Body, Mind & Spirit Articles and Latest News

As a Health Specialist (Clinical Studies), you will perform the following tasks:

• Provide regulatory guidance for the design of NCCAM studies;
• Participate in development and implementation of procedures to establish and maintain coordination among the various components of clinical trials;
• Oversee the clinical monitoring/auditing of assigned studies;
• Oversee the process for clinical study site visits;
• Assist in the development of planning activities for potential future clinical studies; and
• Review the adequacy of information provided in proposals for clinical studies.

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As a Health Specialist (Clinical Studies), you will perform the following tasks:

• Provide regulatory guidance for the design of NCCAM studies;
• Participate in development and implementation of procedures to establish and maintain coordination among the various components of clinical trials;
• Oversee the clinical monitoring/auditing of assigned studies;
• Oversee the process for clinical study site visits;
• Assist in the development of planning activities for potential future clinical studies; and
• Review the adequacy of information provided in proposals for clinical studies.

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No differences in job perceptions amongst Dutch nurse anaesthetists with and without nursing background.

Anestezjol Intens Ter. 2011 Jul-Sep;43(3):130-5

Authors: Meeusen V, Van Dam K, Brown-Mahoney C, Van Zundert A, Knape H

Abstract
BACKGROUND: In the Netherlands, the employment as a “nurse anaesthetist” is comparable to that of a registered nurse anaesthetist in the Scandinavian countries and Poland. However, the Dutch healthcare system employs nurse anaesthetists both with and without nursing backgrounds. This study has investigated whether a nursing background influences the attitudes and perceptions of nurse anaesthetists in the Netherlands.
METHODS: A survey was distributed to all nurse anaesthetists working in Dutch hospitals to discover differences in their perceptions of their work context, job satisfaction, and work climate, as well as health and turnover intention. The questionnaire also sought basic information on socio-demographic factors and psychosomatic symptoms. Descriptive statistics, factor analyses and independent T-tests were computed.
RESULTS: Overall 923 of a total of 2,000 questionnaires were completed and analysed (response rate of 46%). Independent T-tests showed no significant differences between nurse anaesthetists with and those without nursing backgrounds in all the areas examined.
CONCLUSION: Dutch nurse anaesthetists with and without nursing backgrounds reported similar perceptions of and information about their work context, job satisfaction, work climate, psychosomatic symptoms, burnout, sickness absence, general health and turnover intention. Both academic tracks appeared to produce individuals who functioned similarly as professionals.

PMID: 22011919 [PubMed - in process]

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Treatment of posttraumatic embitterment disorder with cognitive behaviour therapy based on wisdom psychology and hedonia strategies.

Psychother Psychosom. 2011;80(4):199-205

Authors: Linden M, Baumann K, Lieberei B, Lorenz C, Rotter M

Abstract
BACKGROUND: Posttraumatic embitterment disorder (PTED) is a reaction to unjust or humiliating life events, including embitterment and impairment of mood, somatoform complaints, reduction in drive, withdrawal from social contacts, and even suicide and murder suicide. Patients have been shown to be nonresponders to many treatments. This paper gives an outline of cognitive behaviour therapy based on wisdom psychology and reports first data on treatment effects.
METHOD: In a first pilot study on psychotherapy for PTED, a cohort of 25 PTED inpatients was treated with routine multidimensional cognitive behaviour therapy. A second consecutive cohort of 28 patients was treated with PTED-specific cognitive behaviour therapy, which is based on wisdom psychology (wisdom psychotherapy) and another 29 patients with cognitive behaviour therapy based on wisdom psychology together with additional hedonia strategies (wisdom and hedonia psychotherapy). Treatment integrity was measured with special modules of the Behaviour Therapy Competency Checklist. The outcomes were measured in all 3 groups with the SCL-90 and a global clinical rating of patients and therapists on treatment outcome.
RESULTS: There were significant and clinically meaningful reductions in the SCL score after wisdom therapy, as compared to routine treatment. In clinical ratings by therapists and patients, both specific treatments were judged as more effective than treatment as usual. Additional hedonia strategies did not lead to better treatment effects.
CONCLUSIONS: The results of this pilot study suggest that wisdom psychology offers an approach to treat PTED and justify further randomized controlled outcome studies.

