Quality of Life and Depressive Symptoms in Transcatheter Aortic Valve Implementation Patients-A Cross-Sectional Study.

Quality of life is an important factor influencing mood. In any group of elderly people undergoing valve implementation or surgical aortic valve replacement, one in three will have depressive symptoms. The aims of this study were as follows: 1. to evaluate the impact of health-related quality of life on depressive symptoms in elderly patients undergoing TAVI, and 2. to analyze beliefs about TAVI. Methods: A total of 131 elderly people (mean age: 82.1 ± 6.1 years) scheduled to receive TAVI completed the Geriatric Depression Scale, EQ-5D-3L, and Mini Mental State Examination. A total of 43 patients completed the questionnaires after the treatment. The narrative interview analyses were performed based on 20 randomly selected patients after TAVI. Results: The mean level of general depression before TAVI was 4.19 ± 2.83, and after it was 3.12 ± 2.52 (p = 0.02), and the frequency decreased from 20% to 3%. An increase in the level of activity and number of interests and a decrease in life satisfaction were identified. The higher the general quality of life was, the lower the levels of depressiveness before and after TAVI were (r = 0.26 vs. r = 0.48; p < 0.05). Conclusions: Patients differed in their depressive symptoms, as well as their intensity and frequency, before and after TAVI. These results underscore the importance of screening for depression at baseline and reassessing changes in depressiveness during follow-up.

Problem Drinking Scale (PDS) - psychometric characteristics. / Skala Picia Problemowego (SPP) ­ wlasciwosci psychometryczne.

OBJECTIVES: The presented study aims at checking and demonstrating the psychometric characteristics of the new tool - the Problem Drinking Scale (PDS), which is used for quantitative and qualitative analysis of alcohol use disorders conceptualized according to DSM-5. METHODS: 08 adults with different levels of alcohol consumption were examined, including 91 individuals recruited in addiction treatment clinics. The remaining persons, with different socio-demographic characteristics, were recruited using the snowball method. Validity of the scale was assessed by correlating the obtained results with the AUDIT (Alcohol Use Disorder Identification Test), while reliability was assessed by internal consistency analysis. RESULTS: The presented analysis demonstrates high validity and reliability in most areas, which means that the PDS is a tool that can be used in clinical practice. Criterion validity was calculated by correlating PDS results with the AUDIT (r = 0.88, p < .01). The results in particular areas range from r = 0.86 (Difficulty in controlling drinking) to r = 0.77 (Pharmacological dependence). Reliability was calculated using the split-half method, individual values of Cronbach's alpha coefficients with the Spearman-Brown correction vary in specific areas from 0.89 (Difficulty in controlling drinking) to 0.65 (Risky use of substances). In none of the areas the results were lower than 0.60. CONCLUSIONS: The PDS is a useful research tool for quantitative and qualitative analysis of alcohol use disorders. This scale is helpful in making a full and accurate clinical diagnosis taking into account the severity of the disorder and in monitoring changes in the treatment process.

Personality characteristics of empathy profiles - practical implications for education of medicine students.

BACKGROUND: Empathy plays the key role in the doctor - patient relationship. The research of empathy determinants plays an important role in formulating practical guidelines for the education of medical students. The aim of this study was to analyse personality characteristics of empathy profiles among students of medicine, with consideration of chief personality factors and their subdimensions according to the FFM model. METHODS: During workshops in Clinical Psychological Skills, 153 students (M = 57, F = 96; mean age 23 years) analysed their psychological functioning styles by examining their personality profiles and empathy indicators. Empathic Sensitiveness Scale (ESS) and Personality Inventory (NEO-PI-R) were applied for this purpose. The analyses of empathy indicators were presented by means of cluster analysis. Variance analysis with post hoc Tukey-b test was performed for differences between clusters and to differentiate between personality factors and their components in empathy clusters. This study was approved by the Jagiellonian University Bioethics Committee (approval number: 1072.6120.175.2018 date: 28.06.2018). RESULTS: The first cluster included students who presented high empathetic concern for others, understood their perspective and needs characterised by medium level of Neuroticism, high levels of other dimensions The second group included students who could understand others very well, yet with lower tendency to react emotionally to suffering, characterised by medium level of Neuroticism, Extraversion, Openness, high Conscientiousness and low Agreeableness. The third cluster included students who react strongly to painful and unpleasant reactions of others, characterised by high Neuroticism and Agreeableness, low Extraversion. CONCLUSIONS: Each empathy profile is manifested in relations with patients in a specific way. Medical education in empathy holds great potential to reduce anxiety, stress, and burnout associated with the medical profession. Discussion of individual results with students, gives an opportunity to talk about how their empathy and personality characteristics may influence their everyday medical practice.

