Reliability and Validity of a Hong Kong Chinese Version of the St George's Respiratory Questionnaire in Patients with COPD

AbstractThe St George's Respiratory Questionnaire (SGRQ) is a self-administered questionnaire designed to measure quality of life (QOL) covering three areas (symptoms, activity and impacts) in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to develop a Chinese version of the SGRQ (SGRQ-HK) and assess its psychometric properties. A forward and back-translation method was used, which included professional and lay people. Psychometric and clinical evaluations included 54 patients with COPD (31 males: mean age, 71.22 ± 5.95 years; 23 females: mean age, 68.8 ± 8.64 years). An additional QOL questionnaire and clinical and physiological data were also collected. The correlation coefficient between “symptoms” and dyspnoea was 0.67, that between “activity” and the 6-minute walk test was −0.78, between “impacts” and “mental health” of the SF-36 Health Survey Mental Health Inventory was −0.62; and between “total” and “general health” of the SF-36 was −0.87. Cronbach's a ranged from 0.74 to 0.95 for the whole questionnaire and its three subscales. Test-retest reliability showed intraclass correlation coefficients of all the dimensions exceeding 0.70. The three-factor structure of the SGRQ-HK was established. In conclusion, the SGRQ-HK is reliable and valid and compares well with the original English version

The Relationship Between Pain Responsiveness And Disease Activity In Fibrositis And Rheumatoid Arthritis

The present research examined the relationship between pain responsiveness and disease activity in patients with the rheumatologic diagnoses of rheumatoid arthritis (R.A.) and fibrositis. Three studies were carried out.;In the first study, 68 R.A. subjects were assessed for levels of disease activity using 7 standard measures, plus the rheumatoid factor titre and the R.A. functional classification. The Basic Personality Inventory was used to measure anxiety, depression, hypochondriasis, and denial. Pain threshold and tolerance levels were taken in each subject using trains of electrical pulses, a constant-pressure algometer, and a variable-pressure dolorimeter. The data were analyzed by multiple regression. The results indicate that pain tolerance is best predicted by levels of disease activity, gender, hypochondriasis and rheumatoid factor titre. Significant differences were found between the sexes on pain responsiveness and disease activity.;One year later, 38 (55%) of the original subjects returned. The same measures, methodology, and analyses were used as on the previous visit. It was found that disease activity and pain responsiveness had decreased between visits. A much clearer pattern of association between the variables was evident. Disease activity was the most important single predictor, in a negative direction, of pain threshold and tolerance levels.;In the third study, 36 patients with the diagnosis of fibrositis completed a 10-week placebo-controlled, randomized double-blind crossover trial of low-dose amitriptyline. Outcome measures were local tenderness (TMS), and pain threshold and tolerance, assessed with the variable-pressure dolorimeter. The other principal measures were, depression, state anxiety, sickness impact, hypochondriasis and pain. The data were initially analyzed using multivariate statistics. Compared to placebo, amitriptyline significantly improved pain, pain threshold, TMS, depression, hypochondriasis and sickness impact. Levels of pain, and pain threshold and the TMS showed a strong negative relationship. A discriminant analysis indicated that pain and the length of symptoms were the most important variables that predicted those who responded to amitriptyline.;This research supports hypervigilance theory which holds that people with chronic pain become more responsive to painful stimuli as a result of their symptoms

Comorbid Chronic Pain and Depression: Who Is at Risk?

The purpose of this study was to investigate the prevalence and demographic risk factors of chronic pain and its comorbidity with depression. Computer-assisted telephone interviewing was utilized to obtain a representative community sample in the state of Michigan (N = 1,179). The prevalence of chronic pain due to any cause was 21.9%. Approximately 35% of participants with chronic pain also had comorbid depression (7.7% of the entire sample). Depression was not associated with pain types or sites. A multinomial regression analysis revealed several demographic correlates of chronic pain and depression. Participants with chronic pain or comorbid pain and depression were more likely to be older, female, employed less than full-time, and have less education than persons without either condition. Logistic regression analyses showed that younger participants were more likely to have comorbid pain and depression than chronic pain only. A similar but marginally significant effect was found for African-American participants. Compared to the depression only group, those in the comorbid group were more likely to be women and middle-aged. These findings provide additional evidence on the prevalence of comorbid pain and depression in the community and suggest that certain demographic groups with chronic pain may especially benefit from depression screenings

The effect of alternating and biphasic currents on humans' wound healing: a literature review

