Psychological tendencies of children with juvenile idiopathic arthritis.

A bulk of studies showed an association between stressful events and juvenile idiopathic arthritis (JIA) but failed to identify specific psychological tendencies that contribute to the patients' vulnerability to stress. The purpose of this paper is to identify psychological tendencies specific to JIA that would unravel characteristic sources of stress. The study is based on the cognitive orientation model of health, which enables us to identify these kinds of tendencies in terms of four belief types (beliefs about self, general beliefs, beliefs about norms, and goals) that refer to specific themes. This is a case-control-cohort study that included a sample of 36 patients (mean age = 12.44 years, SD = 2.97, 21 females) and 41 matched controls (mean age = 13.15 years, SD = 2.01, 22 females). The JIA cognitive-orientation questionnaire was administered, and relevant medical parameters were recorded. The belief types differentiated between the two groups, and the patients were characterized using six themes. Examples of the themes are being over-sensitive, striving for success, and not fulfilling duties well. The themes differentiated between the participants' groups with an accuracy of 89.1%. The likelihood of the patients being characterized by the themes is 3.24-9.35 times more than the controls. The psychological tendencies of JIA were discussed as generators of stress (e.g., being over-sensitive) and cognitive conflicts (e.g., the contradiction between striving for success versus not fulfilling duties well). Also, the suggested reflections of these tendencies in the health workers' and patients' relationships, such as egalitarian interaction, and non-formal communication style, were described.

Motivational disposition towards psychological characteristics of israeli children with inflammatory bowel diseases: A case-control study.

BACKGROUND: Psychological stress is a general and non-specific factor associated with many health conditions, including Inflammatory Bowel Diseases (IBD). It is related not only to external stressors but also to internal characteristics which enhance patients' vulnerability to stress. PURPOSE: To identify specific psychological characteristics of pediatric IBD related to stress. DESIGN AND METHODS: A case-control-cohort study that compared the psychological characteristics of 49 patients and 56 comparisons. The psychological characteristics were defined by four belief types - beliefs about self, general beliefs, beliefs about norms, and goals - which refer to a set of specific themes. RESULTS: The belief types differentiated between the two groups, and the patients were characterized by six themes: like routines, strive to get others' love, caring about the body and the health, doing things only at their own pace, expressing negative emotion without regulations, and feeling over-identification with others. Patients' likelihood of being characterized by the themes is 2.18 to 2.90 times higher than the comparisons. CONCLUSION: Children with IBD are characterized by a set of specific psychological characteristics. These characteristics were discussed mainly concerning generating chronic stress (e.g., over-identification with others) and interpersonal conflicts (e.g., doing things only at their own pace) among the patients. IMPLICATIONS FOR PRACTICE: It is suggested to healthcare workers to be aware of the specific psychological characteristics of children with IBD, and sensitive to these characteristics during interactions with them. Besides, the characteristics may pave the way for developing a targeted psychological intervention that corresponds specifically to the patients' needs.

Adolescents With Cancer Need Trustworthy Information and Prefer to Receive It From a Human Source Rather Than From the Internet: A Qualitative Study.

Background: In pediatric cancer, the legal obligation to provide information is usually toward the parents who are the authorized signatories of the informed consent form. It is now known that aside from providing information to the parents, it is also very important to provide information to the children and adolescents themselves. The question is how the adolescents relate to this. What information do they already possess and what would they like to know? Would they wish to hear the truth in all situations and at what stage? What are their preferred sources of information? Method: A qualitative study that included in-depth interviews with 19 adolescents with cancer, aged 8.5-18, who were receiving active treatments and had been diagnosed at least 1 month previously. The interviews were guided by 15 open-ended questions. Findings: The analysis of the interviews indicated that adolescents know quite a lot about the course of their disease and the information they lack is mainly etiological. The participants reported a lack of knowledge concerning sexuality and a sense of discomfort talking about it, leaving them with open questions. They all claimed that it is important to tell the truth: "Even if the truth is difficult, it is important to tell it." The participants reported that information can be scary, so it must be structured and adapted to the age and emotional readiness of the individual. Most of the participants prefer not to use the internet as an information resource due to the profusion of stressful and non-adapted information. Conclusion: Adolescents with cancer need trustworthy information and prefer to receive it from a human source rather than from the internet. Not telling the truth can lead them to feel fear and loneliness. The medical staff must operate in sensitive and creative ways to provide adolescents with access to information on various subjects, including sexuality, which they are ashamed to talk about, leaving them with a sense of shame and a lack of knowledge in this area.

