Correlation of Anxiety and Structural Factors With Symptoms in Patients With Irritable Bowel Syndrome With Diarrhea / 胃肠病学

Background: Patients with irritable bowel syndrome (IBS) have comorbid anxiety, which influences the severity of IBS symptoms and therapeutic efficacy. Aims: To investigate the intestinal and extra-gastrointestinal symptoms and psychological status of patients with IBS with diarrhea (IBS-D), and to identify the correlation of comorbid anxiety and structural factors with symptoms. Methods: Consecutive patients met the Rome III criteria for IBS-D were enrolled in this study. The IBS symptom questionnaire and Hamilton anxiety scale (HAMA) were completed in a face-to-face manner. Correlations of HAMA and its structural factors with main bowel symptom, defecation symptom, overlapping with gastroesophageal reflux disease and extra-gastrointestinal symptoms were analyzed. Results: A total of 410 IBS-D patients were enrolled, 264 (64.4%) had comorbid anxiety. Compared with patients without anxiety, score of the main bowel symptom and abdominal pain/discomfort after defecation were significantly increased in patients with anxiety, proportions of abdominal bloating, difficulty in stool passage, mucous stool, overlapping with gastroesophageal reflux disease and extra-gastrointestinal symptoms were significantly increased (P<0.05). Psychic anxiety was significantly correlated with main bowel symptom score and degree of improvement of abdominal pain/discomfort after defecation (P<0.05). Somatic anxiety was significantly correlated with degree of pre-defecation abdominal pain/discomfort (P<0.05). No structural factor had significant correlation with bowel movements or stool form either in the symptom episode or in the non-symptom period. HAMA score, psychic anxiety score, somatic anxiety score in patients with abdominal bloating, mucous stool, overlapping with gastroesophageal reflux disease and extra-gastrointestinal symptoms were significantly higher than those in patients without the corresponding symptoms (P<0.05). Conclusions: The comorbid anxiety and structural factors are mainly correlated with degree of abdominal pain/discomfort in IBS-D patients, but not with bowel movements or stool form.

Verificação empírica da estrutura fatorial da escala multidimensional de reatividade interpessoal (EMRI) em jovens religiosos e leigos / Empirical verification of factorial structure of multidimensional scale of reactivity interpessoal (MSRI) in young religious and lay

A empatia é compreendida como a capacidade da pessoa em inferir seus sentimentos e pensamentos, a partir do conhecimento adquirido e se colocar no lugar do outro respondendo afetivamente de forma mais adequada em relação ao outro e a situação do entorno experiencia da pela pessoa. Estudos no Brasil adaptaram, validaram e confirmaram a estrutura trifatorial da Escala Multidimensional de Reatividade Interpessoal (EMRI); o presente estudo pretende verificar a estrutural fatorial da EMRI em jovens em contextos religiosos e não religiosos (leigos). 200 sujeitos, homens e mulheres, de 14 e 27 anos, da rede publica de educação e de igrejas evangélicas na cidade de João Pessoa-PB; estes, responderam a EMRI e um questionário demográfico. Observou-se que na amostra total e, especificamente, na amostra de jovens leigos e religiosos, a escala apresentou indicadores psicométricos e escores lambdas com associações positivas entre os fatores. Tais achados garantiram a estrutura tetrafatorial, previamente proposta pelo autor da escala original e que vem sendo encontrada em sua semelhante organização fatorial, por outros autores brasileiros. O resultado desse estudo, aponta, conceitual e empiricamente, independente da diversidade amostral, para a confiabilidade da EMRI em jovens, podendo ser utilizada com segurança na mensuração desse construto da empatia.

Empathy is understood as a person’s ability to infer their feelings and thoughts, from the knowledge acquired and put yourself in the other affectively responding more adequately relative to each other and the situation surrounding experienced by the person. Studies in Brazil adapted, validated and confirmed the three-factor structure of the Multidimensional Scale of Interpersonal Reactivity (EMRI), the present study investigated the factorial structure of EMRI in young in religious contexts and not religious (lay). 200 subjects, men and women, 14 to 27 years, from public school and evangelical churches in the city of João Pessoa; these responded to EMRI and demographic questionnaire. It was observed that the total sample, and specifically in the sample of young lay people and religious, scale indicators presented psychometric scores and lambdas with positive associations between factors. These findings ensured tetrafatorial structure, previously proposed by the author of the original scale and has been found in a similar organization factor, in other Brazilian studies. The result of this study shows, conceptually and empirically, independent of sample diversity to the reliability of EMRI in young and can be safely used in the measurement of this construct of empathy.

Analysis on Hamilton Depression Scale Structural Factor of Depression Patients with Liver Qi Stagnation Syndrome and Liver Stangation and Spleen Defieiency Syndrome / 中国中医药信息杂志

Objective To discuss the different factorial structure of HAMD Scale between the patients of liver Qi stagnation syndrome and liver stagnation and spleen deficiency syndrome. Methods Factorial structure of HAMD Scale of 91 depression patients of liver Qi stagnation syndrome and liver depression and spleen deficiency syndrome were statistically analyzed. Result There was difference between the two types of patients in factorial structure of HAMD Scale (P

Factors Associated with the Degree of Quality Improvement Implementation / 예방의학회지

OBJECTIVES: To assess the degree of quality improvement (QI) implementation and to identify its associated factors. METHODS: A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. RESULTS: The average QI implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a etter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. CONCLUSIONS: It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.