Bmc Psychiatry
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Observational Study
Anxiety and its predictive value for pain and regular analgesic intake after lumbar disc surgery - a prospective observational longitudinal study.
Ongoing pain after surgery is a major problem and influences recovery and the quality of life of the patient. Associations between anxiety and their impact on postoperative pain after herniated disc surgery have been reported, but the results are inconsistent. The aim of the present longitudinal study was to evaluate the predictive value of preoperative anxiety for postoperative ongoing pain and prolonged analgesic intake after herniated disc surgery. ⋯ We found no evidence for the presence of anxiety before disc surgery being a prognostic factor for ongoing pain and regular postoperative intake of analgesics. Only preoperative pain intensity was predictive for increased pain and continued need for analgesic medication up to 6 months after lumbar disc surgery.
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One of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal. ⋯ Multiple psychosocial and demographic factors were associated with resilience in people who sustained an earthquake-related SCI. Mental health professionals should demonstrate concern and consider such factors in allocating care in this group. Development of intervention research concerning resilience is recommended to strengthen resilience in order to improve rehabilitation outcomes and enhance reintegration of individuals with SCI into their communities.
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Randomized Controlled Trial Pragmatic Clinical Trial
Digital IAPT: the effectiveness & cost-effectiveness of internet-delivered interventions for depression and anxiety disorders in the Improving Access to Psychological Therapies programme: study protocol for a randomised control trial.
Depression and anxiety are common mental health disorders worldwide. The UK's Improving Access to Psychological Therapies (IAPT) programme is part of the National Health Service (NHS) designed to provide a stepped care approach to treating people with anxiety and depressive disorders. Cognitive Behavioural Therapy (CBT) is widely used, with computerised and internet-delivered cognitive behavioural therapy (cCBT and iCBT, respectively) being a suitable IAPT approved treatment alternative for step 2, low- intensity treatment. iCBT has accumulated a large empirical base for treating depression and anxiety disorders. However, the cost-effectiveness and impact of these interventions in the longer-term is not routinely assessed by IAPT services. The current study aims to evaluate the clinical and cost-effectiveness of internet-delivered interventions for symptoms of depression and anxiety disorders in IAPT. ⋯ This study seeks to evaluate the immediate and longer-term impact, as well as the cost effectiveness of internet-delivered interventions for depression and anxiety. This study will contribute to the already established literature on internet-delivered interventions worldwide. The study has the potential to show how iCBT can enhance service provision, and the findings will likely be generalisable to other health services.