From Polyanna syndrome to Eeyore’s Corner? Hope and pain in patients with chronic low back pain

Chronic low back pain affects 50-80% of the population, while its consequences may impair the functioning of patients suffering from it, in many spheres of life . Hope is a factor which may influence coping with pain as well as cognitive reflection of pain experience. The aim of the study has been to check: 1) whether dependencies exist between hope-trait and hope-state and the perception of pain; 2) whether experiencing pain at the time of filling questionnaires matters for the assessment of the level of hope; 3) whether there is interaction between hope, the pain experienced at the moment of investigation, and memory of the intensity of previously experienced pain. 150 patients participated in the study, they all reported aggravation of the chronic low back pain syndrome. The study was a cross-sectional study, based on questionnaires. On the third day of treatment the subjects were given the following questionnaires: Trait Hope Scale, State Hope Scale, and Numerical Rating Scale of Pain to fill. Poor correlation was demonstrated to exist between hope-state and hope-pathways on the one hand, and the intensity of minimum pain level experienced during the first three days of treatment. It has been noted that the presence of pain at the time of filling questionnaires results in reducing the hope-state, but only in those persons, who had experienced severe pain previously. On the other hand, in case of patients who had experienced slight pain previously, the pain present when filling in the questionnaires is conducive to enhanced hope-state. The results of the study confirm the complex character of relations between hope and pain

Humor styles and psychosocial working conditions in relation to occupational burnout among doctors

Medical professionals are an occupational group at a particularly high risk for job burnout. The aim of the study was to determine relationships between humor styles and psychosocial working conditions on the one hand and occupational burnout in the medical profession on the other. Participants in the study were 82 professionally active doctors, interviewed and examined using questionnaire methods: the Maslach Burnout Inventory, Humor Styles Questionnaire, and the Psychosocial Working Conditions instrument. The results show that occupational burnout is a serious problem among medical doctors, even those with a short work history. Diffcult psychosocial working conditions enhance the occupational burnout symptoms. Moreover, higher severity of burnout symptoms correlates with lower support from superiors and with less frequent utilization of adaptive humor styles: self-enhancing and affliative. Therefore, it is worthwhile to develop programs of burnout prevention for medical professionals, with an emphasis on social skills training, and to enlarge such resources as support at workplace and humor utilization skill

The pain of a heart being broken : pain experience and use of analgesics by caregivers of patients with Alzheimer's disease

Background: It has been observed that psychical suffering (e.g. the feeling of losing a significant person) tends to reduce the physical pain tolerance threshold, as well as to increase the subjective sense of painfulness. The purpose of this study was to assess pain sensation among a group of caregivers of patients with Alzheimer's disease, and to determine the psychological factors (emotional and relational) that contribute to both pain perception and coping with pain via the use of analgesics. Methods: The study comprised 127 caregivers of patients with Alzheimer's disease. Questionnaires were used to elicit pain intensity, strength of emotional relationship between caregiver and patient, sense of painfulness of the loss experienced, depression level, and somatic ailments. Results: A large majority (87.4 %) of participants reported pain complaints, while 93 % took analgesics without a doctor's recommendation at least once a week; 8 % took painkillers daily. The strongest predictors of both perceived pain and tendency to use analgesics were sense of loss and painfulness of loss in relation to the patient's deteriorating condition. Conclusions: The pain experienced by caregivers may be connected to social pain resulting from the experience of losing someone they are close to. Caregivers may resort to excessive use of analgesics as a pain-coping strategy

Character of the relationship with Alzheimer patient and the psychological costs of care

Alzheimer’s disease is the most common form of dementia. The aim of this study was to determine the dependence between the quality of the caregiver-patient relationship and the psychological costs the caregiver bears during the caregiving period. This study encompassed 292 caregivers (104 partners, 117 children and 71 friends or others persons). The study indicated the greatest level of depression and caregiving-related burdens in the spouses group, and the least in the friends/others group. The most important predictor of the level of burden in the caregiving role turned out to be the nature of the caregiver-patient relationship; however, a varying set of the signifi cance of individual elements of this relationship were indicated in different caregiver groups

Poznawcze, afektywne i społeczne uwarunkowania stosowania się do zaleceń lekarskich przez chorych na cukrzycę typu 2

