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

Oczekiwania społeczne wobec opiniodawców

W gąszczu aksjologicznym każdy człowiek wybiera określoną drogę, kierując się własnymi przekonaniami o tym, co jest sprawiedliwe. W sytuacjach konfliktowych odwołuje się do wyznawanych zasad, a jeśli to nie przynosi pożądanych rezultatów, czuje się skrzywdzony i zwraca się o pomoc do instytucji powołanych do wymierzania sprawiedliwości. Żywi wówczas nadzieję, że tutaj właśnie zostanie zrozumiany, a trudna sytuacja, w jakiej się znalazł, będzie właściwie rozwiązana. Oczekiwania takie kierowane są wobec sądów i ekspertów, których instytucja ta powołuje. Wachlarz tych oczekiwań jest bardzo rozległy. Szczególnie wyraźnie zaznacza się to w stosunku do opiniodawcy, z którym strony mają możliwość wejścia w relacje, charakteryzujące się mniejszym dystansem niż w przypadku zespołu sędziowskiego. To właśnie opiniodawca jest spostrzegany jako osoba, której diagnoza i sposób oceny sytuacji w dużej mierze będą wyznaczać kierunek działania sądu i jego ostateczną decyzję. Może to stać się przyczyną różnego sposobu ustosunkowywania się do niego. Opiniodawca może zatem być traktowany bądź jako wróg, który czyha na ujawnienie niekorzystnych okoliczności, by pogrążyć badanego, bądź jako sojusznik, u którego trzeba szukać zrozumieni

Use of social media by older adults

The article presents issues regarding the use of information and communication technologies (ICT) by older adults and senior citizens. Over 55 years old people who attend the Jagiellonian University of Third Age, took part in the survey conducted in 2019. The aim of the study was to find out if respondents use social network sites (SNS) and how they participate in specific activities on these websites in order to gratify their needs (questions focused most on the issues connected with privacy management and data security).The study was attended by 89 people (78 correctly completed survey sheets were analysed). The results show that respondents use the internet willingly and that they are also active in SNS. One of the main factors motivating them to do so is curiosity. They prefer Facebook, rarely use Instagram or Twitter. Through SNS, they contact both friends and family. Respondents are cautious about sharing private content and their skills are not sufficient to protect their privacy effectively. The findings of this study contribute to our understanding of older adults' SNS use. The topic is relevant from a social (e.g. digital exclusion) and economic (e.g. older adults as consumers) point of view

The crossroads of gastroenterology and psychiatry : what benefits can psychiatry provide for the treatment of patients suffering from gastrointestinal symptoms

Introduction: Gastrointestinal symptoms are very common in the general population. Many of them coincide with mental disorders (especially with neuroses, stress-related disorders, somatisation disorders, autonomic dysfunction, and anxiety) that are associated with psychological trauma, conflicts, and difficulties with interpersonal relationships. Aim: Assessment of the association between gastrointestinal complaints and stressful situations in relationships, among patients admitted to day hospital for neurotic and behavioural disorders. Material and methods: Analysis of the likelihood of co-occurrence of abdominal symptoms and stressful situations, reported by patients before admission, in a large group of subjects treated with psychotherapy. Results: Gastrointestinal symptoms were highly prevalent in the studied group (they were reported by 40-50% of patients). The most common complaints in women were: loss of appetite (52%), nausea (49%), and constipation and flatulence (45%). In men the most prevalent symptoms were: loss of appetite (47%), heartburn (44%), and flatulence (43%). Functional gastrointestinal symptoms (especially vomiting in cases of nervousness in females or heartburn in males) were significantly associated with greater likelihood of current difficulties in interpersonal relationships, such as conflicts with partner/spouse or parent. Conclusions: The results suggest that in many cases symptoms of anxiety disorders or somatisation disorders coexisted with irritable bowel syndrome and functional dyspepsia

Anxiety and depression in cancer patients — what do we lose?

