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Pagnini, Francesco

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Pagnini

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Francesco

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Pagnini, Francesco
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    A psychological intervention to promote acceptance and adherence to non-invasive ventilation in people with chronic obstructive pulmonary disease: study protocol of a randomised controlled trial
    (BioMed Central, 2017) Volpato, Eleonora; Banfi, Paolo; Pagnini, Francesco
    Background: People with chronic obstructive pulmonary disease (COPD) sometimes experience anxiety, depression and comorbid cognitive deficits. Rather than being merely a consequence of symptom-related physical impairments these additional problems may be part of the clinical course of the condition. The relationship between the physical and psychological aspects of the condition is illustrated by the patterns of use of non-invasive ventilation (NIV); NIV is often rejected or used inappropriately, resulting in clinical deterioration and an increase in health care costs. The study aims to analyse the effects of psychological support on the acceptance of, and adherence to, NIV. The primary outcome will be a latent variable related to indices of use of NIV equipment and adherence to treatment regime; while survival rates and psychological variables will constitute the secondary outcomes. Methods: A two-arm randomised controlled trial will be conducted. We aim to recruit 150 COPD patients for whom NIV is indicated. The experimental group will receive a brief course of psychological support that will include counselling, relaxation and mindfulness-based exercises. In some cases, it will also include neuropsychological rehabilitation exercises. Support will be delivered via four to eight meetings at the HD Respiratory Rehabilitation Unit, at home or via telemedicine. Controls will receive standard care and watch educational videos related to the management of their disease. Discussion This investigation will gain insight about the role of a psychological intervention as part of a treatment plan during the process of adaptation to NIV in COPD patients. Trial registration ClinicalTrials.gov, ID: NCT02499653. Registered on 14 July 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1802-1) contains supplementary material, which is available to authorized users.
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    What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation
    (Frontiers Media S.A., 2018) Castelnuovo, Gianluca; Giusti, Emanuele Maria; Manzoni, Gian Mauro; Saviola, Donatella; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara Anna Maria; Rossi, Alessandro; Varallo, Giorgia; Novelli, Margherita; Villa, Valentina; Luzzati, Francesca; Cottini, Andrea; Lai, Carlo; Volpato, Eleonora; Cavalera, Cesare; Pagnini, Francesco; Tesio, Valentina; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Seitanidis, Ionathan; Ventura, Giuseppe; Capodaglio, Paolo; D’Aniello, Guido Edoardo; Scarpina, Federica; Brioschi, Andrea; Bigoni, Matteo; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Di Lernia, Daniele; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan; Wiederhold, Brenda Kay; Gaudio, Santino; Jackson, Jeffrey B.; Tamburin, Stefano; Benedetti, Fabrizio
    Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0–10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor–patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy.
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    Langerian mindfulness, quality of life and psychological symptoms in a sample of Italian students
    (BioMed Central, 2018) Pagnini, Francesco; Bercovitz, Katherine; Phillips, Deborah
    Background: Noticing new things, accepting the continuously changing nature of circumstances, and flexibly shifting perspectives in concert with changing contexts constitute the essential features of Langerian mindfulness. This contrasts with a “mindless” approach in which one remains fixed in a singular mindset and is closed off to new possibilities. Despite potentially important clinical applications for this construct, few studies have explored them. The instrument developed to measure Langerian mindfulness is the Langer Mindfulness Scale (LMS), although this tool has been limited primarily to English-speaking populations. The study aimed to test LMS validity in the Italian language and to analyze the relationships between Langerian mindfulness and well-being. Methods: We translated the LMS into Italian, analyzed its factor structure, and investigated the correlation between mindfulness and quality of life and psychological well-being in a sample of 248 Italian students (88.7% females, mean age 20.05). A confirmatory factor analysis confirmed the tri-dimensional structure of the English LMS in the Italian version. Results: The primary analysis found a significant negative correlation between mindfulness and psychological symptoms including obsessive-compulsive tendencies, depression, anxiety, and paranoid ideation. There was also a positive correlation between mindfulness and reports of quality of life. Conclusions: The Italian LMS appears reliable and it shows relevant correlations with well-being. Electronic supplementary material The online version of this article (10.1186/s12955-018-0856-4) contains supplementary material, which is available to authorized users.
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    Symptom changes in multiple sclerosis following psychological interventions: a systematic review
    (BioMed Central, 2014) Pagnini, Francesco; Bosma, Colin; Phillips, Deborah; Langer, Ellen
    Background: Multiple Sclerosis is a disease of the central nervous system involving a variety of debilitating physical, sensory, cognitive and emotional symptoms. This literature review evaluated the impact of psychological interventions on the physiological symptoms associated with the illness. Methods: A systematic literature search was conducted using Medline, PsycINFO, Scopus, and the Cochrane Library databases, as well as reference lists. Relevant studies were selected and assessed according to a preset protocol. Results: The search produced 220 articles, with 22 meeting inclusion criteria for the review. A total of 5,705 subjects with Multiple Sclerosis were analyzed. Results from the included studies indicate a general improvement in both psychological and physiological outcomes following psychological treatment. The most highly influenced physical symptoms include fatigue, sleep disturbances, pain, and physical vitality. Conclusions: Findings from the review suggest a positive relationship between psychological interventions and physiological Multiple Sclerosis symptoms. Implications for future research are discussed.