Auditory Training to Improve Speech Perception and Self-Efficacy in Aging Adults.

Purpose Difficulty in understanding spoken speech is a common complaint among aging adults, even when hearing impairment is absent. Correlational studies point to a relationship between age, auditory temporal processing (ATP), and speech perception but cannot demonstrate causality unlike training studies. In the current study, we test (a) the causal relationship between a spatial-temporal ATP task (temporal order judgment [TOJ]) and speech perception among aging adults using a training design and (b) whether improvement in aging adult speech perception is accompanied by improved self-efficacy. Method Eighty-two participants aged 60-83 years were randomly assigned to a group receiving (a) ATP training (TOJ) over 14 days, (b) non-ATP training (intensity discrimination) over 14 days, or (c) no training. Results The data showed that TOJ training elicited improvement in all speech perception tests, which was accompanied by increased self-efficacy. Neither improvement in speech perception nor self-efficacy was evident following non-ATP training or no training. Conclusions There was no generalization of the improvement resulting from TOJ training to intensity discrimination or generalization of improvement resulting from intensity discrimination training to speech perception. These findings imply that the effect of TOJ training on speech perception is specific and such improvement is not simply the product of generally improved auditory perception. It provides support for the idea that temporal properties of speech are indeed crucial for speech perception. Clinically, the findings suggest that aging adults can be trained to improve their speech perception, specifically through computer-based auditory training, and this may improve perceived self-efficacy.

Evaluation of the Efficacy of Psychological Interventions in Promoting Preparedness to Armed Conflicts - A Randomized Controlled Study.

OBJECTIVE: Despite efforts by civil defense authorities, levels of households' preparedness to emergencies remain insufficient in many countries. Engaging the public in preparedness behavior is a challenge worldwide. The purpose of this study was to explore the efficacy of psychological intervention in promoting preparedness behavior to armed conflicts in Israel. METHODS: A randomized controlled trial (N = 381) with two control groups and three intervention groups was used. The psychological interventions studied were elevated threat perception, external reward, and manipulation of a cognitive cluster related to preparedness. RESULTS: The results of the analysis suggest a significant effect of intervention on the increase of reported preparedness (F4,375 = 4.511, P = 0.001). The effect is attributed to the intervention group in which external reward was offered. Participants in this group were about two times more likely to report greater levels of preparedness compared to the control group (RR = 1.855; 95% CI: 1.065, 3.233). CONCLUSIONS: The findings suggest that preparedness behavior can be promoted through external incentives. These are presumably effective motivators because they encourage preparedness while allowing subjects to retain their denial as an adaptive coping mechanism. Innovative thinking is required to overcome the psychological barriers associated with public reluctance to engage in preparedness. (Disaster Med Public Health Preparedness. 2018;13:713-723).

A Placebo-Controlled Double-Blind Randomized Trial with Individualized Homeopathic Treatment Using a Symptom Cluster Approach in Women with Premenstrual Syndrome.

BACKGROUND: In a double-blind placebo-controlled randomized trial with parallel groups, the efficacy of individually prescribed homeopathic medicines was evaluated in women with premenstrual syndrome (PMS). METHODS: In an outpatient department of a university clinic in Jerusalem, Israel (1996-1999), women with PMS, aged 18 to 50 years, entered a 2-month screening phase with prospective daily recording of premenstrual symptoms by the Menstrual Distress Questionnaire (MDQ). They were included after being diagnosed with PMS. A reproducible treatment protocol was used: women received a homeopathic prescription based on symptom clusters identified in a questionnaire. The symptoms were verified during a complementary, structured, interview. Only women whose symptoms matched the symptom profile of one of 14 pre-selected homeopathic medicines were included. Each participant was administered active medicine or placebo via random allocation. Primary outcome measures were differences in changes in mean daily premenstrual symptom (PM) scores by the MDQ. Analysis was by intention-to-treat. RESULTS: A total of 105 women were included: 49 were randomized to active medicine and 56 to placebo. Forty-three women in the active medicine group and 53 in the placebo group received the allocated intervention with at least one follow-up measurement and their data were analyzed. Significantly greater improvement of mean PM scores was measured in the active medicine group (0.443 [standard deviation, SD, 0.32] to 0.287 [SD, 0.20]) compared to placebo (0.426 [SD, 0.34] to 0.340 [SD, 0.39]); p = 0.043. CONCLUSIONS: Individually prescribed homeopathic medicines were associated with significantly greater improvement of PM scores in women with PMS, compared to placebo. Replication, with larger sample size and other refinements, is recommended to confirm the efficacy of this treatment in other settings.

