Sandra J. Weiss

Pain: its mediators and associated morbidity in critically ill cardiovascular surgical patients.

This study was conducted to determine the effects of age, sex, personality adjustment, and analgesic administration on the magnitude of pain experienced by 74 cardiac and abdominal vascular surgical patients during their first few postoperative days. The relationship of pain magnitude to postoperative complications was also examined. Pain intensity was moderate and did not diminish over the first few postoperative days. Physical sensations and emotional tension associated with pain caused little distress. The primary consistent mediator of pain magnitude after surgery was the amount of analgesics administered to patients, although they received small amounts. Neither age nor personality adjustment influenced the magnitude of any pain dimension. However, women and patients having abdominal vascular surgery reported more disturbing physical sensations associated with their pain. Patients with greater pain intensity had a significantly greater incidence of atelectasis as a postoperative complication.

The Effects of Mindfulness-Based Yoga During Pregnancy on Maternal Psychological and Physical Distress

OBJECTIVE To examine the feasibility and level of acceptability of a mindful yoga intervention provided during pregnancy and to gather preliminary data on the efficacy of the intervention in reducing distress. DESIGN Baseline and post-treatment measures examined state and trait anxiety, perceived stress, pain, and morning salivary cortisol in a single treatment group. Postintervention data also included participant evaluation of the intervention. SETTING The 7 weeks mindfulness-based yoga group intervention combined elements of Iyengar yoga and mindfulness-based stress reduction. PARTICIPANTS Sixteen healthy pregnant nulliparous women with singleton pregnancies between 12 and 32 weeks gestation at the time of enrollment. METHODS Outcomes were evaluated from pre- to postintervention and between second and third trimesters with repeated measures analysis of variance and post hoc nonparametric tests. RESULTS Women practicing mindful yoga in their second trimester reported significant reductions in physical pain from baseline to postintervention compared with women in the third trimester whose pain increased. Women in their third trimester showed greater reductions in perceived stress and trait anxiety. CONCLUSIONS Preliminary evidence supports yogas potential efficacy in these areas, particularly if started early in the pregnancy.

The language of touch.

A conceptual framework is discussed from which to consider the meaning of touch in nursing research and practice. The impact of interpersonal touch is examined through a review of literature that demonstrates the relationship of touching to human development. The importance of acknowledging the physiologic foundations of touch is reinforced, with considerations as to dangers in accepting all forms of touch as therapeutic. Existing research into the physiologic and psychosocial bases of tactile interaction is explored, and qualitative symbols for a language of touch are presented. These qualitative symbols create the foundations for discussing a construct of tactile arousal.

Brain regions associated with psychological pain: implications for a neural network and its relationship to physical pain

Research on brain areas involved in experiencing emotion and physical pain is abundant; however, psychological pain has received little attention in studies of the brain. The purpose of this systematic review was to provide an overview of studies on brain function related to psychological pain. The review was limited to studies in which participants experienced actual psychological pain or recalled a significant autobiographical event that may be assumed to have involved psychological pain. Based on results of the studies (N = 18), a tentative neural network for psychological pain is proposed that includes the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. Results indicated that grief may be a more accurate exemplar of psychological pain than recalled sadness, with indications of greater arousal during psychological pain. The proposed neural network for psychological pain overlaps to some extent with brain regions involved in physical pain, but results suggest a markedly reduced role for the insula, caudate, and putamen during psychological pain. Psychological pain is well known for its association with depression and as a precursor of suicidal behavior. Thus, identification of brain areas involved in psychological pain may help guide development of interventions to decrease mortality and morbidity.

The tactile context of a mother’s caregiving: implications for attachment of low birth weight infants☆

Abstract This study examined the degree to which specific properties of maternal touch may be associated with a low birth weight infant’s security of attachment at one year of age, considering the potential modifying effects of maternal sensitivity and history of touch as well as infant gender and biological vulnerability. One hundred and thirty one socioculturally diverse infants and their mothers were evaluated for medical complications during the neonatal period. Videotapes were made of the infant-mother dyads during an infant feeding at three months of age. Each videotape was analyzed for a mother’s properties of touch and her sensitivity as well as for infant responsiveness. When the infant was six months old, each mother completed a questionnaire to determine felt security regarding her own history of touch as a child. Researchers completed the Attachment Q-Set for each infant at one year of age. Analysis of covariance indicated that sheer frequency of touch had no relationship to infant attachment but use of nurturing touch by mothers was associated with security of attachment. However, the degree of infant vulnerability (i.e., perinatal complications, birthweight, and responsiveness) moderated the effects of nurturing touch. Nurturing touch was associated with more secure attachment for robust infants but with less secure attachment for highly vulnerable babies. Neither maternal sensitivity nor gender appeared to moderate the relationship of touch to attachment or to have any direct relationship to attachment outcomes. Infant vulnerability decreased the likelihood of a secure attachment while a mother’s felt security regarding her own tactile experience as a child increased her infant’s chances of having a secure attachment.

