Journal of psychosomatic research
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Two studies assessed whether measures of health, well-being, and sleepiness are better related to sleep quality or sleep quantity. In both studies, subjects completed a 7-day sleep log followed by a battery of surveys pertaining to health, well-being, and sleepiness. ⋯ In addition, average sleep quality was better related to sleepiness than sleep quantity. These results indicate that health care professionals should focus on sleep quality in addition to sleep quantity in their efforts to understand the role of sleep in daily life.
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Interviews with 18 male patients with predominantly psychogenic pain (DSM-III and DSM-III-R) and with 18 male patients with pain of mainly physical origin, consecutively admitted to a medical department, were rated by blinded and independent raters with respect to "symptom description," "manner of speech," "personality characteristics," "interviewer reactions," "interpersonal relationships," and "relationships at work." Patients with predominantly organic pain significantly more often described a clear localization of the pain symptom, used more sensory words for the description of pain quality; more often described discrete changes of pain intensity and periodicity; more often showed pain-intensifying factors dependent on movement and pain-decreasing factors; more often believed pain to be a symptom versus as a disease itself, and tended to have fewer difficulties in their interpersonal relationships than those with predominantly psychogenic pain (p < 0.05 for all factors, two-tailed Fisher's Exact test).
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More than 200 published studies from most medical settings worldwide have reported experiences with the Hospital Anxiety and Depression Scale (HADS) which was specifically developed by Zigmond and Snaith for use with physically ill patients. Although introduced in 1983, there is still no comprehensive documentation of its psychometric properties. ⋯ It is sensitive to changes both during the course of diseases and in response to psychotherapeutic and psychopharmacological intervention. Finally, HADS scores predict psychosocial and possibly also physical outcome.
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Numerous articles have been published investigating the incidence of and risk factors for delirium after cardiac surgery. Smith and Dimsdale reviewed the literature on postcardiotomy delirium in 1987 using a meta-analysis of 44 research studies. However, doubts about their methods and results caused the authors to re-examine the literature using these 44 references as well as computerized literature searches to gather research and review papers from medical journals. ⋯ Therefore, in most cases, the results are not comparable. Only a small number of the studies that were examined fit the criteria for statistical meta-analysis. On the basis of our analysis, a tentative conclusion may be drawn that the incidence of postcardiotomy delirium has declined slightly and that no strong risk factors have yet been identified.
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Assessing the effect of interventions on quality of life in cardiac patients lacks sensitivity because there is no specifically validated scale for measuring depression in cardiac patients. A questionnaire of 35 items (selected for face validity) was given to 246 cardiac outpatients (age 59.3 +/- 14.1 years, 159 male, 87 female). The Beck Depression Scale was then administered, followed by blinded clinical rating of depression. ⋯ The final scale consisted of 26 items (alpha reliability coefficient 0.90) in 2 robust dimensions and 7 subscales. The scale correlated well with clinical rating and with the Beck Depression Scale, but without the marked skewness of the latter. The behavior of the new Cardiac Depression Scale suggests that it will be an excellent measure for studies of outcome in cardiac patients.