Status of the Trait Concept in Contemporary Personality Psychology: Are the Old Questions Still the Burning Questions?

This special issue of Journal of Personality addresses one of the cardinal concerns of personality psychology, namely, the status of traits in contemporary personality science. Trait theory is a major scientific model for personality explanation and research. Although there have been critiques of traits, typically formulated from the point of view of the social-cognitive perspective, the trait approach can be viewed as a continuously developing paradigm. However, personality psychology persists in tackling burning questions concerning the status of traits that need to be answered. Modern trait approaches confront problems such as constructing an objective personality traits assessment, connecting the descriptive traits with explanatory processes, applying traits for understanding the individual person, clarifying the relation of traits to behavior, and using traits for solving cardinal concerns of personality psychology (e.g., personality organization). This special issue presents examples of contemporary trait theories that attempt to provide possible solutions to these issues and/or delineate other main issues to be resolved by future research and theorizing. We have asked contributors to portray their approach and describe in what way their trait theory continues a historic tradition and in what respect it breaks with the past and moves trait models to more mature scientific levels.

The Role of Victimization in Shaping Households' Preparedness for Armed Conflicts in Israel.

OBJECTIVES: One of the most prominent threats to the Israeli population is the risk from armed conflicts. Yet, promoting preparedness behavior proves to be highly difficult. Arguably, this is partially due to the chronic exposure of the Israeli public to this threat, a.k.a. "Victimization." The purpose of this study was to examine whether victimization plays a prominent role in shaping preparedness behavior toward armed conflicts in Israel. METHODS: An online survey of 502 participants representing the adult Jewish population in Israel was carried out. A set of questionnaires designed to assess public perception of preparedness-affecting factors was used. The list of preparedness-affecting factors was conceptualized by an expert panel before the survey. RESULTS: The results suggest that low prioritization and ignoring of civil-defense instructions during routine times are leading causes for non-compliance with preparedness recommendations. Ignoring instructions is also negatively correlated with reported preparedness. Misunderstanding the threat and fearing it also seem to be important factors. CONCLUSIONS: The results of this study support the hypothesis that victimization plays an important role in shaping preparedness behavior toward armed conflicts among Jews in Israel. The findings demonstrate the complexity of the socio-psychological perspective of preparedness behavior in victimized populations. (Disaster Med Public Health Preparedness. 2018;12:67-75).

The meaning profiles of anxiety and depression: similarities and differences in two age groups.

The distinctiveness of anxiety and depression is discussed concerning their nature, definitions, uses, manifestations and determinants. The objective was to examine the difference and similarity of anxiety and depression by applying the psychosemantic approach, which is a theory and methodology based on analysing the cognitive processes applied in communicating meanings. In Study 1, there were 760 participants of both genders, 23-31 years old. They were administered the Meanings Test, which yields the respondent's meaning profile, and one of seven anxiety scales or one of three depression scales. Significant correlations between the meaning profiles and the anxiety or depression scales were summarised and compared. In Study 2, there were 78 individuals over 65 years old who were administered the Meanings Test plus an anxiety or depression scale. The findings for anxiety and depression were compared within and across age groups. The results yielded two distinct meaning profiles for anxiety and depression in the two age groups. The anxiety profile indicated more focusing on one's internal world. whereas the depression profile indicated focusing both on the personal and the interpersonally shared reality. The conclusion was that anxiety and depression are different constructs that need to be considered as separate theoretically and practically.

Personality Traits as Patterns of Meaning Assignment Tendencies.

OBJECTIVE: The purpose is to present a new conception about the nature of personality traits based on the Kreitler Meaning System. The major constructs of the meaning system are referent, meaning value, meaning unit, and meaning variables characterizing the meaning unit. The individual's meaning profile is the set of meaning variables the individual uses as assessed by the Test of Meanings. Personality traits are defined as patterns of meaning assignment tendencies. METHOD: After introducing the meaning system, the article describes the new conception of personality traits and presents the example of extraversion. Correlation coefficients of four different extraversion scales with the meaning profiles are analyzed. RESULTS: The findings enable defining the meaning profile of extraversion and validating it in view of the information available about extraoversion. CONCLUSIONS: Implications of the new conception are providing insight into the structure, nature, and dynamics of a trait, a factor, or a cluster of traits; comparing traits; validating traits; describing interactions between traits; assessing traits by the Test of Meanings; assessing traits and anti-traits; identifying traits; classifying traits; describing traits in interaction with other tendencies; and applying interventions for modifying traits. Applications concerning attitudes, cognitive performance, emotions, defenses, coping, and psychopathology are presented.