The impact of cultural and familial context on behavioral and emotional problems of preschool Latino children

This study examined the impact of financial, cultural, and family variables on the incidence of behavioral and emotional problems in a group of two- and three-year-old Latino children. The vulnerability of these children to mental health problems stems from the many challenges faced by their families, especially those associated with acculturation and poverty. Results indicate that most problems experienced by the children were related to depression and social withdrawal. Children were at greatest risk whose parents had immigrated from Central America, whose families relied more extensively on internal coping strategies such as passive resignation, and whose parents were dissatisfied with their familys interactions.

The efficacy of the web-based childhood obesity prevention program in Chinese American adolescents (Web ABC study).

PURPOSE To examine the feasibility and efficacy of a theory-driven and family-based program delivered online to promote healthy lifestyles and weights in Chinese American adolescents. METHODS A randomized controlled study of a web-based intervention was developed and conducted in 54 Chinese American adolescents (ages, 12-15 years) and their families. Data on anthropometry, blood pressure, dietary intake, physical activity, and knowledge and self-efficacy regarding physical activity and nutrition were collected at baseline and 2, 6, and 8 months after the baseline assessment. Data were analyzed using linear mixed modeling. RESULTS The intervention resulted in significant decreases in waist-to-hip ratio and diastolic blood pressure and increases in vegetable and fruit intake, level of physical activity, and knowledge about physical activity and nutrition. CONCLUSION This web-based behavior program for Chinese American adolescents and their families seems feasible and effective in the short-term. Long-term effects remain to be determined. This type of program can be adapted for other minority ethnic groups who are at high-risk for overweight and obesity and have limited access to programs that promote healthy lifestyles.

Effects of mindful yoga on sleep in pregnant women: a pilot study.

Purpose: The purpose of this experimental pilot study was to measure the effects of a mindfulness-based yoga intervention on sleep in pregnant women. Methods: Fifteen healthy, nulliparous women in their second or third trimesters with singleton pregnancies attended weekly mindfulness meditation and prenatal Hatha yoga classes in the community for 7 weeks. Sleep variables, as estimated by 72 hr of continuous wrist actigraphy and the General Sleep Disturbance Scale (GSDS), were recorded at baseline (Time 1) and postintervention (Time 2). Control data were obtained by evaluating sleep in the third-trimester group at Time 1. Due to small sample size, data were analyzed using parametric and nonparametric statistics. Results: Women who began the intervention in the second trimester had significantly fewer awakenings, less wake time during the night, and less perceived sleep disturbance at Time 2 than at baseline. Those who began during the third trimester had poorer sleep over time in spite of the intervention. Women who began the intervention in their second trimester had less awake time at Time 2 compared to third-trimester controls at Time 1. Conclusions: Mindful yoga shows promise for women in their second trimester of pregnancy to diminish total number of awakenings at night and improve sleep efficiency and merits further exploration. Results from this pilot study provide the data to estimate sample size and design and implement powered and more controlled studies in the future.

Stressors experienced by family caregivers of children with pervasive developmental disorders

The purpose of this study was to identify the perceived stressors experienced by parents who care for children with Pervasive Developmental Disorders. The relationship between demographics and overall stress was also examined. The most frequently cited stressor was difficulty arranging for and collaborating with professional and support services. Problems associated with the childs emotional and mental state were viewed as the most stressful of all. No demographic variables showed a significant relationship to degree of overall stress.

Efficacy of a child-centred and family-based program in promoting healthy weight and healthy behaviors in Chinese American children: a randomized controlled study

OBJECTIVE To examine the efficacy of an interactive, child-centred and family-based program in promoting healthy weight and healthy lifestyles in Chinese American children. DESIGN A randomized controlled study of a culturally sensitive behavioral intervention. SUBJECTS Sixty-seven Chinese American children (ages, 8-10 years; normal weight and overweight) and their families. MEASUREMENTS Anthropometry, blood pressure, measures of dietary intake, physical activity, knowledge and self-efficacy regarding physical activity and diet at baseline and 2, 6 and 8 months after baseline assessment. RESULTS Linear mixed modeling indicated a significant effect of the intervention in decreasing body mass index, diastolic blood pressure and fat intake while increasing vegetable and fruit intake, actual physical activity and knowledge about physical activity. CONCLUSION This interactive child-centred and family-based behavioral program appears feasible and effective, leading to reduced body mass index and improved overweight-related health behaviors in Chinese American children. This type of program can be adapted for other minority ethnic groups who are at high risk for overweight and obesity and have limited access to programs that promote healthy lifestyles.