The impact of muscle relaxation techniques on the quality of life of cancer patients, as measured by the FACT-G questionnaire.

INTRODUCTION: Patients with cancer frequently suffer from emotional distress, characterized by psychological symptoms such as anxiety or depression. The presence of psychological symptoms combined with the complex nature of oncology processes can negatively impact patients' quality of life. We aimed to determine the impact of a relaxation protocol on improving quality of life in a sample of oncological patients treated in the Spanish National Public Health System. MATERIALS AND METHODS: We conducted a multicenter interventional study without a control group. In total, 272 patients with different oncologic pathologies and showing symptoms of anxiety were recruited from 10 Spanish public hospitals. The intervention comprised abbreviated progressive muscle relaxation training, according to Bernstein and Borkovec. This was followed by weekly telephone calls to each patient over a 1-month period. We collected sociodemographic variables related to the disease process, including information about mental health and the intervention. Patients' quality of life was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire. Bivariate and univariate analyses were performed, along with an analysis of multiple correspondences to identify subgroups of patients with similar variations on the FACT-G. RESULTS: Patients showed statistically significant improvements on the FACT-G overall score (W = 16806; p<0.001), with an initial mean score of 55.33±10.42 and a final mean score of 64.49±7.70. We also found significant improvements for all subscales: emotional wellbeing (W = 13118; p<0.001), functional wellbeing (W = 16155.5; p<0.001), physical wellbeing (W = 8885.5; p<0.001), and social and family context (W = -1840; p = 0.037). CONCLUSIONS: Patients with cancer who learned and practiced abbreviated progressive muscle relaxation experienced improvement in their perceived quality of life as measured by the FACT-G. Our findings support a previous assumption that complementary techniques (including relaxation techniques) are effective in improving the quality of life of patients with cancer.

Association among presence of cancer pain, inadequate pain control, and psychotropic drug use.

INTRODUCTION: Pain is a common symptom in cancer patients, and its control and management are complex. Despite the high concomitant use of psychotropic drugs among such patients, the association among pain, inadequate pain control, and psychotropic drug use has not been fully determined. This study examined the prevalence of cancer pain and inadequate pain control and the association with psychotropic drug use. MATERIALS AND METHODS: In this cross-sectional study, we investigated 402 medical records obtained by simple random sampling of oncology patients at a hospital in northern Spain from July 2012 to July 2014. Adjusted odds ratios (ORs) were estimated together with their 95% confidence intervals (95% CIs) by unconditional logistic regression for each type of psychotropic drug (anxiolytics, hypnotics, and antidepressants). RESULTS: The mean patient age was 61.17 (standard deviation ± 13.14) years; 57.5% were women, 42.5% men. Pain was present in 18.4% of patients and inadequate pain control in 54.2%. We found a statistically significant association between the presence of cancer pain and anxiolytic use (adjusted OR, 3.15; 95% CI, 1.49-6.68) and hypnotic use (adjusted OR, 5.19; 95% CI, 1.77-15.25). Inadequate pain control was associated to a greater extent with the use of those drugs: adjusted OR for anxiolytic use, 4.74 (95% CI, 1.91-11.80); adjusted OR for hypnotic use, 6.09 (95% CI, 1.74-21.32). By contrast, no association was found between pain and antidepressant use (adjusted OR, 0.99). CONCLUSION: The presence of pain and (to a greater extent) poor pain control were associated with increased use of certain psychotropic drugs, such as anxiolytics and hypnotics. There appeared to be no association between pain and antidepressant use.

The relationship between experiential avoidance and burnout syndrome in critical care nurses: a cross-sectional questionnaire survey.

BACKGROUND: Critical care nurses often face complex stressful situations, and the phenomenon of burnout syndrome has been recognized as an important and increasing problem. Recent research suggests that another phenomenon, experiential avoidance, may be associated with burnout syndrome. OBJECTIVES: To determine the relationship between burnout syndrome and experiential avoidance in Spanish critical care nurses and to evaluate the relationships between burnout, experiential avoidance, certain health habits, and sociodemographic and job-related factors. DESIGN: A descriptive survey. SETTING: Participants were recruited from the critical care units of five major hospitals in the Northern State of Spain, Principado de Asturias. PARTICIPANTS: Of 98 critical care nurses who met the criteria for study inclusion, 80 agreed to participate and completed the survey. The participants were staff nurses who had worked a minimum of 1 year full-time in a critical care unit. Most were women and were aged 22-56 years. METHODS: The survey instrument consisted of the Maslach Burnout Inventory (to measure burnout) and the Acceptance and Action Questionnaire (to measure experiential avoidance). The survey also collected data regarding age, sex, marital status, type of hospital, years of critical care experience, number of patients per nurse, and self-reported tobacco dependency greater than 6 months. RESULTS: Participants showed high levels of emotional exhaustion (25.19+/-10.52), moderate levels of depersonalization (6.53+/-6.04), and low levels of accomplishment (8.95+/-7.890) as measured by the Maslach Burnout Inventory. The Acceptance and Action Questionnaire revealed a mean low pathologic score of 35.29+/-6.56. Pearson product moment correlation analysis indicated a significant inverse correlation between scores on the Maslach Burnout Inventory accomplishment subscale and scores on the Acceptance and Action Questionnaire frequency (r=0.237, p=0.05). More marked and significant was the positive correlation between the Acceptance and Action Questionnaire score and the depersonalization (r=0.525, p=0.01) and emotional exhaustion (r=0.507, p=0.01) subscale scores. Being older than 30 years and having more than 10 years of experience in a critical care environment as a nurse were significantly related to emotional exhaustion as measured by the Maslach Burnout Inventory. Clear evidence was found of an association between marital status and accomplishment (p=0.01) and between tobacco habit and depersonalization (p=0.003). CONCLUSIONS: This study demonstrates a relationship between experiential avoidance and burnout syndrome in critical care nurses in Spain. Being older than 30 years, having more than 10 years of experience, being single, and smoking were associated with a nurse's vulnerability to burnout syndrome.