Differences in personality related determinants of empathetic sensibility in female and male students of medicine.

The issues of personality and its relations with the level of empathetic sensibility of medical doctors are broadly discussed in the literature. The aim of this study was an assessment of personality related predictors of empathy indicators in female and male students of medicine with consideration of gender differences. Methods applied were Empathic Sensitiveness Scale (ESS) and Personality Inventory (NEO-PI-R). The study included 153 participants, who were students of the fifth year of medical studies. Students filled in questionnaires during workshops in clinical psychological skills. Participation in the study was voluntary and anonymous. The statistical analysis was performed using Statistica 13 PL and PS IMAGO PRO (SPSS). Linear regression analysis with the interaction component was performed to explore the relationship between personality factors and gender and their interaction with the variable dependent level of empathy. The analysis showed that Extraversion, Openness and Agreeableness are associated with the level of Empathic Concern. Neuroticism, Extraversion, Agreeableness and Conscientiousness are associated with the level of Personal Distress. Extraversion, Openness, Agreeableness and Conscientiousness are associated with the level of Perspective-taking. The regression analysis with the interactive component showed that there is no relationship between gender and the level of empathy, therefore the interactions were insignificant. Empathetic sensibility is related to personality dimensions of the students of medicine. Although there has been no interaction among chief personality dimensions, empathy indicators and gender, detailed analysis of personality dimensions' components has shown differences between men and women.

Stress associated with undergraduate medical courses: A translation and validation of the Perceived Medical School Stress Instrument into Polish and its adaptation to the Polish environment.

OBJECTIVES: Medical students are more susceptible to depression than other students. Moreover, students with the symptoms of depression statistically more often abuse drugs and have suicidal thoughts and anxiety. The level of stress and the factors that lead to in among medical students at Polish universities have not yet been measured. The aim of this study was to translate to Polish and validate the Perceived Medical School Stress Instrument (PMSS-PL) and to measure the resulting version's psychometric abilities. MATERIALS AND METHODS: We validated the Polish translation of PMSS in accordance with the recommendations published by the Translation and Cultural Adaptation group of the Quality of Life Special Interest group of the International Society for Pharmacoeconomics and Outcomes Research. The Perceived Stress Scale (PSS-10) was used as an external test to validate the PMSS-PL questionnaire. A total of 430 undergraduate medical students at the Medical College of Jagiellonian University took part. RESULTS: The mean PMSS-PL score was 36.43 and it varied from 13 to 65. The mean PSS-10 was 21.35. The internal reliability, as indicated by Cronbach's alpha, was 0.803, which means there was internal reliability between PSS-10 and PMSS-PL. Moreover, all questions from PMSS-PL had a positive discrimination power, so each question correlated positively with the other questions in PMSS-PL. CONCLUSIONS: PMSS-PL may be used to psychometrically analyze the stress load on undergraduate medical students at Polish universities. The PMSS-PL may also be used as an external test for validating and calculating the reliability and accuracy of other psychometric instruments.

Changes in cognitive functions and quality of life in patients after transcatheter aortic valve implantation.

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic option for patients with severe aortic stenosis (AS). However, an association between cognitive functions (CF) and health-related quality of life (HRQoL) in TAVI patients is still unclear. AIM: To assess the long-term changes in CF and HRQoL in elderly patients with AS after TAVI. MATERIAL AND METHODS: A total of 259 patients who underwent cardiological and psychological TAVI qualification were enrolled and divided into the normal (n = 174) and impaired cognition group (n = 85). CF and HRQoL characteristics assessed at baseline and 13 months were compared between groups. The analysis of multiple linear regression was performed to identify the association between HRQoL and CF and to assess the influence of TAVI on HRQoL. RESULTS: There was no difference in CF between baseline and follow-up. However, an improvement in attention functions and memory skills in the cognitively impaired group was noted at follow-up. In addition, HRQoL scores increased in both groups. An independent predictor associated with HRQoL was global CF (ß = -213, p = 0.01), which explained 7% of CF variation. Improvements in all five dimensions of HRQoL, from 4.8% in self-care and up to 33.6% in pain/discomfort, were found. At follow-up, 60% of TAVI patients had improved health, 12% had worse health, 4% showed no change and 24% had a "mixed" change. CONCLUSIONS: TAVI is associated with positive changes in the functioning of elderly patients at long-term follow-up.