Psychological determinants of pregnancy-related lumbo- pelvic pain: a prospective cohort study

Abstract Objective. To study whether pregnancy-related lumbopelvic pain outcomes at 36 weeks of gestation can be predicted by psychological determinants earlier in pregnancy. Design. Prospective cohort study. Setting. Nine midwifery practices in different regions of the Netherlands. Population. A cohort of 223 low-risk pregnant women in the Netherlands was followed from week 12 of gestation until 36 weeks of gestation. Methods. Both psychological determinants and lumbopelvic pain symptoms were investigated with a set of questionnaires at 12, 24 and 36 weeks of gestation. Psychological determinants were measured with the Perceived Stress Scale (PSS), the Symptom Checklist-90-Revised (SCL-90), the Pregnancy-related Anxiety Questionnaire (PRAQ), and the Utrecht Coping List (UCL). Lumbopelvic pain outcomes were measured with the Pregnancy Mobility Index (PMI) and the Overall Complaints Index (OCI). Main outcome measures. Lumbopelvic pain symptoms and their impact at 36 weeks of gestation. Results. There was a significant increase in scores on both the PMI and OCI across the three sampling occasions in pregnancy. Lumbopelvic pain outcomes showed significant associations with the psychological determinants perceived stress and recently perceived psychological and physical distress at all three times during pregnancy. Pregnancy-related anxiety was not a significant predictor of lumbopelvic pain outcomes, neither was coping. Conclusions. Lumbopelvic pain symptoms and their impact on daily activities at 36 weeks of gestation can be predicted by psychological determinants earlier in pregnancy; the combination of perceived stress and physical disability at 24 weeks of pregnancy seems to be the best predictor of disability in later pregnancy

Counterbalancing work-related stress?: Work engagement among intensive care professionals

Background and objectives: Working in an Intensive Care Unit (ICU) is increasingly complex and is also physically, cognitively and emotionally demanding. Although the negative emotions of work-related stress have been well studied, the opposite perspective of work engagement might also provide valuable insight into how these emotional demands may be countered. This study focused on the work engagement of ICU professionals and explored the complex relationship between work engagement, job demands and advantageous personal resources. Methods: This was a cross-sectional survey study among ICU professionals in a single-centre university hospital. Work engagement was measured by the Utrecht Work Engagement Scale, which included items about opinions related to the respondent's work environment. Additionally, 14 items based on the Jefferson Scale of Physician Empathy were included to measure empathic ability. A digital link to the questionnaire was sent in October 2015 to a population of 262 ICU nurses and 53 intensivists. Results: The overall response rate was 61% (n = 193). Work engagement was negatively related both to cognitive demands among intensivists and to emotional demands among ICU nurses. No significant relationship was found between work engagement and empathic ability; however, agreeableness, conscientiousness, and emotional stability were highly correlated with work engagement. Only the number of hours worked per week remained as a confounding factor, with a negative effect of workload on work engagement after controlling for the effect of weekly working hours. Conclusion: Work engagement counterbalances work-related stress reactions. The relatively high workload in ICUs, coupled with an especially heavy emotional burden, may be acknowledged as an integral part of ICU work. This workload does not affect the level of work engagement, which was high for both intensivists and nurses despite the known high job demands. Specific factors that contribute to a healthy and successful work life among ICU professionals need further exploration

Psychological Symptoms and Well-Being After Treatment for Primary Aldosteronism

Item does not contain fulltex

Effect of active evaluation on the detection of negative dysphotopsia after sequential cataract surgery: discrepancy between incidences of unsolicited and solicited complaints

\u3cbr/\u3ePurpose\u3cbr/\u3eTo evaluate the incidence of negative dysphotopsia after sequential cataract surgery.\u3cbr/\u3eMethods\u3cbr/\u3eRetrospective cohort study. The incidence of negative dysphotopsia was assessed by retrospective reviewing of medical records and interviews with patients between 2 and 4 months after sequential cataract surgery. Inclusion criteria were uncomplicated surgery, postoperative corrected distance visual acuity (CDVA) ≥20/25 Snellen and the absence of ocular comorbidity. The majority of intra-ocular lens (IOL) implants were one-piece AcrySof SN60WF (161 eyes). Other IOLs (29 eyes) were toric (SN6AT3-6), spherical (SN60AT), three-piece (MN60MA) and multifocal (ReSTOR SN6AD1, PanOptix TFNT00 and Finevision Micro F trifocal).\u3cbr/\u3eResults\u3cbr/\u3eThe study population was comprised of 95 patients with a mean age of 72 ± 10 years. Unsolicited complaints of negative dysphotopsia were reported by eight patients (8%), and two of them had a resolution of symptoms within 1 month of follow-up. Eighteen patients (19%) reported negative dysphotopsia at the time of the interview. Two patients reported bothersome negative dysphotopsia, and one of them was successfully treated with implantation of a supplementary IOL in the ciliary sulcus. Patients with negative dysphotopsia were younger than patients without dysphotopsia (p = 0.045) and had shorter axial eye length (p = 0.04), a tendency for higher IOL power (p = 0.09) and a higher CDVA (p = 0.001).\u3cbr/\u3eConclusion\u3cbr/\u3eThe incidence of unsolicited negative dysphotopsia after sequential cataract surgery appears to be a substantial underestimation of complaints identified in active interviewing. Although symptoms are not bothersome in the majority of cases, some patients with undiagnosed severe negative dysphotopsia may benefit from reassurance or secondary treatment.\u3cbr/\u3