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1.
J Am Psychiatr Nurses Assoc ; : 1078390320905669, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-32052669

RESUMEN

BACKGROUND: Substance misuse remains a public health crisis and contributor to morbidity and mortality. The nursing workforce is not immune to the impacts of substance misuse as rates are thought to mirror those of the general population. Additionally, as substance misuse often begins in adolescence or early adulthood, prevalence of misuse among practicing nurses highlights the fact that students are also at risk. OBJECTIVES: The purpose of this study was to examine rates and patterns of substance use and adverse childhood experience (ACE) exposure among nursing students while also examining associations between substance use and ACE exposure. METHOD: This study utilizes a cross-sectional and descriptive design through the provision of email surveys to nursing students. Email surveys consisting of the Alcohol Use Disorders Identification Test, the Drug Abuse Screening Tool 10-item survey, the ACE Questionnaire, and a demographic inquiry were distributed via Qualtrics survey software. RESULTS: A total of 662 individuals participated in the survey, the majority of whom self-identified as female, were undergraduate students, and were between 18 and 21 years. Moderate- to high-risk alcohol use was identified in 20% of students, while moderate- to high-risk drug use was identified in 3.6% of students. More than half of students endorsed exposure to at least one ACE. Significant associations were found between the Drug Abuse Screening Tool 10-item survey and the ACE Questionnaire. CONCLUSIONS: The results of this study have significant implications for nursing educators and must inform groundwork for the development of policies and interventions that are evidence based, nonpunitive, and trauma informed.

2.
Geriatr Nurs ; 40(6): 553-557, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31036404

RESUMEN

Approximately 40% of older adults drink alcohol. Older adults living in community care residences are a vulnerable population at risk for alcohol use related problems especially for those age 65 years and older who are taking medications, have health problems, and have risky alcohol consumption. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach for individuals at risk for alcohol use disorders. A quality improvement project evaluated SBIRT education effects on nursing staff knowledge and attitudes related to alcohol use, and resident alcohol use. The staffs' SBIRT knowledge and alcohol related attitudes increased significantly. The staff documented SBIRT intervention 231 times in three months' post training.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo , Personal de Enfermería/educación , Derivación y Consulta , Instituciones Residenciales , Trastornos Relacionados con Sustancias/terapia , Adulto , Femenino , Humanos , Masculino , Mejoramiento de la Calidad
3.
Can J Nurs Res ; : 844562119840172, 2019 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-30947519

RESUMEN

BACKGROUND: Interprofessional education strategies are becoming more prevalent as nursing schools integrate interprofessional practice activities into their curricula. PURPOSE: This paper presents the results of a federally funded project to deliver online interprofessional education to nursing students on screening for alcohol and substance use in rural areas, in which their perceptions about interprofessional education were measured. METHODS: A quasi-experimental within-subjects repeated measures design was utilized. Students in the bachelor or associate degree program were recruited from two rural nursing schools. A demographic questionnaire, Alcohol and Alcohol Problems Questionnaire, Drug and Drug Problems Questionnaire, and Interprofessional Education Perception Scale were utilized. General linear modeling was used to determine changes in these measurements over time. Data collection was performed at pretraining, posttraining, and following an online interprofessional dialogue. RESULTS: The study consisted of 89 nursing students. The participants were 87% female (n = 77/89) and 91% white (n = 81/89); their mean age was 24.9 years (standard deviation = 10.36). Analysis of evaluation questionnaires demonstrated increased levels of confidence in working with patients who consume alcohol or other drugs and on certain aspects of interprofessional education. CONCLUSION: Online interprofessional preservice education holds the potential to positively increase nursing students' confidence in working with patients and to increase their interprofessional practice.

