Search

Background: The supporting role of caregivers is crucial to cancer patients' care and well-being. Periods of inpatient hospital treatment are common in the cancer trajectory. There is insufficient systematic knowledge of caregivers' experiences and information needs in hospital context., Aim: Aim of this study is to identify information needs and factors contributing to unmet information needs of caregivers in hospital., Design: A qualitative approach was used to identify major themes and specific types of information needs. Interviews with caregivers were conducted and analysed using a qualitative three-step process., Setting/participants: The study was conducted in a hospital oncology department. Seventeen caregivers of patients with advanced cancer were interviewed., Results: Caregivers' needs during inpatient treatment vary and are largely unmet. Four major themes emerged from the analysis, revealing information needs of caregivers related to the cancer disease, patient, caregivers themselves and hospital context. The most mentioned issues were appropriate treatment, treatment outcomes and the related consequences for caregivers' life, hospital processes and transition back home., Conclusion: Caregivers have a variety of specific information needs which often remain unmet. Based on our findings, we provide recommendations for integrating caregivers into oncology care, which should be implemented in clinical practice, policy decisions and research., (© 2019 John Wiley & Sons Ltd.)

Background: Patients with schizophrenia show decreased sensitivity towards clinical and experimental painful conditions. To date, the exact underlying mechanisms are not completely understood. One method to examine central integrative processes of pain perception is the thermal grill illusion (TGI), in which interlacing cold and warm bars create the illusion of a painful sensation., Methods: In 18 unmedicated patients with acute paranoid schizophrenia, cold and heat pain thresholds (CPT/HPT) as well as the perception of the TGI were examined and compared to 18 matched controls. In addition, symptom scales were obtained in order to relate pain perception to psychopathology., Results: CPT and HPT were significantly increased in patients compared to controls. In the range of TGI stimuli that were perceived painful by controls, patients did not indicate painful sensations, instead the stimulus response curve of TGI pain perception was shifted towards higher stimulus intensities, i.e., greater temperature differentials between cold and warm bars. This increase was comparable to that seen in CPT and HPT. There was no association with psychopathology for any pain parameter., Conclusions: CPT and HPT, as well as temperature differentials for the perception of the TGI were increased in patients with schizophrenia as compared to controls. Similar to visual illusions, in which reduced contrast sensitivity has been shown to alter the perception of illusions, the discriminatory somatosensory deficit, which is reflected in higher CPT and HPT as well as the previously reported increased warmth perception thresholds, might account for the attenuation of TGI in patients., (© 2012 European Federation of International Association for the Study of Pain Chapters.)

Background: Cardiac autonomic nervous system (ANS) dysfunction in Huntington's disease (HD) might affect both the sympathetic and parasympathetic branch of the ANS., Results and Conclusions: The pattern of linear heart rate variability we found in mid stage HD patients points towards a predominately reduced cardiovagal modulation compared with healthy subjects, which might influence HD patients' susceptibility for cardiovascular complications such as syncopes and cardiac arrhythmias.

We recently described an increase of pain thresholds and tolerances for thermal and electrical pain in patients suffering from adjustment disorder (AD). Furthermore, we presented evidence that pain perception in major depressive disorder (MDD) depends on pain modality, with thresholds for ischemic pain being decreased compared to increased thermal and electrical pain thresholds. Here, we investigated perception of experimentally induced ischemic pain in 15 patients suffering from AD (subtype with depressive symptoms) and controls matched for age and sex in order to examine whether a similar pattern of modality dependent pain perception can be established. Thresholds and tolerances were assessed on both sides of the body. We found a significant decrease of ischemic pain thresholds in AD patients as compared to controls. Analogue findings have been reported for pain perception in MDD, therefore suggesting similarities with regards to pain perception in both disorders. This adds weight to the assumption that depressive symptomatology might alter pain sensitivity in this subtype of AD since symptoms are milder, yet comparable to MDD.