[Abstract] Although different types of currents, including bidirectional currents, have been used to promote healing, there is neither a summary about their effects nor consensus on best parameters to be used. The aim of this article is to provide an overview of current evidence on the effectiveness of bidirectional electrical stimulation on wound healing in accordance with the parameters used. Relevant articles were selected following a search of Medline, Cochrane, Embase, CINAHL, and PEDro for English, Spanish, Portuguese, Italian, or French articles published between 1980 and 2011. Ten trials and four case-series were found that deal with pressure ulcers, diabetic ulcers, venous ulcers, skin flaps, and amputation. Eight trials were of low-quality. Five of ten controlled trials found a statistically significant difference on wound healing, and another four trials found positive trends. Both of the two skin flap trials, one of two diabetic trials, and two of five pressure ulcer trials found a significant difference in bidirectional stimulated groups. Both TENS and NMES types of currents were used, but many parameters were not specified. In general, bidirectional currents appear to increase wound healing rates and reduce size of wounds, above all in skin flaps. However, there is a lack of well-designed studies on biphasic and alternating stimulation, and there is a need for improvement in description of parameters and in uniformity of nomenclature

Personality styles in patients with fibromyalgia, major depression and healthy controls

BACKGROUND: The fibromyalgia syndrome (FMS) is suggested to be a manifestation of depression or affective spectrum disorder. We measured the cognitive style of patients with FMS to assess personality styles in 44 patients with fibromyalgia syndrome (FMS) by comparing them with 43 patients with major depressive disorder (MDD) and 41 healthy controls (HC). METHODS: Personality styles were measured by the Sociotropy and Autonomy Scale (SAS) and the Dysfunctional Attitude Scale (DAS). The Structured Clinical interview for DSM Axis I was applied to Axis I disorders, while the Beck Depression Inventory was used to measure depression severity. RESULTS: Patients with FMS in general have a sociotropic personality style similar to patients with MDD, and different from HC, but FMS patients without a lifetime history of MDD had a cognitive personality style different from patients with MDD and similar to HC. CONCLUSION: These findings suggest that a depressotypic personality style is related to depressive disorder, but not to FMS

Effect of age, sex and gender on pain sensitivity: A narrative review

© 2017 Eltumi And Tashani. Introduction: An increasing body of literature on sex and gender differences in pain sensitivity has been accumulated in recent years. There is also evidence from epidemiological research that painful conditions are more prevalent in older people. The aim of this narrative review is to critically appraise the relevant literature investigating the presence of age and sex differences in clinical and experimental pain conditions. Methods: A scoping search of the literature identifying relevant peer reviewed articles was conducted on May 2016. Information and evidence from the key articles were narratively described and data was quantitatively synthesised to identify gaps of knowledge in the research literature concerning age and sex differences in pain responses. Results: This critical appraisal of the literature suggests that the results of the experimental and clinical studies regarding age and sex differences in pain contain some contradictions as far as age differences in pain are concerned. While data from the clinical studies are more consistent and seem to point towards the fact that chronic pain prevalence increases in the elderly findings from the experimental studies on the other hand were inconsistent, with pain threshold increasing with age in some studies and decreasing with age in others. Conclusion: There is a need for further research using the latest advanced quantitative sensory testing protocols to measure the function of small nerve fibres that are involved in nociception and pain sensitivity across the human life span. Implications: Findings from these studies should feed into and inform evidence emerging from other types of studies (e.g. brain imaging technique and psychometrics) suggesting that pain in the older humans may have unique characteristics that affect how old patients respond to intervention

The MOBILIZE Boston Study: Design and methods of a prospective cohort study of novel risk factors for falls in an older population

<p>Abstract</p> <p>Background</p> <p>Falls are the sixth leading cause of death in elderly people in the U.S. Despite progress in understanding risk factors for falls, many suspected risk factors have not been adequately studied. Putative risk factors for falls such as pain, reductions in cerebral blood flow, somatosensory deficits, and foot disorders are poorly understood, in part because they pose measurement challenges, particularly for large observational studies.</p> <p>Methods</p> <p>The MOBILIZE Boston Study (MBS), an NIA-funded Program Project, is a prospective cohort study of a unique set of risk factors for falls in seniors in the Boston area. Using a door-to-door population-based recruitment, we have enrolled 765 persons aged 70 and older. The baseline assessment was conducted in 2 segments: a 3-hour home interview followed within 4 weeks by a 3-hour clinic examination. Measures included pain, cerebral hemodynamics, and foot disorders as well as established fall risk factors. For the falls follow-up, participants return fall calendar postcards to the research center at the end of each month. Reports of falls are followed-up with a telephone interview to assess circumstances and consequences of each fall. A second assessment is performed 18 months following baseline.</p> <p>Results</p> <p>Of the 2382 who met all eligibility criteria at the door, 1616 (67.8%) agreed to participate and were referred to the research center for further screening. The primary reason for ineligibility was inability to communicate in English. Results from the first 600 participants showed that participants are largely representative of seniors in the Boston area in terms of age, sex, race and Hispanic ethnicity. The average age of study participants was 77.9 years (s.d. 5.5) and nearly two-thirds were women. The study cohort was 78% white and 17% black. Many participants (39%) reported having fallen at least once in the year before baseline.</p> <p>Conclusion</p> <p>Our results demonstrate the feasibility of conducting comprehensive assessments, including rigorous physiologic measurements, in a diverse population of older adults to study non-traditional risk factors for falls and disability. The MBS will provide an important new data resource for examining novel risk factors for falls and mobility problems in the older population.</p