4.
J Am Psychiatr Nurses Assoc ; 25(6): 467-475, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30596312

RESUMEN

BACKGROUND: Alcohol and/or opioid stigma perceptions are barriers to screening, brief intervention, and referral to treatment (SBIRT) implementation. AIM: To examine SBIRT education and clinical exposure efficacy at decreasing nursing students' stigma perceptions toward caring for patients affected by alcohol and/or opioid use problems. METHOD: A single-sample, pretest-posttest design with N = 124 nursing students. The students had a 1.5-hour SBIRT education session and a 12-week clinical experience with some patients who had alcohol and/or opioid use problems. RESULTS: The participants' stigma perceptions improved toward patients who had alcohol and/or opioid use problems. CONCLUSIONS: SBIRT education and clinical exposure may provide a basis for promoting understanding of alcohol and/or opioid use-related stigma and can be used as an intervention to decrease some of stigma's negative effects.

5.
J Addict Nurs ; 29(3): 163-166, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30180001

RESUMEN

PURPOSE: The United States is in the midst of an unprecedented public health crisis, with annual morbidity and mortality data related to opioid use consistently increasing and appearing more worrisome. To mitigate such consequences, it is critical that those with opioid use disorders are provided with and have access to evidence-based treatment modalities. METHODS: The project utilized a course scaffolding approach to integrate a comprehensive substance use framework into an advanced practice nursing curriculum, with an emphasis on medication-assisted treatment as part of an advanced pharmacology course required for licensure. RESULTS: Students' knowledge assessment increased significantly, from an average of 2.82 to 3.78 out of 5 items, t(217) = -10.31, p < .01. CONCLUSIONS: Educators and academic administrators must be steadfast in their resolve to include substance use, and specifically opioid use, education into all areas and levels of nursing study.


Asunto(s)
Curriculum , Educación de Postgrado en Enfermería/organización & administración , Tratamiento de Sustitución de Opiáceos/métodos , Trastornos Relacionados con Opioides/tratamiento farmacológico , Buprenorfina/administración & dosificación , Enfermería Basada en la Evidencia , Humanos , Metadona/administración & dosificación , Naltrexona/administración & dosificación , Antagonistas de Narcóticos/administración & dosificación , Investigación en Educación de Enfermería , Trastornos Relacionados con Opioides/epidemiología , Estados Unidos/epidemiología
6.
J Dent Educ ; 82(5): 469-474, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29717070

RESUMEN

Dental professionals have an opportunity to screen for substance use, provide targeted feedback based on patients' oral health, provide patient education, and refer for further assessment as needed. The aim of this study was to assess the impact on dental hygiene students of an interprofessional Screening, Brief Intervention, and Referral to Treatment (SBIRT) educational intervention with standardized patients as a tool for initiating discussions on alcohol and drug use with patients. Starting in 2015, dental hygiene students in two classes at the University of Pittsburgh participated with nursing students in one and a half hours of didactic instruction followed within a ten-week period by SBIRT simulation scenarios utilizing standardized patients, with subsequent debriefing of students by faculty. Students' attitudes were assessed before and after the didactic session and immediately after the SBIRT simulation, using the Alcohol and Alcohol Problems Perceptions Questionnaire and the Drug and Drug Problems Perceptions Questionnaire. All 67 dental hygiene students in the program at the time participated in the educational intervention and surveys. The results showed significant positive changes in role security, defined as the acceptance of SBIRT delivery as part of their role identity as dental hygienists, following the intervention. This study found that the IPE intervention with dental hygiene and nursing students improved the dental hygiene students' attitudes through using SBIRT.


Asunto(s)
Higienistas Dentales/educación , Educación en Enfermería , Comunicación Interdisciplinaria , Simulación de Paciente , Estudiantes del Área de la Salud , Trastornos Relacionados con Sustancias/diagnóstico , Femenino , Humanos , Masculino , Estudiantes de Enfermería , Adulto Joven
7.
Issues Ment Health Nurs ; 39(2): 151-158, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29370546

RESUMEN

Nurses are in an ideal position to talk to their patients of reproductive age about alcohol use and encourage the prevention of alcohol-exposed pregnancies. Effective conversations can be efficiently included in the clinical encounter to identify alcohol misuse and offer appropriate follow-up. This report presents results of an environmental scan of resources relevant to nursing professionals and nurses' role in addressing alcohol misuse. Gaps in nursing education and practice guidelines with regard to defining the nursing role in preventing alcohol-exposed pregnancies were revealed. Findings identified a need to promote adoption among nurses of evidence-based preventive practices to prevent alcohol misuse.


