Christina Hägnebo

Stress and symptoms of meniere's disease: a time-series analysis

Menieres disease is an inner ear disease in which the symptom cluster of hearing loss, tinnitus, and dizziness is found along with attacks of vertigo and nausea. In this study, 20 subjects diagnosed with Menieres disease completed daily measures of stress and symptoms during periods ranging between 45 and 351 days (M = 193.5). Data were analyzed by means of time-series analysis (ARIMA), and the temporal associations were investigated by lagged correlations. The results showed concurrent (same day) associations between stress and symptoms, but individual differences were found regarding which symptoms were associated with stress. Although stress is linked with symptom perception, this study does not support the role of stress as a precursor of symptoms in Menieres disease.

The Influence of Vertigo, Hearing Impairment and Tinnitus on the Daily Life of Meniere Patients

The aim of this questionnaire study was to investigate the impact of the symptoms in Menieres disease on the daily life of patients and to analyse the relationships between the cardinal symptoms and environmental, emotional and activity factors. The study comprised 514 patients, recruited from two different sources. The results showed that vertigo, hearing impairment and tinnitus had a strong negative influence on the daily life of patients. Seventy-five percent of the subjects avoided certain everyday activities or situations because of the disease. However, the correlation between discomfort and reported satisfaction with life was moderate. Most of the subjects experienced premonitory symptoms of the attacks and 80% reported relations between external factors and vertigo attacks.

A Review of psychological treatment approaches for patients suffering from tinnitus.

Disabling tinnitus (ringing or buzzing in the ear) is a condition experienced by at least 1–2% of the population. Since medical and technical treatments are only partly successful, several psychological treatment approaches have been applied in the treatment of tinnitus. This article reviews 38 studies on hypnosis, biofeedback, and cognitive-behavioral approaches together with relaxation techniques. It is concluded that relaxation training together with cognitive-behavioral coping techniques is the method which so far has received the most empirical support. Still, more research is needed on the effects of psychological treatment. Finally, five recommendations are made regarding the treatment of tinnitus patients.

Hearing Impairment, Coping Strategies, and Anxiety Sensitivity

The aim was to study coping strategies among hearing-impaired individuals by using a validated coping instrument—The Ways of Coping Questionnaire (WOCQ; S. Folkman & R. Lazarus, 1988)—and to relate the use of coping with anxiety sensitivity and experience of hearing impairment. A questionnaire booklet was sent out to the members of the local branch of the Swedish Hard of Hearing Association. Ninety-four members responded to the questionnaire, yielding a 53% response rate. Primary outcome measures were the WOCQ, the Anxiety Sensitivity Index, and visual analogue scale rating of discomfort from hearing impairment. Repeated measures analysis of WOCQ subscales showed that the participants used planful problem solving and self-controlling coping strategies whereas escape/avoidance responses were less frequently used than the other coping strategies. Anxiety sensitivity was associated with escape/avoidance coping (r = .63, p < .0001). In conclusion, hearing-impaired individuals do not use escape/avoidance coping more than other coping strategies. However, escape/avoidance coping is associated with anxiety sensitivity, suggesting that sensitivity to anxiety sensations is an important associated factor. Coping strategies were not associated with discomfort from hearing impairment in any meaningful way.

Coping strategies and anxiety sensitivity in Meniere's disease

Menieres disease, an inner ear disorder, is known to cause considerable distress. The aims of this study were to investigate whether coping strategies would predict the perceived handicap from dizziness, reported discomfort from Menieres disease and anxiety sensitivity. The relations of anxiety sensitivity to the other above variables were also investigated. Fifty Meniere patients participated in the study, completing three standardized questionnaires: the Ways of Coping Questionnaire (WOCQ), the Anxiety Sensitivity Index (ASI) and the Dizziness Handicap Inventory (DHI). Results showed that three coping strategies correlated with perceived functional handicap from dizziness. Escape/Avoidance and Distancing were positively and Self-Controlling negatively related to perceived functional handicap. The coping strategies Accepting Responsibility and Escape/Avoidance were correlated with anxiety sensitivity. Moreover, anxiety sensitivity was correlated with perceived emotional handicap from dizziness and repo...

Correlates of Vertigo Attacks in Ménière’s Disease

Background: Ménière’s disease is a medical condition that involves hearing loss, tinnitus and attacks of vertigo. The attacks can be severely disabling with nausea, dizziness, and aural sensations. Method: Three scales assessing the correlates of vertigo attacks in Ménière’s disease were developed and completed by 514 subjects diagnosed with the disease. The three scales measured were somatic sensations (SOM), psychological state (PSYCHOL), and situational characteristics (SIT) associated with an attack. Results: Psychometric properties of the three scales were investigated showing Cronbach’s alphas of 0.76, 0.80, and 0.62 for the three scales respectively. The results on the scales were related to disease progression. Principal components factor analyses showed that the SOM scale could be divided into two subscales: dizziness/vertigo/anxiety and sensations in the ear. The PSYCHOL scale showed an energy/awareness factor and a negative emotional state factor. The SIT scale, finally, showed two factors: environmental disturbances and stressful conditions. Conclusions: Knowledge of somatic, psychological and situational premonitory characteristics of attacks in Ménière’s disease could lead to improved therapy and counselling.

IMPROVED CARE OF PATIENTS WITH SMALL CELL LUNG CANCER Nutritional and quality of life aspects

A comprehensive cancer care project was carried out in Uppsala with the aim of improving the overall situation for patients treated with intensive chemotherapy with curative intent. This report gives the results in 58 patients with small cell lung cancer (SCLC), focusing on the nutritional aspects of the care and chemotherapy-related adverse effects. Responses, survival and simple nutritional parameters were compared with a historical control group (n = 81), and quality-of-life parameters with a pre-project group (n = 22). Groups were comparable with respect to pre-treatment characteristics. In contrast to the historical control group, weight, body mass index and S-albumin did not decrease during treatment in patients diagnosed during the project period. Yet, food intake in the study group was low, and for most patients below what is recommended. Survival, proportion of responses and response duration did not differ from those of the control group. Compared with the pre-project quality-of-life controls, a number of scores were more favourable for study patients (n = 36) interviewed in association with the 8th treatment course by a Swedish version of the Cancer Inventory of Problem Situations (CIPS). The global score was lower in the study group than in the pre-project group (0.80 vs 1.20, p < 0.001). Significant differences in a favourable direction were also seen in several higher order factors and miscellaneous subscales constituting the CIPS. On individual items, the study group expressed less problems with appetite/food taste in hospital, nervousness before chemotherapy and worry about adverse effects. The greatest differences in positive direction for the study group were seen within areas where the project focused on caring activities. We therefore conclude that a cancer care project with the present goals and means of intervention can improve the quality of life in patients with SCLC treated with intensive chemotherapy.

Cognitive stress, emotional factors and balance in Ménière's disease: An experimental study

The role of stress in the causes of vertigo attacks in Menieres disease, an inner ear disorder has been emphasised by clinicians. The principal aim of the present study was to investigate the imme ...