Cukrzyca typu 2 jest chorobą przewlekłą i nieuleczalną, dotykającą ponad 1% ludzi na świecie. Podstawą leczenia cukrzycy jest zmiana stylu życia, polegająca na wprowadzeniu zachowań, sprzyjających normalizacji glikemii. Niedostosowanie się do reżimu terapeutycznego przekłada się na ryzyko wystąpienia powikłań znacznie upośledzających funkcjonowanie pacjentów, a nawet zwiększających ryzyko przedwczesnego zgonu. Tymczasem poziom stosowania się do zaleceń lekarskich (compliance) przez chorych na cukrzycę typu 2 jest niewystarczający. Celem niniejszej pracy było zbadanie uwarunkowań stosowania się do zaleceń lekarskich w cukrzycy. Dla potrzeb badania stworzono własny model, uwzględniający czynniki poznawcze (obraz własnej choroby), afektywne (depresyjność) i społeczne (wsparcie społeczne), jako predyktory podejmowania zaleconych zachowań zdrowotnych. Badaniem objęto 202 pacjentów Poradni Diabetologicznej w Rudzie Śląskiej chorych na cukrzycę typu 2. Badaniem objęto także życiowych partnerów osób chorych. Badanie wykazało dalece niewystarczający poziom compliance. Badani stosowali się do zaleconych zadań jedynie w 58,23%. Uzyskane wyniki badania wykazały istotny wpływ obrazu własnej choroby i depresyjności na zakres podejmowania zaleceń lekarskich. Nasilone objawy depresyjne oraz negatywny obraz własnej choroby (przejawiający się postrzeganiem licznych przykrych konsekwencji dla codziennego funkcjonowania pacjenta, niskim poczuciem możliwości osobistego wpływu na przebieg choroby i słabą wiarą w efektywność leczenia) wpływały na pogorszenie się poziomu stosowania się do zaleceń lekarskich. Testowany model uzyskał zadowalające wskaźniki dopasowania do uzyskanych danych empirycznych, co pozwala sądzić, iż trafnie opisuje on badane aspekty rzeczywistości. Wyniki przeprowadzonego badania oprócz wniosków teoretycznych umożliwiły wysunięcie wniosków praktycznych, dotyczących optymalizacji procesu leczenia cukrzycy. Optymalizacja ta powinna obejmować elementy terapii poznawczo-behawioralnej, skierowanej na budowanie sprzyjającego stosowaniu się do zaleceń lekarskich obrazu własnej choroby, a także diagnostykę i leczenie depresji. Uwzględnienie tych postulatów może znacznie poprawić stan zdrowia chorych, obniżyć koszty społeczne cukrzycy, przyczynić się do wzrostu jakości życia pacjentów oraz optymalizacji relacji lekarz-pacjent

Does anybody support the supporters? Social support in the cancer patient-caregiver dyad

Background. Cancer and its treatment enforce changes in patient functioning. The principal objective of each patient is to efficiently cope with the disease, i.e. to completely recover or at least to slow its progression. Under such circumstances, patients and their relatives require various forms of support: emotional, informational and instrumental. Objectives. The aim of the study was to determine the level and sources of support available for cancer patients and their close relatives, who deal with the latter on a daily basis. Material and methods. The cross-sectional self-inventory study, conducted at cancer centers in Krakow and Tarnow, included 193 pairs of cancer patients and their caregivers. The study was based on the Berlin Social Support Scales and a sociodemographic-clinical survey. Results. Cancer patients had more perceived and received social support than their caregivers. Patients identified more sources of available support than their caregivers. When the level of support was stratified according to the caregiver’s relation with the patient, caregivers-partners and caregivers-children presented higher levels of perceived support than caregivers-siblings and caregivers-parents. Caregivers received less support than patients from medical personnel. Conclusions. The discrepancy between the level of social support among patient and their caregivers leads to further research on the patient-caregiver dyad, especially with regard to the consequences for the whole family’s quality of life. In connection with a deficit of support for caregivers from oncologists, GP’s may constitute a valuable source of support, especially emotional and informational

MENTAL STATE AND ITS PSYCHOPHYSICAL CONDITIONS IN PATIENTS WITH ACUTE LEUKAEMIA TREATED WITH BONE MARROW TRANSPLANTATION

Background: Acute leukaemia and bone marrow transplantation (BMT) as a method of its treatment are great psychological stressors, which are responsible for anxiety and depression in the group of patients. The aim of the study was to assess the patients’ mental state and its psychophysical predictors before and after BMT. Subject and method: The study was of a longitudinal and self-descriptive character. The questionnaires: LOT-R, AIS, Mini-Mac, CECS, RSCL and HADS were filled by 60 patients with acute leukaemia before and after BMT. Results: There were no essential statistical differences between the severity of anxiety and depression before and after BMT but the pattern and the power of various mental state predictors changed in the course of the hospitalization. Anxiety before transplantation was greater when the psychological stress and the strategy of “anxious preoccupation” were stronger and the strategy of “fighting spirit” and the level of generalized optimism were weaker. The factors explained 51% variations of anxiety before transplantation. After BMT 77% variations of anxiety were explained, which were associated with a high level of distress at the end of the hospitalization, higher level of anxiety before transplantation, weaker strategy of “fighting spirit” before transplantation and stronger strategy of “anxious preoccupation” after BMT. Before transplantation 36% variations of depression were explained and estimated as weaker “fighting spirit” and worse “global life quality”. The essential predictors of depressive symptoms after transplantation, explained by 81% variations of depression, were weaker “fighting spirit” before transplantation, stronger “anxious preoccupation” after transplantation, worse “global life quality” after transplantation and higher level of anxious and depressive symptoms on admission to hospital. Conclusion: The psychological and pharmacological interventions, which reduce anxiety, depression and “anxious preoccupation” as well as enhance “fighting spirit”, should be introduced before BMT to improve the patients’ mental state

Alopecia areata as a manifestation of unconscious trauma : a case report

Objective. To indicate the importance of somatic and behavioural symptoms of a psychological trauma for the diagnostic process and further treatment planning. Case. A case is reported of a self-injuring woman, suffering from alopecia areata, hospitalized for depressive disorders with associated suicidal tendencies. Commentary. Alopecia areata may be a somatic manifestation of self-aggression. An analysis of the course of alopecia areata is a source of information valuable in the diagnostic process. Verification of a psychological background to the dermatological condition allows to introduce an appropriate treatment leading to a remission of somatic symptoms