Asunto(s)
Trastornos Relacionados con Alcohol/prevención & control , Trastornos del Espectro Alcohólico Fetal/prevención & control , Rol de la Enfermera , Actitud del Personal de Salud , Humanos
8.
J Am Psychiatr Nurses Assoc ; 24(6): 510-521, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29313418

RESUMEN

BACKGROUND: Stigma associated with substance use is considered a barrier to implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT) and assisting patients to receive appropriate treatment. OBJECTIVES: To test the efficacy of SBIRT education and training in changing undergraduate nursing students' attitudes about working with patients who have problems with alcohol and opioid use. DESIGN: A sample of 49 undergraduate nursing students were surveyed, using five subscales, at three time points. RESULTS: After a 15-week semester that included (a) SBIRT education and (b) weekly clinical experiences with patients who had alcohol use problems the undergraduate nursing students' stigma decreased as measured by three of the five subscales. The students' attitudes toward working with patients who had opioid use problems exhibited favorable change as measured by four of the five subscales. CONCLUSION: SBIRT education and training for undergraduate nursing students might help mitigate some of their stigma toward working with patients who have mild to moderate alcohol and opioid use problems.


Asunto(s)
Bachillerato en Enfermería/métodos , Evaluación de Programas y Proyectos de Salud/métodos , Derivación y Consulta/estadística & datos numéricos , Estereotipo , Estudiantes de Enfermería/psicología , Trastornos Relacionados con Sustancias/terapia , Adulto , Alcoholismo/terapia , Actitud del Personal de Salud , Femenino , Educación en Salud/métodos , Humanos , Masculino , Trastornos Relacionados con Opioides/terapia , Proyectos Piloto , Estudiantes de Enfermería/estadística & datos numéricos , Adulto Joven
9.
J Transcult Nurs ; 29(4): 387-394, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-28854846

RESUMEN

INTRODUCTION: Cultural competency is an integral component in undergraduate nursing education to provide patient-centered care and addressing patients' cultural differences. Students need to consider the prevalence of alcohol and other drug use/misuse in patients from all cultures. This project combines cultural competency education, simulation, and educating students to use screening, brief intervention, and referral to treatment for alcohol and other drug use. METHOD: Culturally diverse simulation scenarios were developed and used in the simulation lab with students to reduce stigma surrounding other cultures while learning an evidence-based practice to screen and intervene with patients who use/misuse substances. RESULTS: Results show students value simulation and 91% of the students felt that they were able to apply culturally competent knowledge after the simulation experience. DISCUSSION: Cultural competency principles can be embedded in teaching the broader evidence-based practice of screening, brief intervention, and referral to treatment with undergraduate students. This is a replicable teaching methodology that could be adapted in other schools of nursing.


Asunto(s)
Competencia Cultural/educación , Derivación y Consulta/normas , Entrenamiento Simulado/normas , Estudiantes de Enfermería/psicología , Trastornos Relacionados con Sustancias/terapia , Adulto , Asistencia Sanitaria Culturalmente Competente/métodos , Asistencia Sanitaria Culturalmente Competente/normas , Bachillerato en Enfermería , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Entrenamiento Simulado/métodos , Entrenamiento Simulado/tendencias , Estudiantes de Enfermería/estadística & datos numéricos , Trastornos Relacionados con Sustancias/psicología , Enseñanza , Resultado del Tratamiento
10.
J Addict Nurs ; 28(4): 196-202, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29200046