Depresja i lęk stanowią poważny problem medyczny u około 50% chorych na nowotwory. Depresja utrudnia leczenie i negatywnie wpływa na przebieg choroby, funkcjonowanie psychospołeczne i jakość życia pacjentów i zwiększa istotnie ryzyko zgonu. Koszty depresji są trudne do oszacowania, chociaż w globalnych kosztach leczenia nowotworów coraz częściej są uwzględniane medyczne i społeczne koszty powikłań depresji, natomiast koszty indywidualne ponoszone przez pacjentów i ich opiekunów najczęściej nie są uwzględniane w analizach.Depression and anxiety is a serious medical problem in about 50% of cancer patients. Depression may worse treatment, course of the illness, psychosocial functioning and quality of patients life and significantly increases mortality as well. The costs of depression is difficulty to account, however in global cost of cancer treatment more and more often medical and social cost of depression is taken into account, however individual patients and caregivers costs are not included in these analyses

Neurotic personality and pseudo-cardiac symptoms in a day hospital patients diagnosed at pretreatment between 2004 and 2014

Aim. Assessment of associations between occurrence of pseudocardiac symptoms inpatients qualified for psychotherapy, with intensity and picture of their neurotic personality disorder. Material and methods. Case records of 2450 patients from years 2004-2014 were analysed in terms of associations between symptoms reported by means of symptom checklist and global neurotic symptom scores (OWK), global neurotic personality level (XKON) and elevated scores of 24 scales of KON-2006 personality inventory. Associations expressed by OR coefficients with 95% confidence intervals were estimated with logistic regression analyses. Results. Presence of pseudocardiac symptoms seems to be linked to significantly higher neuroticism described both as global neurotic symptom level (OWK) as well as by global neurotic personality desintegration (XKON), and most of 24 scales of KON-2006 inventory. Conlusions. 1. Personality background examined with the use of KON-2006 seems to be an important risk factors of pseudo-cardiac symptoms being part of or accompanying neurotic syndromes. 2. In women especially strong appeared associations of tachycardia and Sense of being in danger, Exaltation, Asthenia and Conviction of own resourselessness. 3. In men pain in heart area was substantially associated with Sense of being overloaded. Probably pseudocardiac symptom cure may be attained by psychotherapeutic treatment aimed at its background – at elimination of neurotic personality dysfunctions

Brain-derived neurotrophic factor serum concentration and BDNF Val66Met polymorphism in patients with peripheral artery disease: the importance of heart failure

Introduction: Brain-derived neurotrophic factor (BDNF) and BDNF Val66Met polymorphism have been associated with cardiovascular diseases such as atherosclerosis, congestive heart failure (CHF), hypertension and ischaemic heart disease (IHD). To the authors’ knowledge, such connections have not been described in peripheral artery disease (PAD) yet. Material and methods: 159 PAD subjects and 57 controls were included. All enrolled subjects underwent evaluation of clinical status. Information on comorbidities such as diabetes type 2, hypertension, IHD and CHF, was gathered. Serum concentrations of BDNF were measured by ELISA. Genotypes of the BDNF-AS SNP rs6265 were determined using TaqMan SNP Genotyping Assay. Results: PAD patients had significantly lower BDNF serum concentrations compared to controls (median values of 7.2 vs. 35.1 ng/mL, P < 0.001). Concentrations were significantly lower in patients with concomitant CHF (P < 0.05). The CHF subgroup was characterised by a greater prevalence of diabetes and ischaemic heart disease (P < 0.01). There was no significant difference between BDNF serum concentrations and other comorbidities, ABI, and medical history including disease duration and past interventions. No important correlations were found for BDNF Val66Met polymorphism. Conclusions: The present study adds to the body of evidence associating BDNF and atherosclerosis. The serum BDNF concentrations were lower in PAD, especially in a subgroup with comorbid CHF. These results suggest that a larger cardiovascular burden is connected with decreased BDNF serum concentrations. No evidence was found to support the hypothesis that BDNF gene polymorphism may be a contributing factor in the pathogenesis of cardiovascular diseases such as PAD