Search

The Nociception Coma Scale–Revised (NCS-R) is a rating scale developed and validated for measurement of nociception and pain among patients with brain injuries in unresponsive wakefulness syndrome or minimally conscious state. However, little is known about its use in daily clinical practice. The aim of this study was to explore clinical experience with the NCS-R by means of focus group interviews with nurses and nurse assistants in a subacute rehabilitation ward for patients with severe brain injuries. Qualitative focus group interview study. Department for highly specialized neurorehabilitation for patients with severe brain injuries. Nurses and nurse assistants. In total, 12 experienced registered nurses and nurse assistants participated in two recorded focus group interviews. The participants were selected from the subacute neurorehabilitation ward on the following criteria: Employed at the ward for at least 11 months and being introduced to and having experience with using the NCS-R in own patients for a minimum period of 6 months. An inductive qualitative analysis was conducted by reading the interview text through several times, and meaning units were defined first separately and later jointly between the authors. Then meaning units were coded and categorized into subthemes and themes. We found three themes, general relevance of the NCS-R, NCS-R versus level of consciousness, and overall assessment of pain in patients with disorders of consciousness, with a total of eight subthemes. The content and subscales of the NCS-R are relevant for pain assessment in patients with severe brain injury in subacute rehabilitation. However, with the present cutoff value at 4 points, challenges are associated with using NCS-R, especially in patients with unresponsive wakefulness syndrome because they are at risk of not being assessed with respect to pain. • The Nociception Coma Scale-Revised (NCS-R) is a relevant tool for pain assessment in most patients with severe brain injury in sub-acute rehabilitation. • The recommended cut-off level of 4 points to indicate pain should be re-considered for patients in the lowest levels of consciousness. • NCS-R should be supplemented with physiological signs of pain and nurses' clinical judgement to achieve an overall pain assessment that may identify pain and evaluate the pain-relieving interventions. [ABSTRACT FROM AUTHOR]

Abstract: The relationship between negative affectivity (NA) and emotion regulation (ER) in determining anxiety and depressive symptomatology was examined in a large (n =1441) sample of adolescents (12–17 years old). Two models, diverging only as to inclusion or exclusion of a path from NA to negative ER, were analyzed through structural equation modeling; the goal was to explore the mediational or non-mediational role of ER in determining anxiety symptoms. The models yielded similar adequate fit to data, indicating that both NA and negative ER contribute to anxiety symptoms which, in turn, significantly determine depressive symptomatology. The mediational model better captures the relationships revealed in the data, with NA determining negative ER to a great extent. Additionally, most individuals scoring highly in NA also tend to score highly in negative ER, indicating that adolescents with heightened NA are prone to a dysfunctional style of ER. [ABSTRACT FROM AUTHOR]

This meta-analysis aimed at gathering and summarising the findings on nonlinear biomarkers in the field of emotional disorders under the hypothesis that diseased systems show lowered complexity and hence less flexibility to adjust daily contexts. Scientific manuscripts from 1970 to 2014 were reviewed, 58 articles were analysed, and independent meta-analyses on anxiety disorders, bipolar disorders, and depressive disorders were conducted. Results revealed that anxious patients exhibited lower complexity than controls ( p < 0.05) despite panic patients showed more irregular respiratory activity. Inconclusive results were found for bipolar patients but pointed to higher randomness when suffering manic episodes. Finally, depressed patients showed a loss of complexity in the cardiac system and a loss of orderliness (despite a higher complexity) in brain and stress-related hormonal systems. As a conclusion, our findings highlight that either a loss of complexity or a loss of ordered complexity characterise the physiological systems of patients with emotional disorders. Several considerations for complexity, its related measurements, and suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]