PMID: 21494061 [PubMed - indexed for MEDLINE]

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Psychological treatment for anorexia nervosa: a meta-analysis of standardized mean change.

Psychother Psychosom. 2011;80(4):216-26

Authors: Hartmann A, Weber S, Herpertz S, Zeeck A,

Abstract
BACKGROUND: For the German treatment guidelines for eating disorders, the literature on psychological treatment of anorexia nervosa (AN) was reviewed systematically. As a common meta-analysis of randomized clinical trials proved to be impossible, a review of all available clinical trials was conducted, statistically integrating standardized mean change scores. Research questions comprised differential effects of therapeutic techniques and settings as well as determining which weight gains could be expected.
METHODS: After an extensive literature search, studies were selected, rated by 3 independent raters. Weight gain as the main outcome criterion was transformed into standardized mean change scores. Effect sizes were checked for homogeneity.
RESULTS: 57 studies containing 84 treatment arms and 2,273 patients could be integrated. Studies differed considerably in quality. The strongest bias identified was reporting selectively on completers or failures, versus intention-to-treat samples. No significant differences between effect sizes could be identified concerning treatment setting, technique or patient characteristics. If treatment time is taken into account, inpatient treatment produced a faster weight gain than outpatient treatment.
CONCLUSION: The study describes weight gains which can be reached in outpatient and inpatient settings. It yielded no salient results speaking for a certain therapy technique, setting or procedure. Treatment guidelines for psychological treatment of AN still have to rely on lower level evidence.

PMID: 21494063 [PubMed - indexed for MEDLINE]

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Disclosing information about randomised controlled trials in oncology: training concept and evaluation of an individualised communication skills training for physicians COM-ON-rct.

Eur J Cancer Care (Engl). 2011 Sep;20(5):570-6

Authors: Wuensch A, Goelz T, Bertz H, Wirsching M, Fritzsche K

Abstract
When physicians disclose information about randomised controlled trials, they have to balance the requirements of conducting high standard research and the respect for patients’ rights. Physicians need training in this difficult matter. An individualised communication skills training (CST) about randomised controlled trials for oncologists has been developed. The aim of this publication is to describe the concept of our CST and present data of evaluation by the participants: First, a theoretical introduction about a communication model and important ethical and legal issues was presented. Individual learning goals of participants were then derived through video assessment with actor-patients. The learning goals were the basis for practicing in role play. Individual coaching helped physicians to transfer the made experience into their daily work. Forty physicians have been trained. The acceptance of the training concept was assessed by a questionnaire consisting of 14 items and using a 6-point scale from 1 (very best) to 6 (very bad): the individualised CST was highly accepted (mean = 1.33). Practicing with actor-patients (mean = 1.4), providing constructive feedback (mean = 1.3) and assessing individual learning goals (mean = 1.85) were seen as helpful. Our CST trains physicians to realise best research standards and incorporate patients’ rights.

PMID: 21029223 [PubMed - indexed for MEDLINE]

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[Complex regional pain syndrome and myoclonus: an uncommon combination.]

An Pediatr (Barc). 2011 Oct 17;

Authors: Alvarez Fuente M, Aleo Luján E, Cascón Criado E, Galindo Doncel G, San Antonio Arce V

Abstract
Complex regional pain syndrome (CRPS) is quite uncommon in paediatric patients. There is no identified organic aetiology. CRPS has a very significant psychosomatic component; therefore it is necessary to take a multidisciplinary approach to its treatment, which should include psychiatric assessment. CRPS is very difficult to diagnose, and can take months to control its symptoms. The association with myoclonus is rare, and since myoclonus is the clinical manifestation of a vast spectrum of different neurological disorders, some of which are degenerative, it is important to make a diagnosis as quickly as possible. We present the case of an adolescent male with an atypical presentation of CRPS. CRPS was located in the thorax, which is very unusual and was associated with myoclonus and dystonias. This made the diagnosis harder and widened the aetiological spectrum.