RESUMEN

The Drug and Drug Problems Perception Questionnaire (DDPPQ) is a multidimensional instrument that measures healthcare providers' attitudes toward working with patients who use drugs. Five- and six-subscale versions of the DDPPQ have been published. Although the reliability of the DDPPQ subscales was reported to be satisfactory, the factor structure of either version was not validated by a confirmatory factor analysis. The aim of this study was to examine the internal factor structure of the 22-item DDPPQ instrument using a sample of undergraduate nursing students. This study was a secondary analysis that utilized baseline data from the Addiction Training for Nurses using Screening, Brief Intervention, and Referral to Treatment Program. The DDPPQ was administrated during the undergraduate nursing students' junior year in a single university setting in southwestern Pennsylvania. A sample of 473 students was used in this study. The sample was split equally to conduct both principal component analysis (n = 237) and confirmatory factor analysis (n = 236). On average, the sample had a mean age of 22.9 years and was predominantly female (87.2%) and Caucasian (90.9%). A principal component analysis revealed that a five-factor structure had the best fit after the removal of two items. Reliabilities of the five subscales ranged from α = .696 to α = .904. Thus, a five-factor structure with removal of Items 9 and 19 is recommended when using the DDPPQ with undergraduate nursing students.


Asunto(s)
Actitud del Personal de Salud , Estudiantes de Enfermería , Trastornos Relacionados con Sustancias/enfermería , Adolescente , Adulto , Bachillerato en Enfermería , Análisis Factorial , Femenino , Humanos , Masculino , Pennsylvania , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
11.
Subst Abus ; 38(4): 464-467, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28622136

RESUMEN

BACKGROUND: Despite the devastating impact of alcohol and other drug involvement and misuse within society, medical students still receive very limited exposure to these issues. The Scaife Advanced Medical Student Fellowship in Alcohol and Other Drug Dependency, offered by the Institute for Research, Education and Training in Addictions for over 10 years, offers a unique, 3-week intensive educational experience, including didactic, observation, and experiential learning in these topics to first-year medical students. The goal of this project was to evaluate the impact of the Scaife Fellowship on medical students' attitudes toward patients with alcohol and other drug involvement 1 to 5 years after completion of the experience. METHODS: Past Scaife students and individuals who applied but did not attend were located and recruited to participate in an online attitude survey. RESULTS: Results indicated that Scaife Fellowship students largely retain their sense of role security around working with patients with alcohol and other drug involvement at the follow-up time point. Although therapeutic commitment or the motivation to work with these patients decreased for drug use, the decrease was smaller than that typically noted in the literature. The group of comparison students showed lower scores on both subscales at the evaluation time point compared with Scaife students. CONCLUSIONS: A three-week experiential program significantly improved medical students' Role Security and Therapeutic Commitment toward working with patients with substance use disorders. Moreover, the positive effects gained from the program were sustained over time.


Asunto(s)
Competencia Clínica , Educación de Pregrado en Medicina , Estudiantes de Medicina/psicología , Trastornos Relacionados con Sustancias , Adulto , Curriculum , Becas , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Adulto Joven
12.
J Addict Med ; 11(3): 163-173, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28557958

RESUMEN

: Biological drug testing is a tool that provides information about an individual's recent substance use. Like any tool, its value depends on using it correctly; that is, on selecting the right test for the right person at the right time. This document is intended to clarify appropriate clinical use of drug testing in addiction medicine and aid providers in their decisions about drug testing for the identification, diagnosis, treatment, and recovery of patients with, or at risk for, addiction. The RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) process for combining scientific evidence with the collective judgment of experts was used to identify appropriate clinical practices and highlight areas where research is needed. Although consensus panels and expert groups have offered guidance on the use of drug testing for patients with addiction, very few addressed considerations for patients across settings and in different levels of care. This document will focus primarily on patients in addiction treatment and recovery, where drug testing is used to assess patients for a substance use disorder, monitor the effectiveness of a treatment plan, and support recovery. Inasmuch as the scope includes the recognition of addiction, which often occurs in general healthcare settings, selected special populations at risk for addiction visiting these settings are briefly included.


