For clinical use, we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use. For research use, the FPS-R has been recommended on the basis of utility and psychometric features. Data are sparse for children below the age of 5 years, and future research should focus on simplified measures, instructions, and anchors for these younger children.
Objective-To determine whether, in the treatment of major depression in primary care, a brief psychological treatment (problem solving) Results-At six and 12 weeks the difference in score on the Hamilton rating scale for depression between problem solving and placebo treatments was significant (5.3 (95% confidence interval 1-6 to 9.0) and 4-7 (0.4 to 9.0) respectively), but the difference between problem solving and amitriptyline was not significant (1-8 (-1l8 to 5.5) and 0 9 (-3.3 to 5.2) respectively). At 12 weeks 60%'/. (18/30) of patients given problem solving treatment had recovered on the Hamilton scale compared with 52% (16/31) given amitriptyline and 27% (8/30) given placebo. Patients were satisfied with problem solving treatment; all patients who completed treatment (28/30) rated the treatment as helpful or very helpful. The six sessions of problem solving treatment totalled a mean therapy time of31/, hours.Conclusions-As a treatment for major depression in primary care, problem solving treatment is effective, feasible, and acceptable to patients.
Numerous randomized controlled trials have been conducted to determine efficacy of exercise on cancer-related fatigue. However, many trials lacked sufficient power to demonstrate significant differences, and little is known about how the effect of exercise differs depending on patient- and intervention-level characteristics. A meta-analysis was performed to determine whether exercise reduces fatigue compared with usual care or nonexercise control intervention in patients with cancer. The authors searched Ovid MEDLINE, EMBASE, PsycINFO, The Cochrane Central Register of Controlled Trials, and CINAHL. Two authors independently extracted the data. Randomized controlled trials comparing exercise with control intervention in cancer patients in which fatigue was quantified were eligible. Seventy-two randomized controlled trials were identified, 71 in adults and 1 in children. Exercise had a moderate effect on reducing fatigue compared with control intervention. Exercise also improved depression and sleep disturbance. Type of exercise did not significantly influence the effect on fatigue, depression, or sleep disturbance. Exercise effect was larger in the studies published 2009 or later. There was only one pediatric study. The results of this study suggest that exercise is effective for the management of cancer-related fatigue.
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