Psychological Correlates of Civilian Preparedness for Conflicts.

OBJECTIVES: Preparedness for emergencies and disasters is imperative for public resilience. Previous studies have revealed low levels of civilian preparedness for conflicts. Classic behavioral models prove inapt in describing preparedness patterns in victimized populations chronically exposed to this threat. In an effort to expand this perspective, we hypothesized that other psychological constructs are correlated with preparedness. METHODS: A cross-sectional, Internet-based study was performed in Israel in early 2016. A sociodemographically diverse sample included 385 participants, Jews and Arabs. The tools included a preparedness index, sense of preparedness questionnaire, Trait Anxiety Inventory, Life Orientation Test, Behavioral Inhibition & Activation System scales, and ego defenses. RESULTS: The results suggested that optimistic and rational individuals reported significantly higher levels of preparedness, whereas those who scored highly on the trait anxiety scale and those with a tendency to use denial coping mechanisms reported significantly lower levels of preparedness. CONCLUSIONS: The findings suggest that additional constructs, other than classic threat perception components, might play a key role in governing preparedness behavior. In particular, psychological manipulation of dispositional optimism or optimistic thinking might be effective in motivating preparedness behavior. Future research should explore such innovative ways to promoting preparedness. (Disaster Med Public Health Preparedness. 2017;11:451-459).

Psychosocial Outcomes of Sharing a Diagnosis of Cancer with a Pediatric Patient.

PURPOSE: This innovative pilot study was designed to provide research-based evidence on the variables to consider informing a child of his/her cancer diagnosis, so as to minimize the negative psychosocial effects of the cancer experience on survivors. The hypotheses of the study were that "good information" about cancer, will allow the child a better understanding way to cope with treatment and improve sociopsychological outcomes at adulthood. METHODS: Ninety-one adult childhood cancer (CC) survivors got the questionnaires while waiting to their routine checkup at a grate CC medical center in center Israel. RESULTS: To our surprise and not according to the hypothesis, there was a difference between children diagnosed up to 12 years of age and those diagnosed during adolescence. (Participants were divided into two groups according to their age at diagnosis: from birth to 12 years old and from age 12-18). In the group diagnosed at a younger age, those who had received "good information" were found to have better quality of life, lower mental pain, and higher mental pain tolerance than did those in the same group (diagnosed at a younger age) who received "not good information." By contrast, in the group diagnosed during adolescence, those who had received "not good information" scored higher on these measures than did their counterparts who had received "good information." CONCLUSION: Given that information conveyed to children diagnosed with cancer can have a significant impact on survivors' quality of life, further research is needed to determine the precise information to be divulged to children at the time of diagnosis. In the meantime, extreme caution, sensitivity, and careful judgment are required. CLINICAL RELEVANCE: Findings of the current study and of future studies can be used to formulate clear guidelines for assessing a child's readiness and the information to be divulged, so as to improve the quality of life of CC survivors.

Perception of the threat of War in Israel- implications for future preparedness planning.

BACKGROUND: It has been recently reported that the preparedness of the Israeli public to a war scenario is mediocre. These findings suggest a need to study the psychosocial mechanisms behind individual motivation to engage in preparedness behavior. One component of these mechanisms is the perception of threat. The purpose of this study is to portray the perception of the threat of war by the Israeli public and to deduce possible implications for resilience-promoting policies. METHODS: Portions of the data accumulated in a telephone-based random sampling of 503 households (representing the Israeli population) performed in October 2013 were utilized to examine the perception of the threat of war by Israelis. The questionnaire was used to examine the level of household preparedness, as well as attitudes toward perception of threat, preparedness responsibility, willingness to search for information, and sense of preparedness. Statistical analysis was performed to determine the correlations between different components of threat perception, and to evaluate the preparedness promoting features of specific perception factors. RESULTS: The data suggest that the perception of threat is influenced by different socio-demographic factors. In particular, age, religion and education seem to play an important role in the perception of threat. Compared to data collected almost a decade ago, the likelihood perception and threat intrusiveness rates were significantly reduced. The regression analysis suggests that perception of the severity of the impact on a family's routine and willingness to search for information, two known preparedness promoting factors, can be predicted by various socio-demographic and threat perception components. CONCLUSION: The data suggest that the Israeli public, post the Second Lebanon War (2006) and the Gaza conflicts of 2009 and 2012, perceives the probabilities of war and being affected by it as diminished. The Israeli public demonstrates what can be considered as the unique characteristics of a war-victimized population. Implications for a future resilience-promoting policy were discussed.

