Effects of a compassion-based program on the grief experienced by caregivers of people suffering from dementia: a randomized controlled clinical trial.

BACKGROUND: Dementia is a syndrome that reduces the cognitive and functional abilities of the brain increasing the need for care. The caregivers of these patients are mostly their family members. The great care burden causes devastating effects on the health of family caregivers and the grief experienced by these family caregivers is considerable. This study was conducted to investigate the effects of a compassion-based program on the grief experienced by caregivers of people suffering from dementia. METHOD: The present study was a randomized controlled clinical trial in which 70 family caregivers of people suffering from dementia were sampled through the block method and they were divided into experimental and control groups. The data collection tools included demographic information questionnaire and grief inventory that was completed before, a week and a month after the implementation of the compassion-based program in five sessions virtually by sending offline content to the experimental group. The obtained data were analyzed by SPSS 22 software using the repeated measures analysis of variance. RESULTS: The mean comparison of scores of the grief experienced in the experimental group between pretest and posttest and follow-up, unlike the control group, showed a significant difference (p < 0.001). The mean scores of the experimental and the control groups were significantly different in terms of experiencing mourning and all of its fields (p < 0.001). The mean comparison of post-test and follow-up showed that the effect of a compassion-based program at the follow-up stage has been mitigated. CONCLUSIONS: According to the study results, the compassion-based program reduced the grief experienced by the family caregivers of people suffering from dementia. Nevertheless, the effect of a compassion-based program has been reduced over time. This program can be a good guide for providing society-oriented services to the health team. TRIAL REGISTRATION: This study is registered by Iranian Registry of Clinical Trials with decree code: IRCT20190712044181N4  on 02/06/2020.

A comparative MRI study of upper and lower lumbar motion segments in patients with low back pain.

STUDY DESIGN: The study is a prospective cross-sectional study of 514 patients with low back pain and sciatica. OBJECTIVE: The aim of this study was to assess the relation of various risk factors on upper and lower lumbar levels. SUMMARY OF BACKGROUND DATA: Various risk factors such as aging, job (physical habits), obesity, and cigarette smoking have been reported to accelerate lumbar degenerative process, possibly to a different extent in upper and lower lumbar spine. Lumbar spine motion segment degenerative process has been radiologically assessed by severity of nucleus pulposus (NP) dislodgement, annular tears, and Modic changes in adjacent end plates. METHODS: Five hundred and fourteen patients with low back pain of at least 4 weeks duration, aged 18 to 70 years were prospectively enrolled. All underwent thorough neurological assessment and lumbar 1.5 T high-resolution magnetic resonance imaging, being evaluated by independent neurosurgeon and neuroradiologists. NP dislodgement and Modic changes as well as neurological findings were graded. Statistical analysis was performed by analysis of variance, t test, chi, and Fisher exact test. RESULTS: There were 244 men and 270 women. Sixty-six percent of lower lumbar levels showed NP dislodgement at least in 1 level. Aging had significant association with NP dislodgement, and patients with lower lumbar NP dislodgement had a mean age, 10 years younger than those with upper lumbar NP dislodgement. There was no significant association between sex, body mass index >25 kg/m, and vibratory job either in upper or lower lumbar levels and NP degeneration. Heavy lifting was associated with upper lumbar NP dislodgement while, sedentary and housework were associated with NP dislodgement only in lower lumbar levels. Also cigarette smoking (> or =10 pack/y) and older age (>50 y) were associated only with upper lumbar NP dislodgement. Modic changes correlated only with advanced age (>50 y), and there was no association with body mass index >25, smoking, job habits and sex. CONCLUSIONS: The study revealed that pathological alteration in vertebral end plates is the same in upper and lower lumbar bony tissues as detected by Modic's criteria, whereas those of intervertebral discs is different regarding spinal level and risk factor.

Comparative study of quality of life, anxiety, depression, and fatigue among patients with neuromyelitis optica spectrum disorder and multiple sclerosis: The first report from Iran.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are associated with reduced Health Related Quality of Life (HRQOL). To the best of our knowledge, change of HRQOL in patients with NMOSD has not been yet measure in Iran. The objective of this study was to assess HRQOL in NMOSD and MS patients and identify related factors METHODS: A cross sectional study of 41 patients with NMOSD and 136 age and sex-match MS patients was performed. A series of questionnaires including Persian validated questionnaires on HRQOL (SF-36), fatigue (MFIS), depression (BDI-II), anxiety (HAM-A) and sleep quality (PSQI) were record. All demographic variables, socioeconomic status and clinical data were also obtained. Student's T test and Mann-Whitney U test used to compare variables between groups and multivariate regression analysis applied to assay predictor factors. RESULTS: The mean scores of mental (MCS) and physical (PCS) components of QOL were statistically lower in patients with NMOSD compare with MS patients (ß = -4.49, P = 0.004; ß = -3.52, P = 0.015). Multivariate analysis indicated fatigue, depression and anxiety were independent, significant predictor of MCS (ß = -0.229, P = 0.002; ß = -0.229, P = 0.002; ß = -0.258, P = 0.020 respectively). However, PCS was significantly predicted by fatigue (ß = -0.258 P < 0.001), solely. CONCLUSION: These findings indicate NMOSD patients have lower HRQOL in compare to patients with MS. Also, screening and treatment of fatigue as the most important predictor for HRQOL is necessary.