PURPOSE: The objective of this systematic review was to assess the effects of family support programs on caregiving burden, depression, and stress in family caregivers of people with dementia. METHODS: A literature search was conducted of electronic databases to identify randomized controlled studies with family support programs done between 2000 and 2014. Studies published in English and/or Korean were included for the analysis with search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. Studies were rated for quality assessment by two independent reviewers using the appraisal checklist developed by Cochrane Reviews and Dissemination. Of 8,334 articles identified in the literature search, full texts of 76 articles that met the inclusion criteria were reviewed and 38 were found to include relevant outcomes. RESULTS: Results from selected studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed using the Chisquare test. Meta-analysis showed that the effect sizes of family caregiver support programs were small to medium for categories of caregiving burden (Hedge's g= - 0.17, 95% CI= - 0.30~ - 0.04), depression (Hedge's g= - 0.30, 95% CI= - 0.40~ - 0.20), and stress (Hedge's g= - 0.39, 95% CI= - 0.52~ - 0.25). CONCLUSION: The review results indicate that a support programs can assist family caregivers in reducing their psycho-emotional distress.
Caregivers/*psychology ; Clinical Trials as Topic ; Databases, Factual ; Dementia/*pathology ; Depression/*etiology ; Humans ; *Program Evaluation ; *Stress, Psychological

Acute Disease ; Aged ; Cardiomyopathies ; etiology ; pathology ; China ; Female ; Humans ; Stress, Psychological ; complications

Animals ; Apoptosis ; Hippocampus ; pathology ; Male ; Neurons ; pathology ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological ; pathology

PURPOSE: Purpose of this study was to examine the effects of the Mindfulness Meditation program on perceived stress, ways of coping, salivary cortisol level, and psychological stress response in patients with breast cancer. METHODS: This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants in this study were 50 patients who had completed breast cancer treatment (experimental group, 25, control group, 25). The experimental group received the Mindfulness Meditation program for 3 hours/session/ week for 8 weeks. Data were analyzed using chi2-test and t-test for subject homogeneity verification, and ANCOVA to examine the hypotheses. RESULTS: The experimental group had significantly lower scores for perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response compared to the control group. However, no significant differences were found between two groups for the scores on problem focused stress coping. CONCLUSION: According to the results, the Mindfulness Meditation program was useful for decreasing perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response. Therefore, this program is an effective nursing intervention to decrease stress in patients with breast cancer.
Adaptation, Psychological ; Adult ; Breast Neoplasms/metabolism/pathology/*psychology ; Emotions ; Female ; Humans ; Hydrocortisone/analysis ; Middle Aged ; Perception ; *Program Evaluation ; Questionnaires ; Salivary Glands/metabolism ; Stress, Psychological

The objective of this study was to investigate the effects of chronic stress on the testes of prepubertal and adult rats and to evaluate whether any alterations could be reversed when stress induction is ended. Seventy-six male rats were assigned to eight groups depending on the type of treatment (control or stressed), the age at which stress was initiated (prepubertal or adult), and the time of evaluation (immediate or late). Stress stimuli were applied for 6 weeks. Stressed prepubertal and adult rats evaluated immediately after the last stress stimulus were included in SP-I and SA-I groups, respectively. The late prepubertal (SP-L) and adult (SA-L) groups of stressed rats were evaluated 6 weeks after the last stress stimulus. Age-matched rats were used as controls (CP-I, CA-I, CP-L, and CA-L groups). Application of stress stimuli to rats in the SP-I group resulted in body weight and seminiferous tubule diameter reduction. The rats in the SA-I group also showed several functional (testosterone level and sperm parameter) and morphological (testicular weight and seminiferous tubule diameter) reductions. The rats in the SP-L group showed increased body weight and intertubular compartment volumetric and absolute densities and reduced tubular compartment volumetric density. The rats in the SA-L group presented only reduced sperm viability. Stress stimuli promoted changes in the rats in all the study groups. The testes of the adult rats were the most affected by chronic stress. However, the stressed adult rats recovered well from the testicular alterations.
Aging/pathology* ; Animals ; Body Weight ; Chronic Disease ; Male ; Organ Size ; Rats ; Rats, Wistar ; Restraint, Physical ; Semen Analysis ; Seminiferous Tubules/pathology* ; Spermatogenesis ; Stress, Psychological/pathology* ; Testis/pathology* ; Testosterone/blood*

PURPOSE: To analyze the psychosocial factors associated with central serous chorioretinopathy (CSC) according to its phases and subtypes and to correlate the factors with the extent of choroidal hyperpermeability. METHODS: Age- and sex-matched CSC patients and controls (n = 37 in each group) were enrolled, and their psychosocial factors were compared. CSC was divided into two phases (active and inactive), and active CSC was further divided into two subtypes (acute and chronic). The correlations between the size of the hyperpermeable choroidal lesion identified on indocyanine green angiography and psychosocial factors were examined. RESULTS: Active CSC patients experienced more stressful events (p = 0.030), were more depressive (p = 0.037), and felt less emotional (p = 0.014) and informational (p = 0.014) support than the matched controls, whereas inactive CSC patients were comparable to the matched controls in all psychosocial factors. Among the active CSC patients, acute patients were more depressive (p = 0.029), while chronic patients experienced more stressful events (p = 0.024) than their matched controls. The size of the hyperpermeable choroidal lesion was correlated with the severity of depression in acute patients. CONCLUSIONS: Association of CSC with psychosocial factors was dependent on the phase and subtype of CSC. Psychosocial factors were associated with CSC in the active phase, and severity of depression was correlated with the size of the choroidal pathology in acute active CSC. Further prospective studies to investigate if psychosocial factors can trigger CSC are warranted.
Angiography ; Anxiety ; Central Serous Chorioretinopathy* ; Choroid ; Depression ; Humans ; Indocyanine Green ; Life Change Events ; Pathology ; Prospective Studies ; Psychology* ; Stress, Psychological

OBJECTIVETo assess the occurrence of stressful life events in the year before the initiation of systemic sclerosis.

