Instrumentos de avaliação da ansiedade da criança hospitalizada / Instrumentos de evaluación de ansiedad de niños hospitalizados / Anxiety assessment tools in hospitalized children

Resumo Objetivo Identificar na literatura os instrumentos existentes para a avaliação da ansiedade em crianças hospitalizadas. Métodos Trata-se de uma revisão integrativa. As buscas foram realizadas de janeiro a maio de 2017 nas seguintes bases de dados: PubMed, LILACS e CINAHL, com os descritores anxiety, hospitalized child, inpatients, children, emotional responses, emotional manifestation, emotional reactions, validation studies, manifest anxiety scale e test anxiety scale. Resultados Após a seleção, foram analisados 33 artigos, sendo identificados dez instrumentos para a avaliação da ansiedade da criança. Oito instrumentos utilizaram a Escala de Likert nas respostas, um empregou a escala analógica de um a dez e o único instrumento que utilizou uma estratégia lúdica, o desenho dirigido, foi o Child Drawing: Hospital. Conclusão Recomenda-se a tradução, adaptação transcultural e validação do instrumento CD:H. Este estudo visa contribuir para o conhecimento dos enfermeiros pediatras no manejo da ansiedade da criança em unidades pediátricas, a fim de diminuir seu sofrimento emocional durante a hospitalização.

Resumen Objetivo Identificar en la literatura los instrumentos existentes para evaluar la ansiedad de niños hospitalizados. Métodos Se trata de una revisión integradora. Las búsquedas se realizaron de enero a mayo de 2017 en las siguientes bases de datos: PubMed, LILACS y CINAHL, con los descriptores anxiety, hospitalized child, inpatients, children, emotional responses, emotional manifestation, emotional reactions, validation studies, manifest anxiety scale y test anxiety scale. Resultados Luego de realizar la selección, se analizaron 33 artículos, en los que se identificaron diez instrumentos para evaluar la ansiedad de niños. Ocho instrumentos utilizaron la escala de Likert en las respuestas, uno empleó la escala analógica de uno a diez y el único instrumento que utilizó una estrategia lúdica, el dibujo dirigido, fue el Child Drawing: Hospital. Conclusión Se recomienda la traducción, adaptación transcultural y validación del instrumento CH:H. Este estudio tiene el objetivo de contribuir para el conocimiento de los enfermeros pediatras en el manejo de la ansiedad de los niños en unidades pediátricas, a fin de reducir su sufrimiento emocional durante la hospitalización.

Abstract Objective Identify existing tools for the assessment of anxiety in hospitalized children in the literature. Methods An integrative review was undertaken. The searches took place from January to May 2017 in the following databases: PubMed, LILACS and CINAHL, using the descriptors anxiety, hospitalized child, inpatients, children, emotional responses, emotional manifestation, emotional reactions, validation studies, manifest anxiety scale and test anxiety scale. Results After the selection, 33 articles were analyzed, in which 10 child anxiety assessment tools were identified. Eight instruments used the Likert scale in the answers, one used the analogue scale from one to ten and the only instrument that used a playful strategy, directed drawing, was the Child Drawing: Hospital. Conclusion The translation, cross-cultural adaptation and validation of the CD:H is recommended. This study aims to contribute to pediatric nurses' knowledge in the management of child anxiety in pediatric wards, with a view to reducing their emotional suffering during hospitalization.

Validation of an anxiety scale for prenatal diagnostic procedures / Validação de uma escala de ansiedade para procedimentos diagnósticos prénatais

