Examinando por Autor "Rogers, Heather L."

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  • Miniatura
    Ítem
    Depressive and anxiety symptoms and social support are independently associated with disease-specific quality of life in Colombian patients with rheumatoid arthritis
    (Elsevier Editora Ltda, 2015-07-13) Rogers, Heather L.; Brotherton, Hardin; Olivera Plaza, Silvia Leonor; Segura Durán, María Angélica; Peña Altamar, Marvín Leonel
    Objective: To examine the relationship between disease-specific quality of life (QOL) andsocio-demographic, medical, and psychosocial factors in Colombian patients with Rheuma-toid Arthritis (RA). Methods: One hundred and three RA patients recruited from ambulatory centers in Neiva, Colombia were administered the Disease Activity Scale 28 (DAS-28), QOL-RA, ZungSelf-Rating Depression Scale, State-Trait Anxiety Inventory (STAI), Interpersonal Support Evaluation List-12 (ISEL-12), and Symptom Checklist-90 Revised (SCL-90R). Results: Lower QOL-RA was associated with lower socio-economic status (r = 0.26, p < 0.01), higher likelihood of using opioids (t = -2.51, p < 0.05), higher likelihood of comorbid pul-monary disease (t = -2.22, p < 0.05), and lower ISEL-12 sub-scales (r's = 0.41-0.31, p's < 0.001). Lower QOL-RA was associated with higher DAS-28 (r = -0.28, p < 0.01), Visual AnalogScale (VAS; r = -0.35, p < 0.001), Zung Depression (r = -0.72, p < 0.001), STAI-State (r = -0.66,p < 0.001), STAI-Trait (r = -0.70, p < 0.001), SCL-90R Global Severity Index (r = -0.50, p < 0.001),SCL-90R Positive Symptom Total (r = -0.57, p < 0.001), and all SCL-90R sub-scales (r's = -0.54 to-0.21, p's < 0.01). A multivariate linear regression model indicated that SES (B = 2.77, p < 0.05), Zung Depression (B = -0.53, p < 0.001), STAI-State (B = -0.26, p < 0.05), and ISEL-12 Belonging (B = 1.15, p < 0.01) were independently associated with QOL-RA, controlling for significantassociations. Conclusions: More depressive and anxiety symptoms were independently associated withlower disease-specific QOL, while higher perceptions of having people to do activities with (belonging social support) and higher SES were independently associated with higher disease-specific quality of life. Psychosocial factors impact QOL in RA above and beyond disease activity. Additional research into the benefits of psychosocial assessment of RA patients and provision of comprehensive care to improve QOL is warranted.
  • Miniatura
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    Missed opportunities for the diagnosis of colorectal cancer
    (Hindawi Limited, 2015-10-04) Siminoff, Laura A.; Rogers, Heather L.; Harris-Haywood, Sonja
    Objective. To examine patient and medical characteristics which predict a missed diagnostic opportunity (MDO) for colorectal cancer (CRC). Methods. The sample consisted of 252 patients diagnosed with Stages 1-4 CRC who were diagnosed in the prior six months, had experienced symptoms prior to diagnosis, and were not diagnosed through routine screening. Systematic review of all medical records prior to patients' diagnosis was conducted. An MDO was defined as a clinical encounter where, even in the presence of presumptive CRC symptoms, the CRC diagnostic process is not started. Results. 92 patients (36.5%) experienced an MDO. Almost 80% of alternate diagnoses were other GI-GU diseases, including hemorrhoids and diverticulitis. Stomach pain, anemia, and constipation were the most common symptoms experienced by the MDO group. These symptoms, and weight loss and vomiting, were more likely to be noted in the charts of the MDO patients (P < 0.04). Independent risk factors for MDO included age (<50) [OR = 2.29 (1.14-4.60), P = 0.02 ] and female sex [OR = 2.19 (1.16-4.16), P = 0.03 ]. Each additional physician seen, more than doubled the MDO risk [OR = 2.05 (1.53-2.74), P < 0.001 ]. Conclusions. Females, younger patients, and those consulting more physicians were all more likely to experience an MDO. Continued increased training of physicians to enhance knowledge of who is vulnerable to CRC is needed in addition to an increased focus to adherence to screening recommendations.
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    Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial
    (BioMed Central Ltd., 2016-02-24) Lugo Agudelo, Luz Helena; García García, Héctor Iván ; Rogers, Heather L.; Plata, Jesús Alberto
    Background: Myofascial pain syndrome (MPS) of the shoulder girdle and cervical region is a common musculoskeletal problem that is often chronic or recurrent. Physical therapy (PT) and lidocaine injections (LI) are two treatments with demonstrated effectiveness compared to a control group, however little is known about their combined value. The objective of this study was to determine whether LI into trigger points combined with a PT program would be more effective than each separate treatment alone in improving pain, function, and quality of life in a group of patients with MPS of the shoulder girdle and cervical region. Methods: A single-blind, randomized, controlled clinical trial (RCT) was conducted with three parallel groups in the Departments of Physical Medicine and Rehabilitation of two urban hospitals in Medellin, Colombia. One hundred and twenty seven patients with shoulder girdle MPS for more than 6 weeks and pain greater than 40 mm on the visual analog scale (VAS) were assigned to 1 of 3 intervention groups: PT, LI, or the combination of both (PT + LI). The primary outcome was VAS pain rating at 1-month post-treatment. The secondary outcomes included VAS pain rating at 3 months, and, at both 1 and 3 months post-treatment: (a) function, evaluated by hand-back maneuver and the hand-mouth maneuver, (b) quality of life, as measured by sub-scales of the Short Form - 36 (SF-36), and (c) depressive symptoms, as measured by the Patient Health Questionnaire - 9 (PHQ-9). Independent t-tests were used to compare outcomes between groups at 1 month and 3 months post-treatment. Results: In the per protocol analysis, there were no significant intergroup differences in VAS at 1 month PT + LI, 40.8 [25.3] vs. PT, 37.8 [21.9], p = 0.560 and vs. LI, 44.2 [24.9], p = 0.545. There were also no differences between groups on secondary outcomes except that the PT and PT + LI groups had higher right upper limb hand-back maneuver scores compared to the LI alone group at both 1 and 3 months (p = 0.013 and p = 0.016 respectively). Conclusions: The results of this RCT showed that no differences in pain ratings were observed between the individual treatments (PT or LI) compared to the combined treatment of PT and LI. In general, no difference in primary or secondary outcomes was observed between treatments.