Assessment of Emergency Preparedness of Households in Israel for War--Current Status.

OBJECTIVE: In recent decades, many efforts have been made, both globally and locally, to enhance household preparedness for emergencies. In the State of Israel in particular, substantial investment has been made throughout the years in preparing the population for one of the major threats to the civilian population--a rapidly deteriorating regional conflict that involves high-trajectory weapons (ie, rocket and missile fire) launched at the home front. The purpose of this study was to examine the current preparedness level of the Israeli public for this threat and determine the correlates of such preparedness with known factors. METHODS: A telephone-based, random sampling of 503 households representative of the Israeli population was carried out during October 2013. The questionnaire examined the level of household preparedness as well as attitudes towards threat perception, responsibility, willingness to search for information, and sense of preparedness. Statistical analysis was performed to determine the level of preparedness in the general population and to find correlates to this preparedness in attitudes and demographic variables. RESULTS: More than half of the sample reported complying with 50% or fewer of the actions recommended by the Israeli Home Front Command. Having an increased sense of preparedness and willingness to search for related information were positively correlated with actual household preparedness, and the latter was also found to be the most predictive variable of household preparedness. CONCLUSIONS: Although the overall household preparedness reported is mediocre, the level of preparedness found in this study suggests better preparedness of the population in Israel for its primary threat. The findings suggest that in order to promote preparedness of the Israeli public for war, emphasis should be put on increasing the public demand for information and encouraging people to evaluate their sense of preparedness.

Where to die? That is the question: A study of cancer patients in Israel.

OBJECTIVE: Most patients prefer to die at home, but barely 30% do so. This study examines the variables contributing to dying at home. METHODS: The participants were 326 cancer patients, of both genders, with a mean age of 63.25 years, who died from 2000 to 2008 and were treated by the palliative care unit of the Barzilai Hospital. Some 65.7% died at home and 33.4% in a hospital. The data were extracted from patient files. The examined variables were demographic (e.g., age, gender, marital status, ethnic background, number of years in Israel until death), medical (e.g., age at diagnosis, diagnosis, nature of last treatment, patient received nursing care, patient given the care of a social worker, patient had care of a psychologist, family received care of a social worker, patient had a special caregiver), and sociological (e.g., having insurance, having worked in Israel, living alone or with family, living with one's children, living in self-owned or rented house, family members working). RESULTS: The findings indicate that the chances of dying at home are higher if the patient is non-Ashkenazi, the family got social worker care, the patient lived in a self-owned house, the patient lived with his family, the family members worked, and the patient's stay in Israel since immigration was longer. Logistic regression showed that all the predictors together yielded a significant model accounting for 10.9-12.3% of the variance. SIGNIFICANCE OF RESULTS: The findings suggest that dying at home requires maintaining continued care for the patient and family in a community context.

The relationship of depression, anxiety and stress with low bone mineral density in post-menopausal women.

UNLABELLED: The goal of the present study was to examine the relationships of depression, anxiety and stress with bone mineral density (BMD). We hypothesized negative relations between those mood variables and BMD in three assessed areas. The study showed association between depression and decreased BMD. The hypothesis regarding anxiety and stress was partially confirmed. INTRODUCTION: In the last decade, the relationship of osteoporosis to psychological variables has been increasingly studied. The accumulating evidence from these studies supports the conclusion that depression is related to decreased BMD. Nevertheless, several studies found no support for this relationship. Moreover, only a small number of studies examined the association between anxiety or stress and decreased BMD. The goal of the present study was to examine the relationships of depression, anxiety and stress with BMD by means of adequate measuring instruments, while controlling for background factors known to be related to BMD decrease (e.g., body mass index, family history). METHOD: The study included 135 post-menopausal female participants, who arrived for BMD screening, between the years 2006 and 2009. Several days prior to the examination, participants completed a series of questionnaires assessing depression and anxiety. BMD was measured using DXA, in spine, right and left hip. RESULTS: The study showed negative associations between depression and BMD variables in the three assessed areas. There were negative correlations between anxiety, stress and spine BMD, as well as a tendency towards negative relations in the right and left hip BMD. Concurrent hierarchical regressions showed that the addition of the three psychological variables increased the explained variance by 6­8 %. In addition, depression was found to have a unique significant contribution to the explained variance in right and left hip BMD. CONCLUSIONS: The findings provide supporting evidence for the existence of associations between mood variables and decreased BMD. Further research is required for gaining deeper insight into these relationships.