ABSTRACT OBJECTIVE: To perform a cross-cultural adaptation of the Prenatal Diagnostic Procedures Anxiety Scale questionnaire for application in the Brazilian cultural context. METHODS: The translation and back translation processes followed internationally accepted criteria. A committee of experts evaluated the semantic, idiomatic, experimental and conceptual equivalence, proposing a pre-final version that was applied in 10.0% of the final sample. Afterwards, the final version was approved for the psychometric analysis. At that stage, 55 pregnant women participated which responded to the proposed Brazilian version before taking an ultrasound examination at a public hospital in Santa Catarina, in the year of 2017. The Edinburgh Postnatal Depression Scale was used as an external reliability parameter. The internal consistency of the instrument was obtained by Cronbach's alpha. Validation was performed by exploratory factorial analysis with extraction of principal components by the Kaiser-Guttman method and Varimax rotation. RESULTS: The Cronbach's alpha value of the total instrument was 0.886, and only the percentage of variance from item 2 (0.183) was not significant. The Kaiser-Guttman criterion defined three factors responsible for explaining 78.5% of the variance, as well as the Scree plot. Extraction of the main components by the Varimax method presented values from 0.713 to 0.926, with only item 2 being allocated in the third component. CONCLUSIONS: The Brazilian version is reliable and valid for use in the diagnosis of anxiety related to the performance of ultrasound procedures in prenatal care. Due to the lack of correlation with the rest of the construct, it is suggested that item 2 be removed from the final version.

RESUMO OBJETIVO: Proceder à adaptação transcultural do questionário Prenatal Diagnostic Procedures Anxiety Scale para aplicação no contexto cultural brasileiro. MÉTODOS: Os processos de tradução e retrotradução seguiram critérios aceitos internacionalmente. Um comitê de especialistas avaliou as equivalências semântica, idiomática, experimental e conceitual, propondo uma versão pré-final que foi aplicada em 10,0% da amostra final. Em seguida, foi aprovada a versão final para a análise psicométrica. Nessa etapa participaram 55 gestantes que responderam à versão brasileira proposta antes de realizarem um exame ultrassonográfico em um hospital público de Santa Catarina, no ano de 2017. A Edinburgh Postnatal Depression Scale foi utilizada como parâmetro de confiabilidade externa. A consistência interna do instrumento foi obtida pelo alfa de Cronbach. A validação foi realizada por análise fatorial exploratória com extração de componentes principais pelo método de Kaiser-Guttman e rotação Varimax. RESULTADOS: O alfa de Cronbach do instrumento total foi 0,886, e apenas o percentual de variância do item 2 (0,183) não foi significativo. O critério de Kaiser-Guttman definiu três fatores responsáveis por explicar 78,5% da variância, assim como o gráfico de Escarpa. A extração dos componentes principais pelo método Varimax apresentou valores de 0,713 a 0,926, sendo apenas o item 2 alocado no terceiro componente. CONCLUSÕES: A versão brasileira é confiável e válida para uso no diagnóstico de ansiedade relacionada à realização de procedimentos ultrassonográficos no pré-natal. Devido à falta de correlação com o restante do construto, sugere-se a retirada do item 2 da versão final.

Adaptação cultural do instrumento Child Drawing: hospital / Cultural adaptation of the instrument Child Drawing: Hospital