Asunto(s)
Medicina de las Adicciones/métodos , Detección de Abuso de Sustancias/métodos , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/terapia , Competencia Clínica , Humanos , Relaciones Profesional-Paciente
13.
Int Emerg Nurs ; 33: 32-36, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28438480

RESUMEN

Alcohol and other drug (AOD) diagnoses in the ED co-occur with injury-related presenting conditions including: falls, motor vehicle accidents, poisonings, and both intentional and unintentional injuries. Clinical attention to ED admissions resulting from hazardous AOD use can significantly improve patient care and reduce high cost utilization of ED visits and treatment. The EDRN-SBIRT project is designed to improve the knowledge and attitudes of ED nurses working in a large academic medical center to identify and address risky AOD use as it relates to an ED visit. ED nurses' knowledge and attitudes toward patients with AOD use can be improved through SBIRT education. SBIRT education can establish an evidence-based standard of nursing practice to improve healthcare outcomes, but it must be reinforced with ongoing ED review and supportive educational sessions until practice is firmly established.


Asunto(s)
Educación Continua en Enfermería/métodos , Conocimientos, Actitudes y Práctica en Salud , Rol de la Enfermera/psicología , Enfermeras y Enfermeros/normas , Adulto , Anciano , Alcoholismo/enfermería , Educación Continua en Enfermería/normas , Servicio de Urgencia en Hospital/organización & administración , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Derivación y Consulta/normas , Derivación y Consulta/tendencias , Trastornos Relacionados con Sustancias/enfermería , Triaje/métodos , Triaje/tendencias
14.
Issues Ment Health Nurs ; 37(9): 682-687, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27387524

RESUMEN

Although substance use is prevalent in the United States, the majority of people who misuse substances do not receive appropriate treatment. This paper describes, (1) an interprofessional education (IPE) program for health professionals to provide Screening Brief Intervention and Referral to Treatment to rural substance use patients, and (2) compares registered nurses' [RNs] and behavioral health professionals' [BHPs] attitudes to work with those patients and their perceptions on IPE. A data analysis of 62 RNs and 36 BHPs shows statistically significant increases in both attitudes and perceptions. This paper discusses the implications of the IPE program vis-á-vis substance use treatment.

15.
J Interprof Care ; 30(4): 542-4, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27295396

RESUMEN

Interprofessional collaborative practice expands resources in rural and underserved communities. This article explores the impact of an online education programme on the perceptions of healthcare providers about interprofessional care within alcohol and drug use screening for rural residents. Nurses, behavioural health counsellors, and public health professionals participated in an evidence-based practice (screening, brief intervention, and referral to treatment-SBIRT) model that targets individuals who use alcohol and other drugs in a risky manner. SBIRT is recommended by the United States Preventive Services Task Force as a universal, evidence-based screening tool. Online modules, case simulation practice, and interprofessional dialogues are used to deliver practice-based learning experiences. A quasi-experimental method with pre-tests and post-tests was utilised. Results indicate increased perceptions of professional competence, need for cooperation, actual cooperation, and role values pre-to-post training. Implications suggest that online interprofessional education is useful but the added component of professional dialogues regarding patient cases offers promise in promoting collaborative practice.