METHODSA consecutive series of 40 patients with systemic sclerosis (mean age (56.3+/-11.9) years, mean disease duration (4.3+/-3.1) years; 32 females and 8 males), including 28 with diffuse cutaneous scleroderma and 12 with limited cutaneous scleroderma, were evaluated. A control group of 40 healthy subjects free of systemic sclerosis also was included. Socioeconomic status was investigated and Paykel's interview for recent life events (a semi-structured research interview covering 64 life events) was conducted.

RESULTSPatients with systemic sclerosis showed higher percentages of lower education (72.5%) and working class (82.5%), and reported more stressful life events (P<0.05), such as exits (P<0.05), undesirable events (P<0.01), and uncontrolled events (P<0.001), when compared with the control. More events that had an objective negative impact (P<0.001) were also reported in systemic sclerosis patients than in the control. These results are in accordance with a multifactorial model of pathogenesis in systemic sclerosis.

CONCLUSIONWe reported a strong relationship between stressful life events and the initiation of systemic sclerosis. Our findings are consistent with current understanding of the extensive links of behavioral responses to stress with neurophysiological and biochemical processes.

Female ; Humans ; Interviews as Topic ; Life Change Events ; Male ; Middle Aged ; Scleroderma, Systemic ; etiology ; pathology ; psychology ; Socioeconomic Factors ; Stress, Psychological ; complications ; pathology ; psychology

BACKGROUND AND OBJECTIVES: To determine the diagnostic clues to differentiate tuberculous lymph node infection from nodal metastasis in patients with both papillary thyroid carcinoma and cervical tuberculous lymphadenitis. SUBJECTS AND METHOD: We retrospectively reviewed 11 patients suffering concurrently from papillary thyroid carcinomas with cervical tuberculous lymphadenitis. Nine of the 11 patients underwent preoperative neck ultrasonography (US) and seven CT scans. Using the surgical pathology as the reference standards, the results of the preoperative diagnostic tools were re-evaluated according to lymph node level-based analysis. US and CT features were also compared between metastatic nodes and tuberculous lymphadenitis. RESULTS: Preoperative CT could localize the involved lymph node levels and differentiate tuberculous infection from metastasis of thyroid carcinoma in only two of seven patients. The site of the involved lymph nodes, the presence of pulmonary tuberculosis, and the tumor volume of the thyroid carcinoma were the clues to diagnose the lymph node status. However, in five of seven cases, CT could not differentiate tuberculosis from metastasis in the lymph nodes. The morphological characteristics of lymph nodes seen on CT and US did not differ between tuberculous infection and metastasis of papillary thyroid carcinomas. CONCLUSION: Pre-operative CT or US does not provide differential information about lymph node status between tuberculous infection and metastasis in patients with concurrent papillary thyroid carcinomas and cervical tuberculous lymphadenitis. Rather, clinical characteristics such as the site of the involved lymph nodes, the primary tumor burden, and the associated clinical features can help the physician differentiate between them.
Carcinoma ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Neck ; Neoplasm Metastasis ; Pathology, Surgical ; Retrospective Studies ; Stress, Psychological ; Thyroid Gland ; Thyroid Neoplasms ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary ; Tumor Burden

Animals ; Antidepressive Agents ; pharmacology ; Brain-Derived Neurotrophic Factor ; metabolism ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Depression ; metabolism ; pathology ; physiopathology ; Hippocampus ; metabolism ; pathology ; physiopathology ; Humans ; Nerve Degeneration ; physiopathology ; Nerve Regeneration ; drug effects ; Neurons ; pathology ; Stress, Psychological ; metabolism ; pathology ; physiopathology

OBJECTIVETo investigate the effect of Guangdong Liangcha Keli on restraint stress-induced liver damage in mice.

METHODThirty-five male C57BL/6J mice of 7 weeks old were divided into 5 groups randomly with 7 mice in each group: normal group, restraint stress group, 250 mg kg(-1) Vitamin C, Guangdong Liangcha Keli 500 mg kg(-1) and 250 mg kg(-1). After 18 hr restraint stress, the ALT acitivity in plasma, MDA level in plasma and liver, GSH content, GSH-PX and GST activities, NO level and ORAC value in liver were determined.

RESULTCompared with restraint model group, Guangdong Liangcha Keli could markedly reduce ALT activity (92.75 +/- 1.91 vs 39.29 +/- 2.56, 32.69 +/- 1.46) U L(-1), and protect the liver damage induced by oxidative stress. In addition, Guangdong Liangcha Keli could effectively increase the ORAC value, GSH content, GSH-PX activity and GST activity and reduce the MDA level and NO level in liver.

CONCLUSIONOral treatment of Guangdong Liangcha Keli is found to reduce restraint stress-induced liver damage in terms of above mentioned biochemical parameters, and these protective effects may be related to its free radical scavenging activity and lipid peroxidation inhibitory effects.

Alanine Transaminase ; blood ; Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Glutathione ; metabolism ; Liver ; drug effects ; metabolism ; pathology ; Liver Diseases ; blood ; etiology ; metabolism ; prevention & control ; Male ; Mice ; Mice, Inbred C57BL ; Nitric Oxide ; metabolism ; Oxidative Stress ; drug effects ; Restraint, Physical ; Stress, Psychological ; complications