Introdução: A hospitalização representa para as crianças um momento geralmente assustador e incomum à sua rotina, pois frequentemente são submetidas a procedimentos hospitalares, bem como a tratamentos terapêuticos que podem acarretar dor, sofrimentos físicos e psicológicos. Estudos demonstram que, apesar de algumas crianças verbalizarem suas necessidades e sentimentos, outras não o fazem tão claramente, o que exige do profissional de enfermagem uma abordagem mais lúdica e criativa, tal como o desenho. Entretanto, é importante também realizar intervenções nessas necessidades, tornando-se imprescindíveis escalas e instrumentos validados para proceder tal ação. Um dos instrumentos existentes, porém ainda não traduzido e adaptado no Brasil, é o CD:H Child Drawing: Hospital, um instrumento que analisa a ansiedade de crianças hospitalizadas em idade escolar por meio do desenho. O instrumento CD:H é peculiar, no sentido que o que deve ser traduzido são as instruções de aplicação do instrumento e de análise do desenho realizado pela criança. Apesar de ser aplicado em crianças, o profissional que utiliza o instrumento é quem deve entender as instruções de aplicação e análise, a fim de que todos os profissionais que o utilizarem possam chegar ao mesmo diagnóstico do nível de ansiedade, confirmando a sua aplicabilidade. Objetivo e Método: O objetivo deste estudo foi adaptar o instrumento para a língua portuguesa falada no Brasil, de acordo com as diretrizes de adaptação transcultural de Guillemin, Beaton e Bombardier (1993) e Beaton et al. (1998, 2000, 2007) adotando os seguintes passos: a) Tradução; b) Revisão e Síntese das traduções; c) Comitê de Juízes; d) Retrotradução; e) Reavaliação da pontuação dos resultados; f) Validação de face e de conteúdo. Resultados: Foram realizadas duas traduções independentes do inglês para o português por duas pessoas fluentes na língua pretendida. Após as traduções, pesquisadora, orientadora e tradutora realizaram reuniões para gerar a síntese das traduções. O Comitê de Juízes foi composto por oito enfermeiros de quatro regiões do Brasil: Sul, Sudeste, Nordeste e Centro-Oeste. O valor mínimo necessário de Razão de Validade de Conteúdo (RVC) deveria ser igual ou maior a 0,75, a partir do cálculo realizado pelo psicometrista pelo Critério de Lawshe (Wilson, Pan, Schumsky, 2012). O instrumento como um todo foi bem avaliado pelo Comitê de Juízes, com boa validade semântica e de conteúdo, com RVC=1 (66,95%) e RVC de 0,75 a 1 em 175 itens do CD:H VB (73,23%). Os 15 itens discordantes (6,28%), que receberam o índice RVC de 0,75, tiveram modificações gramaticais para uma melhor adequação do instrumento. Foi elaborada somente uma retrotradução do português para o inglês e a revisão do instrumento por um professor associado da Escola de Enfermagem de uma universidade norte-americana pela impossibilidade de as autoras originais o fazerem. Após rigoroso processo de tradução e adaptação transcultural, a versão final do instrumento Child Drawing: Hospital foi finalizada, apenas com ajustes gramaticais e a substituição do crayon pelo lápis de cor como principal adaptação cultural, uma vez que, na cultura brasileira, as atividades de desenhar e pintar geralmente são realizadas com lápis de cor e não giz de cera. Conclusão: Este estudo é a primeira fase do processo de validação do instrumento CD:H, tendo sido realizada sua tradução e adaptação cultural, obtendo-se o instrumento Child Drawing: Hospital Versão Brasileira CD:H VB. Pode-se concluir que os objetivos do estudo foram alcançados e que o instrumento CD:H VB tem condições de continuar o processo de validação a ser realizado posteriormente.

Introduction: Hospitalization is normally a frightening and unusual time for children, because in such occasions they often undergo hospital procedures, as well as therapeutic treatments that can lead to pain, besides physical and psychological suffering. Studies show that, while some children verbalize their needs and feelings, others do not do it so clearly, a situation that requires a more playful and creative approach from the nursing professional, such as the use of drawing. However, it is also important to make interventions about such needs. Considering that, it is necessary to validate scales and instruments to carry out such action. One of the existing instruments, but not yet translated or adapted in Brazil, is CD:H - Child Drawing: Hospital, an instrument that aims at analyzing the anxiety of hospitalized children of school age through drawing. The CD:H instrument is peculiar, in the sense that what should be translated are the instructions for applying the instrument and analyzing the drawing performed by the child. Although the instrument is applied in children, the professional who uses it is the one who must understand the instructions for application and analysis, so that all professionals who use it can arrive at the same diagnosis for the level of anxiety, confirming the instruments applicability. Objective and Method: The objective of this study was to adapt the aforementioned instrument to the Portuguese language spoken in Brazil, according to Guillemin, Beaton and Bombardier (1993) and Beaton et al. (1998, 2000, 2007). The study was based on the following steps: a) Translation; b) Review and Synthesis of translations; c) Expert Committee; d) Back-translation; e) Re-evaluation of the scores of the results; f) Validation of face and content. Results: Two independent translations were performed from English to Portuguese by two professionals fluent in the intended language. After this process was finished, researcher, counselor and translator held meetings to generate a synthesis of all translations. The Expert Committee was composed of eight nurses from four regions of Brazil: South, Southeast, Northeast and Midwest. The minimum required Content Validity Ratio (CVR) value should be equal to or greater than 0.75, based on a calculation performed by a psychometrist, which was based on the Lawshe's Criterion (Wilson; Pan; Schumsky, 2012). The instrument as a whole was well evaluated by the Expert Committee, presenting good semantic and content validity, with CVR=1 (66.95%) and CVR of 0.75 to 1 in 175 CD:H VB items (73.23%). The 15 discordant items (6.28%), which received the CVR index of 0.75, suffered grammatical modifications for better instrument suitability. Only a back-translation from Portuguese to English and a revision of the instrument by an associate professor of the Nursing School of an American university was carried out, because the original authors could not do so. After rigorous transcultural translation and adaptation, the Child Drawing: Hospital instrument received its final version, with only grammatical adjustments and the replacement of crayons with colored pencils, which was considered the main cultural adaptation, since, in Brazil, the activities of drawing and painting are usually done with colored pencil, and not crayon. Conclusion: This study represents the first phase of the validation process of the CD:H instrument, offering translation and cultural adaptation. As a result, the instrument Child Drawing: Hospital Versao Brasileira (CD:H VB) was obtained. It can be concluded that the objectives of this study were achieved and that the CD:H VB instrument is able to have its validation process continued later in the future.