Asunto(s)
Conducta Cooperativa , Personal de Salud/educación , Relaciones Interprofesionales , Tamizaje Masivo , Detección de Abuso de Sustancias , Adulto , Práctica Clínica Basada en la Evidencia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Población Rural , Encuestas y Cuestionarios , Estados Unidos
17.
Subst Abus ; 36(2): 209-16, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25844527

RESUMEN

BACKGROUND: Although the number of physicians credentialed to prescribe buprenorphine has increased over time, many credentialed physicians may be reluctant to treat individuals with opioid use disorders due to discomfort with prescribing buprenorphine. Although prescribing physicians are required to complete a training course, many have questions about buprenorphine and treatment guidelines have not been updated to reflect clinical experience in recent years. We report on an expert panel process to update and expand buprenorphine guidelines. METHODS: We identified candidate guidelines through expert opinion and a review of the literature and used a modified RAND/UCLA Appropriateness Method to assess the validity of the candidate guidelines. An expert panel completed 2 rounds of rating, with a meeting to discuss the guidelines between the first and second ratings. RESULTS: Through the rating process, expert panel members rated 90 candidate guideline statements across 8 domains, including candidacy for buprenorphine treatment, dosing of buprenorphine, psychosocial counseling, and treatment of co-occurring depression and anxiety. A total of 65 guideline statements (72%) were rated as valid. Expert panel members had agreement in some areas, such as the treatment of co-occurring mental health problems, but disagreement in others, including the appropriate dosing of buprenorphine given patient complexities. CONCLUSIONS: Through an expert panel process, we developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians' comfort with prescribing buprenorphine to patients with opioid use disorders. Future efforts should focus on appropriate dosing guidance and ensuring that guidelines can be adapted to a variety of practice settings.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Buprenorfina/uso terapéutico , Trastornos Relacionados con Opioides/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Consejo , Humanos
18.
Nurse Educ ; 39(3): 126-34, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24743176

RESUMEN

Alcohol use and other drug use affect patient healthcare outcomes. This article describes a classroom-to-clinical approach teaching nursing students to utilize motivational interviewing techniques to support patient behavior change. Through the lens of a universal prevention method, nursing students learned about reward circuit activation leading to risky substance use and the difference between addiction and at-risk use. Specific assessment tools and motivational interviewing techniques were presented in the classroom. Students then applied their knowledge in simulation laboratories and clinical rotations.


Asunto(s)
Alcoholismo/enfermería , Evaluación en Enfermería/métodos , Trastornos Relacionados con Sustancias/enfermería , Enseñanza/métodos , Competencia Clínica , Humanos , Entrevista Motivacional , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería , Investigación Metodológica en Enfermería , Medición de Riesgo , Estudiantes de Enfermería/psicología
19.
Appl Psychophysiol Biofeedback ; 27(1): 29-44, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12001884

RESUMEN

Anxiety, depression, and frequent headache are closely associated. The comorbidity may be due to selection bias (such as inherent in treatment seeking), shared environmental or genetic factors, or a common underlying process. In this study, comorbidity is considered an alternative explanation for correlates of frequent headache found in earlier work. This study addressed whether EMG, peripheral temperature, performance measures, and measures of affect were independently attributable to depression or headache proneness, after control of trait anxiety. Headache state was evaluated in parallel analysis. Seventy-two participants, comprising four groups, were tested: depressed/headache-prone depressed/headache-resistant, not depressed/headache-prone, and not depressed/headache-resistant. Participants completed a performance task that allowed assessment of ambition and performance accuracy while measures of affect, headache state, EMG, and peripheral temperature were obtained. Headache proneness, independently of depression and trait anxiety, was related to heightened EMG. Depression was related to EMG, ambition, and performance accuracy independently of headache proneness and trait anxiety. Headache state was associated only with negative affect, independently of depression and anxiety. These results suggest that headache states during assessment, as well as comorbid depression and anxiety, are not primarily responsible for the heightened EMG found in headache-prone individuals. Negative affect often reported in the headache prone, however, may be due to concommitant anxiety. Other analyses address a variety of issues surrounding distinctions among these variables raised in previous research.


Asunto(s)
Ansiedad , Atención , Depresión/fisiopatología , Cefalea/fisiopatología , Músculo Esquelético/fisiología , Adulto , Afecto , Temperatura Corporal , Electromiografía , Femenino , Humanos , Masculino , Análisis y Desempeño de Tareas
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