RESUMEN
BACKGROUND: Care staff in Germany is being increasingly affected by physical and mental stress, which is reflected in high number of sick days and early retirement rates. A prevention program that addresses the specific needs of caregivers - strengthening their resources in dealing with workloads and daily challenges- was developed in the project PFLEGEprevent. The prevention program was implemented in an RCT and its effects on stress, work ability and quality of life were evaluated. METHOD: The randomized controlled intervention study was conducted with 6 survey periods over 9 months. Targeted data were collected using validated tools: Perceived Stress Questionnaire (PSQ), Perceived Stress Scale (PSS), Work Ability Index (WAI), Recovery-Load Questionnaire for work (EBF-Work 27), Short Form-Health Survey (SF-12) and WHO-Five Well-Being Index (WHO-5). Descriptive analyses and the t-test for independent samples to compare changes in primary and secondary outcomes between study groups were conducted. RESULTS: A total of 125 (92% female, average age 46.7 years) caregivers participated in the study. There were significant group differences in changes of the target size to the follow-up measures up to 9 months. Especially stress was reduced in the long term in the intervention group. Overall well-being in this group improved significantly from baseline to follow-up. CONCLUSION: The evaluation of the prevention program showed a positive effect in the measured outcome of perceived stress. In other outcomes, significant group differences could be shown after 1 and 3 months.
Asunto(s)
Cuidadores , Carga de Trabajo , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Encuestas y CuestionariosRESUMEN
Psychometric studies indicate that anxiety sensitivity (AS) is a risk factor for anxiety disorders such as panic disorder (PD). To better understand the psychophysiological basis of AS and its relation to clinical anxiety, we examined whether high-AS individuals show similarly elevated reactivity to inhalations of carbon dioxide (CO2) as previously reported for PD and social phobia in this task. Healthy individuals with high and low AS were exposed to eight standardized inhalations of 20% CO2-enriched air, preceded and followed by inhalations of room air. Anxiety and dyspnea, in addition to autonomic and respiratory responses were measured every 15 s. Throughout the task, high AS participants showed a respiratory pattern of faster, shallower breathing and reduced inhalation of CO2 indicative of anticipatory or contextual anxiety. In addition, they showed elevated dyspnea responses to the second set of air inhalations accompanied by elevated heart rate, which could be due to sensitization or conditioning. Respiratory abnormalities seem to be common to high AS individuals and PD patients when considering previous findings with this task. Similarly, sensitization or conditioning of anxious and dyspneic symptoms might be common to high AS and clinical anxiety. Respiratory conditionability deserves greater attention in anxiety disorder research.
Asunto(s)
Ansiedad/fisiopatología , Ansiedad/psicología , Sistema Nervioso Autónomo/fisiopatología , Dióxido de Carbono/administración & dosificación , Trastornos Fóbicos/fisiopatología , Respiración , Administración por Inhalación , Adolescente , Análisis de Varianza , Arritmia Sinusal/fisiopatología , Sistema Nervioso Autónomo/efectos de los fármacos , Femenino , Respuesta Galvánica de la Piel/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Pruebas Psicológicas , Autoinforme , Volumen de Ventilación Pulmonar/efectos de los fármacos , Adulto JovenRESUMEN
Inhalation of carbon dioxide (CO2) enriched air triggers anxiety in panic disorder (PD) patients, which is often interpreted as a sign of biological vulnerability. However, most studies have not measured respiration in these tasks. We compared patients with PD (n=20) and social phobia (SP, n=19) to healthy controls (n=18) during eight inhalations of 20% CO2, preceded and followed by two inhalations of room air, while continuously measuring subjective anxiety and dyspnea as well as autonomic and respiratory variables. PD patients showed increased reactivity and delayed recovery during CO2 inhalations for most measures. Unlike both other groups, the PD group's tidal volume responses did not habituate across CO2 inhalations. However, PD patients did not differ from SP patients on most other measures, supporting a continuum model of CO2 sensitivity across anxiety disorders. Both patient groups showed continued reactivity during the last air inhalations, which is unlikely to be due to a biological sensitivity.