Trait vs. state anxiety in different threatening situations / Ansiedade traço versus ansiedade estado em diferentes situações de ameaça

Abstract Objective Anxiety as a uni- or multidimensional construct has been under discussion. The unidimensional approach assumes that there is a general trait anxiety, which predisposes the individuals to increases in state anxiety in various threatening situations. In this case, there should be a correlation between state and trait anxiety in any situation of threat. Therefore, the aim of this study was to investigate the correlation between trait and state anxiety in participants exposed to two different anxiogenic situations: interpersonal threat (Video-Monitored Stroop Test - VMST) and physical threat (third molar extraction - TME). Methods Participants with various levels of trait anxiety (general trait: State-Trait Anxiety Inventory - STAI, Hospital Anxiety and Depression Scale; specific trait: Social Phobia Inventory, Dental Anxiety Scale) had their anxious state evaluated (STAI, self-evaluation of tension level, heart rate, electromyogram activity) before, during and after the VMST or the TME. Results In VMST, trait anxiety correlated to state anxiety (psychological parameters) in all test phases. However, in TME, the only trait measurement that correlated to state anxiety (psychological parameters) was the Dental Anxiety Scale. Conclusion Trait anxiety correlates positively to state anxiety in situations of interpersonal threat, but not of physical threat.

Resumo Objetivo A ansiedade como um construto uni ou multidimensional tem estado em discussão. A abordagem unidimensional presume que há uma ansiedade-traço geral, a qual predispõe o indivíduo a aumentar a ansiedade-estado em situações de ameaça. Neste caso, deveria existir uma correlação entre estado e traço ansioso em diferentes situações ameaçadoras. Portanto, o objetivo deste estudo foi avaliar a correlação entre ansiedade-traço e ansiedade-estado em participantes que foram expostos a duas situações ansiogênicas diferentes: ameaça interpessoal (Teste de Stroop Monitorado por Vídeo - TSMV) e ameaça física (exodontia do terceiro molar - ETM). Métodos Participantes com vários níveis de ansiedade-traço (traço geral: Inventário de Ansiedade Traço-Estado - IDATE; Escala Hospitalar de Ansiedade e Depressão; traço específico: Inventário de Fobia Social, Escala de Ansiedade Dental de Corah) tiveram seus estados ansiosos avaliados (IDATE, escala analógica de tensão, frequência cardíaca, eletromiografia) antes, durante e depois do TSMV ou da ETM. Resultados No TSMV, a ansiedade-traço correlacionou-se com a ansiedade-estado (parâmetros psicológicos) em todas as fases do teste. Entretanto, na ETM, a única medida de traço que se correlacionou com a ansiedade-estado (parâmetros psicológicos) foi a Escala de Ansiedade Dental de Corah. Conclusão A ansiedade-traço correlaciona-se positivamente com a ansiedade-estado em situações de ameaça interpessoal, mas não de ameaça física.