PMID: 22015053 [PubMed - as supplied by publisher]

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Organizational justice at school and its associations with pupils’ psychosocial school environment, health, and wellbeing.

Soc Sci Med. 2011 Oct 12;

Authors: Elovainio M, Pietikäinen M, Luopa P, Kivimäki M, Ferrie JE, Jokela J, Suominen S, Vahtera J, Virtanen M

Abstract
It has been shown that the psychosocial environment perceived by school staff is associated with children’s academic performance and wellbeing. In this study we examined the associations between organizational justice (procedural and relational justice) as reported by school staff and pupils’ perceptions of their school environment, health problems, academic performance, and absenteeism. We combined data from two surveys: for the staff (the Finnish Public Sector Study, n = 1946) and pupils (the Finnish school health promotion survey, n = 11,781 boys and 12,842 girls) of 136 secondary schools, collected during 2004-2005. Multilevel cumulative logistic regression analyses showed that after adjustment for potential individual and school-level confounding factors, low procedural justice was associated with pupils’ dissatisfaction with school-going. Low relational justice was associated with a 1.30 times higher risk of poor academic performance, 1.15 times higher risk of psychosomatic symptoms and 1.13 times higher risk of depressive symptoms among pupils. Both organizational justice components were associated with truancy. We concluded that staff perceptions of organizational justice at school are associated with pupils’ reports of their psychosocial school environment, health, performance, and absenteeism due to truancy. Improving managerial and decision making procedures among school personnel may be an important factor for protecting pupils’ academic performance and wellbeing.

PMID: 22019366 [PubMed - as supplied by publisher]

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How to compare scores from different depression scales: equating the Patient Health Questionnaire (PHQ) and the ICD-10-Symptom Rating (ISR) using Item Response Theory.

Int J Methods Psychiatr Res. 2011 Oct 20;

Authors: Fischer HF, Tritt K, Klapp BF, Fliege H

Abstract
A wide range of questionnaires for measuring depression are available. Item Response Theory models can help to evaluate the questionnaires exceeding the boundaries of Classical Test Theory and provide an opportunity to equate the questionnaires. In this study after checking for unidimensionality, a General Partial Credit Model was applied to data from two different depression scales [Patient Health Questionnaire (PHQ-9) and ICD-10-Symptom Rating (ISR)] obtained in clinical settings from a consecutive sample, including 4517 observations from a total of 2999 inpatients and outpatients of a psychosomatic clinic. The precision of each questionnaire was compared and the model was used to transform scores based on the assumed underlying latent trait. Both instruments were constructed to measure the same construct and their estimates of depression severity are highly correlated. Our analysis showed that the predicted scores provided by the conversion tables are similar to the observed scores in a validation sample. The PHQ-9 and ISR depression scales measure depression severity across a broad range with similar precision. While the PHQ-9 shows advantages in measuring low or high depression severity, the ISR is more parsimonious and also suitable for clinical purposes. Furthermore, the equation tables derived in this study enhance the comparability of studies using either one of the instruments, but due to substantial statistical spread the comparison of individual scores is imprecise. Copyright © 2011 John Wiley & Sons, Ltd.

PMID: 22021205 [PubMed - as supplied by publisher]

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Is there evidence for the use of art therapy in treatment of psychosomatic disorders, eating disorders and crisis? A comparative study of two different systems for evaluation.

Scand J Psychol. 2011 Oct 25;

Authors: Holmqvist G, Persson CL

Abstract
Holmqvist, G. & Lundqvist Persson, C. (2011). Is there evidence for the use of art therapy in treatment of psychosomatic disorders, eating disorders and crisis? A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.

PMID: 22023072 [PubMed - as supplied by publisher]

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