operative quality of sexual life of gynecological patients undergoing planned hysterectomy, and to find out opinions of patients and their partners about expected impact of operation and changes after surgery. Material and methods. Questionnaire method was used to survey gynecologic patients undergoing planned subtotal / total hysterectomy due to benign indication. Sexual Quality of Life Questionnaire – Female (SQoL-F) was used to assess quality of sexual life before and after surgery. Questions about other influencing factors and patients’ opinions before and after operation were added. 38 completed questionnaires were used for data analysis. Results. Only 55% of subtotal hysterectomy group and 38.9% of total hysterectomy group told their partners completely about planned surgery. Mean period of beginning sexual activities after operation was 5.15 weeks after surgery in subtotal hysterectomy and 5.78 weeks in total hysterectomy group. SQoL-F after three months post-operation period was 6.50 points less in total hysterectomy group, which was not statistically significant. There was a slight statistically insignificant decrease of SQoL-F points within each group after three months observation period: -0.44 points in subtotal hysterectomy group and -2.47 points in total hysterectomy group. Although patients of total hysterectomy more frequently (22.2% vs. 5%) indicated negative impact on sexual function after operation, differences were not statistically significant. There were no differences in co-morbidities, concomitant medications, hormone use history and post-operative complications between groups. Conclusions. Patients before hysterectomy are worried about possible negative impact of surgery on their sexual function, they do not talk to their partners candidly about planned surgery. There were no statistically significant changes of sexual quality of life found after subtotal and total abdominal hysterectomy operation after three months observation period.Peer reviewe

Rīgas Stradiņa universitātes Psihosomatiskās medicīnas un psihoterapijas katedras 25 gadi un klīnikas 10 gadi

Grāmatā izmantoti fotoattēli no RSU Psihosomatiskās medicīnas un psihoterapijas katedras arhīva, RSU muzeja krājuma un personiskajiem arhīviem. Elektroniskajā izdevumā izņemta 6., 8., 10., 12., 14., 16., 18., 22., 50., 171. lpp., jo tajās nav iekļauta informācija