Written Educational Material Relieves Anxiety after Endoscopic Biopsy: A Prospective Randomized Controlled Study / 대한소화기학회지

BACKGROUND/AIMS: Patients who undergo endoscopic biopsy suffer anxiety until results are confirmed. This study assesses the effects of written educational material on the anxiety level of patients following endoscopic biopsy. METHODS: This study was a randomized controlled study trial with 83 patients divided into the following three groups: a biopsy group given written educational material prepared by our institution following the biopsy (intervention group, n=28), a biopsy group without written material (biopsy only group, n=25), and a control group without biopsy (control group, n=30). The anxiety level of each patient was evaluated three times using Spielberger's State-Trait Anxiety Inventory (STAI): for baseline at the first visit to our institution, at the day of endoscopy, one day later, and one week after the procedure. We compared baseline characteristics, STAI scores at each visit, and differences in STAI scores among the three groups. RESULTS: No difference was found in STAI score among groups at baseline and before and after the endoscopic procedure. However, the STAI-state score of the intervention group was slightly lower than biopsy only group one day post-procedure (40.3+/-7.7 vs. 43.9+/-7.1, p=0.135). The STAI-state score significantly decreased from pre- to post-procedure only in the intervention group (-2.75+/-6.1 vs. 0.92+/-4.0, p<0.027). CONCLUSIONS: Use of written educational material for patients having biopsy might lessen their anxiety level.

Efficacy of Wrist-ankle Acupuncture plusAuricular Point Sticking for Pre-exam AnxietySyndrome / 上海针灸杂志

ObjectiveTo observe the efficacy of wrist-ankle acupuncture plus auricular point sticking in treating pre-exam anxiety syndrome.MethodSixty patients with pre-exam anxiety syndrome were randomized into a treatment group to receive wrist-ankle acupuncture plus auricular point sticking (30 cases, 11 cases dropped out) and a control group to receive auricular point sticking (30 cases, 1 dropped out). In the treatment group, the bilateral Upper 1 zones were punctured regarding the wrist-ankle acupuncture, and for the auricular point sticking, Heart (CO 15), ear Shenmen (TF 4), Endocrine (CO 18), Adrenal Gland (TG 2p), Subcortex (AT 4) were selected. In the controlgroup, the same auricular points were treated. For both groups, the intervention began from 1 week prior to the exam, 3 d as a treatment course, and the therapeutic efficacy was evaluated after 2 successive courses. The Sarason Test Anxiety Scale (TAS) and autonomic function test were used to assess the anxiety severity before and after treatment. ResultThe total effective rate was 84.2% (16/19) in the treatment group versus 82.8% (24/29) in the control group, and the difference was statistically insignificant (P>0.05). The TAS score dropped significantly in the control group after intervention (P<0.01).ConclusionWrist-ankle acupuncture plus auricular point sticking and auricular point sticking alone both can effectively improve the symptoms of pre-exam anxietysyndrome.

Estudo do perfil sociodemográfico e psicossocial de mães de neonatos e seus conhecimentos sobre a Triagem Auditiva Neonatal / Study of the social-demographic and psychosocial profile of mothers of newborns and their knowledge about Newborn Hearing Screening

Este estudo teve como objetivos caracterizar o perfil sociodemográfico e psicossocial das mães de neonatos que realizaram Triagem Auditiva Neonatal (TAN); avaliar seu o conhecimento sobre TAN; e mensurar o nível de ansiedade materna frente à testagem do bebê. Participaram do estudo 107 mães, que inicialmente responderam um questionário com o objetivo de obter os dados socioeconômicos (escolaridade e profissão), demográficos (idade e estado civil) e psicossociais (suporte social e planejamento da gestação). A segunda parte do questionário referiu-se aos aspectos da TAN: conhecimentos e importância da TAN, informante do procedimento, consequências da perda auditiva e aos sentimentos envolvidos na realização da TAN. Em seguida, para investigar o nível de ansiedade materna antes da realização da TAN, foi utilizado um questionário de ansiedade. A idade das mães variou entre 14 e 44 anos; 53,27% mulheres tinham escolaridade igualou inferior ao fundamental completo. No que se refere à ocupação, 66,36% das entrevistadas referiu ser dona de casa;64,49% são casadas; e 88,78% planejaram a gestação. Ao investigar o suporte social, 88,79% possuía o marido como fonte de apoio financeiro, afetivo e emocional. Em relação ao conhecimento sobre TAN, 76,64% não sabia o que era o exame. Além disso, 42% das mães souberam que seu filho faria o procedimento durante a internação, e a enfermeira foi o principal profissional da saúde que informou sobre a TAN. Observou-se o predomínio de reações negativas (81,70%)frente à TAN quando a mãe não conhecia o procedimento. Concluiu-se que o perfil encontrado foi de mães jovens, com baixa escolaridade, donas de casa, casadas, com suporte social do marido e que planejaram a gestação. O conhecimento sobre TAN foi restrito. Existiu associação entre sentimentos negativos e falta de conhecimento sobre TAN.

