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      Illness acceptance, pain perception and expectations for physicians of the elderly in Poland

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          Abstract

          Background

          Ageing of society is a significant challenge to public health, both socially and health wise. Adaptation to illness and its acceptance play an important role in control and patients’ self-control in many diseases of old age. The right attitude of doctors to patients, especially, geriatric patients determines, among others, a patient’s quality of life and acceptance of illness. Recently, there has been observed the rapid development of research on interactions between pain as a physiological process and its perception by an individual.

          The aim of the study was to evaluate the acceptance of illness, perception of pain and expectations of geriatric patients for physicians among the inhabitants of Bialystok (Poland) over the age of 60.

          Methods

          The study included 300 people, inhabitants of Bialystok and the surrounding area – aged over 60: 100 elderly residents of a nursing home, 100 students of the University of the Third Age in Bialystok and 100 students of the University of Healthy Senior. The study used three standardised psychometric scales: Patient Request Form (PRF), Acceptance of Illness Scale (AIS) and The Beliefs about Pain Control Questionnaire (BPCQ).

          Results

          The median of the overall score of AIS was 26 points, which is considered average in terms of acceptance of illness. The median value of the influence of internal factors on the control of pain in case of BPCQ scale was generally16 of 30 points, the influence of physicians – 15 of 24 points, while random events – 14 of 24 points. The overall result for PRF scale proved that the respondents were the least expected to look for emotional support (5 of 12 points). It was established that the group affiliation significantly affected the result of AIS ( p < 0.001). There was also noted a negative relation between AIS and the search for emotional support (PRF) depending on the group. The higher the AIS value, the lower the score in case of search for emotional support (PRF).

          Conclusions

          Neither gender nor age played a significant role in acceptance of illness, control of pain or expectations for physicians. The key variable determining the occurrence of dependencies between the studied features was being a part of a group. The elderly residents of the nursing home were negatively distinguished from the other two studied groups. The respondents, in regard to other groups described in the literature, were characterised by relatively high values in illness acceptance, pain control and expectations for physicians.

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          Most cited references31

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          Is distraction less effective when pain is threatening? An experimental investigation with the cold pressor task.

          Distraction is a commonly used strategy to control pain. However there is doubt about its effectiveness as a clinical tool, and results from both experimental and clinical studies remain inconclusive. Recent theoretical advancements suggest that distraction of attention may be less effective when pain is threatening. The aim of the present study was to experimentally investigate this hypothesis. Pain-free volunteers (N=101) participated in a cold pressor test. Half of the participants simultaneously performed a cognitive distraction task, the other half did not. The threat value of the pain was manipulated by means of verbal information. The results showed that distraction resulted in less attention to the pain and lower pain ratings once the cold pressor procedure was halted. The hypothesis that the effectiveness of distraction is modulated by the threat value of pain could not be confirmed. However, threatening information increased catastrophic thoughts and anxiety, and interfered with performance on the distraction task. These findings suggest that caution is required in using distraction as a pain control strategy when the threat value is high, because fearful appraisal of pain is associated with less engagement in distraction tasks.
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            Out of Balance. A New Look at Chronic Stress, Depression, and Immunity

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              Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD

              Background COPD is a civilization disease. It affects up to 8%–10% of population >30 years of age. Coexistence of depression occurs in 20%–40% of patients with COPD. Depression and anxiety reduce compliance and worsen prognosis. Objective The aims of this study were to determine the degree of illness acceptance among patients with COPD, to examine the relation between disease acceptance and perceived anxiety and depression, and to verify which of the sociodemographic and clinical factors are associated with illness acceptance, anxiety, and depression. Materials and methods The study included 102 patients with COPD (mean age 65.8 years), hospitalized due to exacerbations. Acceptance of Illness Scale and Hospital Anxiety and Depression Scale were used. For statistical analysis, Student’s t-test and Pearson’s r correlation coefficient were carried out. Results The overall illness acceptance level was moderate with a tendency toward lack of acceptance (mean 20.6, standard deviation [SD] 7.62). The overall scores were 10.2 (SD 3.32) for anxiety and 10.8 (SD 4.14) for depression, which indicate borderline or high intensity of these symptoms. Acceptance of illness was negatively correlated with the intensity of depression symptoms (r=−0.46, P<0.05). Intensity of depression was significantly associated with intensity of smoking, duration of the disease, severity of dyspnea, and living in a rural area. Conclusion Early identification and assessment of depression and anxiety symptoms allow health care providers to offer patients at risk of depression a special medical supervision. Rapid start of antidepressant therapy may increase illness acceptance and improve prognosis among patients with COPD.
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                Author and article information

                Contributors
                mateusz.cybulski@umb.edu.pl
                l.cybulski97@gmail.com
                elzbieta.krajewska@wp.pl
                urszula.cwalina@umb.edu.pl
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                8 February 2017
                8 February 2017
                2017
                : 17
                : 46
                Affiliations
                [1 ]ISNI 0000000122482838, GRID grid.48324.39, Department of Integrated Medical Care, Faculty of Health Sciences, , Medical University of Bialystok, ; 7a M. Sklodowskiej-Curie str., 15-096 Bialystok, Poland
                [2 ]ISNI 0000 0001 2149 6795, GRID grid.412607.6, National security student, Faculty of Social Sciences, , University of Warmia and Mazury in Olsztyn, ; Olsztyn, Poland
                [3 ]ISNI 0000000122482838, GRID grid.48324.39, Department of Statistics and Medical Informatics, Faculty of Health Sciences, , Medical University of Bialystok, ; Bialystok, Poland
                Article
                441
                10.1186/s12877-017-0441-4
                5299679
                28178921
                dbd4e15e-959e-488d-9a9e-ed5412e45dc6
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 July 2016
                : 3 February 2017
                Funding
                Funded by: Ministry of Science and Higher Education
                Award ID: N/ST/MN/16/001/3310
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Geriatric medicine
                illness acceptance,pain control,a list of a patient’s expectations,the elderly,old age,psychology of ageing

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