Adjuvant chemotherapy for breast cancer patients: patients' expectations and physicians' attitudes.

OBJECTIVE: Findings show that there is a certain degree of refusal on the part of breast cancer patients to undergo adjuvant therapy. Accordingly, the major goals of the study were, first, to learn more about the beliefs of breast cancer patients in regard to adjuvant therapy; second, to find out about the sources of the patients' beliefs; and third, to learn about the attitudes of oncologists concerning the same aspects of adjuvant therapy to which the patients' beliefs referred. METHOD: The participants were 92 breast cancer patients (mean age 61.2) and 57 doctors of both genders specialized in oncology or affiliated domains. Both groups were administered questionnaires referring to goals of adjuvant treatment, the chances of attaining these goals, side effects, and difficulty of the treatment. Doctors were specifically asked about the views they thought proper to communicate to patients in regard to the mentioned issues. Patients were also asked about whether they had doubts about the treatment and sources of information. RESULTS: The findings showed disparities between the views of patients and doctors in regard to goals, chances of attainment, side effects, and difficulty of treatment. Patients endorsed more goals than doctors and tended to assign to them lower chances of attainment. Doctors were divided in their views about whether to communicate the side effects and difficulties. SIGNIFICANCE OF RESULTS: The results reveal the importance of outlining goals for patients undergoing adjuvant treatment and the disagreements between doctors about what should be communicated to patients, and highlight the complexity of providing to patients information that is both scientifically correct and emotionally helpful.

Burnout in nephrology nurses in Israel.

The purpose of this study was to examine burnout in nephrology nurses working in Israel and explore its correlates in demographic characteristics, job aspects, and extra-professional activities. Total participants included 132 nurses of both genders working in different wards and clinics. They were administered a background information questionnaire and two burnout questionnaires (Maslach and Shirom-Melamed). The findings showed burnout was related to gender, religion, religious observance, number of children, major working place, role as nurse, domain of nephrology, size of unit, and seniority. It was reduced by engaging in sport and hobbies. Recommendations for reducing burnout include attention to special groups with high burnout and engaging in sports and hobbies.

A Hebrew adaptation of the tinnitus handicap inventory.

OBJECTIVE: To establish a Hebrew version of the English THI. DESIGN: The English THI (THI-E) was translated into Hebrew by two bilingual investigators, independently. A third investigator then constructed the final Hebrew THI version (THI-H) from the two translations. This version was administered to fifty consecutive patients at the tinnitus clinic. Participants also assessed tinnitus severity and loudness, and completed the Hebrew versions of the Beck's depression inventory and the state anxiety inventory. STUDY SAMPLE: The participants were fifty consecutive patients (older than 18 years of age, with a tinnitus lasting over three months) who were referred to a tinnitus clinic (none of them declared compensation seeking). RESULTS: A very good internal consistency was found (α = 0.93), with significant correlation between the subscales of the THI-H and the Beck depression inventory score and the state anxiety inventory score. CONCLUSIONS: A valid and reliable THI-H questionnaire was constructed.

Cerumen removal: comparison of cerumenolytic agents and effect on cognition among the elderly.

Cerumen impaction may affect hearing and decrease hearing acuity, thus decreasing cognitive functions among the elderly. The objective of this study was to compare the safety and the efficacy of three cerumenolytic agents and to assess the effect of cerumen removal on cognition. Thirty eight elderly subjects (mean age: 78 years, total 76 ears) were treated with either Auro®, Cerumol® or the newer CleanEars®, and the change in the degree of ear canal occlusion was examined after a week. In addition, a change in cognition following cerumen removal was evaluated using Raven's standard progressive matrices (RSPM) test. There was no difference regarding the eventual degree of occlusion between the three treatment groups. Only in the CleanEars® group a complete resolution of obstruction in both ears was achieved. A statistically significant difference between the RSPM score before and after the removal of cerumen was found. Using CleanEars® is as effective and safe as other agents and may be advantageous due to its spray application. Removal of cerumen significantly improves the well-being of elderly patients.