This study aimed to characterize the social-demographic and psychosocial profiles of mothers of newborns submitted to Newborn Hearing Screening (NHS); to evaluate their knowledge of NHS and to measure the level of maternal anxiety towards baby testing. Subjects were 107 mothers who at the outset answered a questionnaire in order to supply socioeconomic (education and occupation), demographic (age and marital status) and psychosocial (social support and planning of pregnancy) data. The second part of the questionnaire referred to aspects of the NHS: the importance and the knowledgeabout NHS, procedures’ informant, consequences of the hearing loss and the feelings involved in making NHS. Then, to investigate the level of maternal anxiety prior to NHS, an anxiety questionnaire was used. The mothers’ ages ranged from14 to 44 years, 53.27% of the women have educational status equal or inferior to Elementary School. As regards occupation,66.36% of the interviewed mothers said to be housewives, 64.49% of them are married and 88.78% of them planned pregnancy. When investigating the social support, 88.79% of them have a husband as financial, affective and emotion al support. As regards knowledge about NHS, 76.64% did not know what it was. In addition, 42% of the mothers knew thattheir children were submitted to the procedure during hospitalization and the nurse was the main health professional who informed them about NHS. It was observed that negative reactions (81.70%) about NHS predominated when mothers didnot know what the procedure is. It was concluded that the profile was: mothers are young, have low education, the majorityis housewives, married, having social support from the husband and planned pregnancy. Knowledge of NHS was rare.There was a relationship between negative feelings about the test and the lack of knowledge about NHS.

Content validity of the short version of the subscale of the State-Trait Anxiety Inventory (STAI) / Validade de conteúdo de versão resumida da subescala do Inventário de Ansiedade Traço-Estado (IDATE) / Validez de contenido de versión corta de la subescala del Cuestionario State-Trait Anxiety Inventory (STAI)

The goal was to describe the content validity of a short version of the state subscale of Spielberger's "State-Trait Anxiety Inventory (STAI)", based on the original version adapted to Spanish, in Spanish patients receiving invasive mechanical ventilation (IMV). The sample consisted of 16 patients receiving IMV at the Alicante Hospital (Spain), who selected the items from the full Spanish version of the STAI-state that were most relevant to them. Items 1, 5, 9, 10, 12 and 20 from the original scale are the most relevant for the Spanish patients receiving IMV and 5 of these are included in the short version of the scale (83.3 percent agreement). The short scale has shown adequate content validity for Spanish patients receiving IMV.

Teve-se como objetivo descrever a validade de conteúdo de uma versão resumida da subescala estado do State-Trait Anxiety Inventory (STAI) de Spielberger, a partir da versão original adaptada ao espanhol, em pacientes espanhóis, sob ventilação mecânica invasiva (VMI). A amostra foi composta por 16 pacientes, sob VMI, no hospital de Alicante, Espanha, que selecionaram os itens da versão espanhola completa do Idate-estado de maior relevância para eles. Os itens nº1, 5, 9, 10, 12 e 20 da escala original são os mais relevantes para os pacientes espanhóis sob VMI, e 5 deles estão incluídos na versão resumida da escala (83,3 por cento de concordância). A escala resumida mostrou adequada validade de conteúdo para pacientes espanhóis sob VMI.

Se tuvo por objetivo describir la validez de contenido de una versión corta de la subescala Estado del State-Trait Anxiety Inventory (STAI) de Spielberger, a partir de la versión original adaptada al español, en pacientes españoles con ventilación mecánica invasora (VMI). La muestra fue integrada por 16 pacientes con VMI en el hospital de Alicante (España), que seleccionaron los ítems de la versión española completa del STAI-estado de mayor relevancia para ellos. Los ítems nº: 1,5,9,10,12 y 20 de la escala original son los más relevantes para los pacientes españoles con VMI; siendo que 5 de ellos están incluidos en la versión corta de la escala (83.3 por ciento de acuerdo). La escala corta ha demostrado una adecuada validez de contenido para pacientes españoles con VMI.

Predictors of Medical Students' Beliefs about Intelligence: Affective and Cognitive Factors, Parental Interest, and Home Economic Status / 한국의학교육

PURPOSE: To identify predictors of medical students' beliefs about intelligence among affective and cognitive factors, parental interest in children's education, and home economic status (HES). Of the 408 medical students who participated in this study, 398 completed and returned the questionnaires, yielding a total response rate of 97.5%. METHODS: Measures of students' beliefs about intelligence, intrinsic value, self-efficacy, test anxiety, cognitive strategies, self-regulation, parental interest in children's education, and HES were obtained. RESULTS: Spearman's correlations indicated that an entity theory of intelligence was negatively related to intrinsic value, self-efficacy, cognitive strategies, self-regulation, parental interest in children's education, and HES, and positively related to test anxiety. An incremental theory of intelligence was positively related to intrinsic value, self-efficacy, cognitive strategies, self-regulation, parental interest in children's education, and HES, and negatively related to test anxiety. Findings of independent t-tests showed that incremental theorists showed higher intrinsic value, self-efficacy, cognitive strategies, self-regulation, parental interest in children's education, and lower test anxiety than entity theorists. A binary logistic regression analysis showed that 72.9% of the medical students in the study were accurately classified as either incremental theorists or entity theorists with respect to intrinsic value, self-efficacy, test anxiety, and cognitive strategies. CONCLUSION: Medical educators need to be aware that medical students who have incremental beliefs about intelligence have higher intrinsic value, self-efficacy, cognitive strategies, and lower test anxiety than those who have fixed beliefs about intelligence. Perhaps a training program needs to be developed to enhance medical students' conceptions of intelligence based on the findings.

Lymphocyte Subsets and Mood States in Panic Disorder Patients

This study was conducted to examine lymphocyte subset counts and mood states in panic disorder patients. Twenty patients with panic disorder and 20 age- and gendermatched normal healthy subjects were recruited for the study. We used the Spielberger State (STAIS) & Trait (STAIT) Anxiety Inventory, Hamilton Depression Rating scale (HAMD) and Hamilton Anxiety Rating scale (HAMA) to measure mood states in all subjects. Lymphocyte subsets counts were made by flow cytometry. Panic patients showed significantly higher scores for anxiety and depression than normal subjects. Panic patients showed no differences in terms of the numbers of immune cells, as compared with normal healthy subjects, other than a lower proportion of T suppressor cells and a higher T helper cell/T suppressor cell ratio. HAMA and STAIS scores were common factors that could predict T cell numbers and proportions, T helper cell numbers, and natural killer cell proportions in panic disorder patients. We suggest that anxiety levels are related to the T-cell population in panic disorder patients and that quantitative immune differences may reflect altered immunity in this disorder.

Preoperative Anxiety and Propofol Requirement in Conscious Sedation for Ovum Retrieval

The purpose of the present study was to evaluate the correlation among the trial number of in vitro fertilization (IVF), preoperative anxiety, and propofol requirement for conscious sedation. One hundred and twenty six Korean women undergoing oocyte retrieval were enrolled. The target-controlled infusion by the anesthesiologist was conducted with initial target propofol concentration of 2.5 microgram/mL, which was manipulated until the sedation score 3 and desired clinical end point were achieved. A weak correlation was observed between visual analogue scale (VAS) anxiety and the dose of propofol required for the induction of conscious sedation (r=0.22, p=0.0192). A weak correlation was also found between VAS anxiety and the sedation time needed to reach the proper conscious sedation level for the procedure (r=0.181, p=0.0484). Multiple regression analysis showed that VAS anxiety, preoperative baseline prolactin level, and cortisol level had statistically significant effects on the propofol induction dose for target controlled conscious sedation. We concluded that the induction dose and time requirements for propofol in anesthesiologist- controlled conscious sedation be modified based on the preoperative anxiety level and the baseline blood concentration of stress hormone, cortisol and prolactin.