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    Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation
    (Frontiers Media S.A., 2016) Castelnuovo, Gianluca; Giusti, Emanuele M.; Manzoni, Gian Mauro; Saviola, Donatella; Gatti, Arianna; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara A. M.; Corti, Stefania; Novelli, Margherita; Villa, Valentina; Cottini, Andrea; Lai, Carlo; Pagnini, Francesco; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Capodaglio, Paolo; D'Aniello, Guido E.; Scarpina, Federica; Brioschi, Andrea; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan G.; Wiederhold, Brenda; Tamburin, Stefano
    Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive—Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post—Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper.
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    Validation of the Persian Version of the Langer Mindfulness Scale
    (Frontiers Media S.A., 2017) Moafian, Fatemeh; Pagnini, Francesco; Khoshsima, Hooshang
    This study validates the Persian version of the Langer Mindfulness Scale (LMS). The original scale consists of 21 items and 4 subscales; namely, novelty producing, novelty seeking, engagement, and flexibility. In this study, four samples including 2271 individuals in total participated. Confirmatory factor analysis was employed to test the factorial structure of the Persian version. The results verified a two-factor structure including novelty producing and novelty seeking for the scale and the two subscales of engagement and flexibility were omitted due to marginal fit. The questionnaire showed satisfying psychometric properties in terms of reliability. Furthermore, convergent and discriminant validity of the instrument was examined via investigating the relationship between the Persian LMS with the WHOQOL instrument and negative and positive affect scales. The findings revealed a significant positive relationship between the Persian LMS and positive affect, physical health, psychological health and environmental health. No significant correlations were found between the LMS, social relationships and negative affect.
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    Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation
    (Frontiers Media S.A., 2016) Castelnuovo, Gianluca; Giusti, Emanuele M.; Manzoni, Gian Mauro; Saviola, Donatella; Gatti, Arianna; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara A. M.; Corti, Stefania; Novelli, Margherita; Villa, Valentina; Cottini, Andrea; Lai, Carlo; Pagnini, Francesco; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Capodaglio, Paolo; D'Aniello, Guido E.; Scarpina, Federica; Brioschi, Andrea; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan G.; Wiederhold, Brenda; Tamburin, Stefano
    Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.
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    Mindful Learning: A Case Study of Langerian Mindfulness in Schools
    (Frontiers Media S.A., 2016) Davenport, Chase; Pagnini, Francesco
    The K-12 classroom applications of mindfulness as developed by Ellen Langer are discussed in a case study of a first-year charter school. Langerian Mindfulness, which is the act of drawing distinctions and noticing novelty, is deeply related to well-being and creativity, yet its impact has yet to be tested at the primary or secondary school level. The objective of the article is to display how Langerian Mindfulness strategies could increase 21st century skills and Social-Emotional Learning in primary classrooms. The New School San Francisco, an inquiry-based, socioeconomically and racially integrated charter school, serves as a model for mindful teaching and learning strategies. It is concluded that when mindful strategies are implemented, students have significant opportunities to exercise the 21st century skills of creativity, collaboration, communication and critical thinking. Langerian Mindfulness is also considered as a tool for increasing Social-Emotional Learning in integrated classrooms. It is recommended that mindful interventions be further investigated in the primary and secondary school context.
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    Changes in Pain Perception following Psychotherapy: The Mediating Role of Psychological Components
    (Hindawi, 2018) Zanini, Susanna; Voltolini, Alessandra; Gragnano, Gaia; Fumagalli, Emilia; Pagnini, Francesco
    Chronic pain is frequently associated with significant psychological issues, such as depression or anxiety. Psychological treatments, such as psychotherapy, can often alleviate both psychological and pain symptoms. However, there is limited research about the association between psychological symptoms and perceived pain in the context of psychotherapeutic interventions. We conducted a retrospective study that analyzed, in a hospital context, how changes in psychological functioning and well-being were associated with pain reduction. Thirty-seven records of patients with chronic pain attending psychotherapy in a public hospital were included. All patients were assessed before psychotherapy, as well as after 6 and 10 months, with self-reported questionnaires about pain, anxiety, depression, and psychological functioning. Results indicate that reductions in anxiety, depression, psychological problems, risk factors, and well-being are strongly related with a reduction in pain, further confirming the hypothesis that psychological morbidity is associated with pain severity.
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    A quick relaxation exercise for people with chronic obstructive pulmonary disease: explorative randomized controlled trial
    (BioMed Central, 2018) Volpato, Eleonora; Banfi, Paolo; Nicolini, Antonello; Pagnini, Francesco
    Background: People with Chronic Obstructive Pulmonary Disease (COPD) suffer from dyspnoea, which may be increased by anxiety. Previous studies suggest that relaxation techniques may have positive effects in pulmonary rehabilitation. The main aim of this study is to explore the clinical impact of a quick, one-session, relaxation training for people with COPD. Methods: In this perspective, 38 participants with COPD were recruited and randomly assigned to listen to a relaxing audio or to watch a neutral stimulus, during their routine exams. Participants were assessed for psychological and physiological variables, analysed through non-parametric tests. Results: Those who joined the relaxation training showed more positive outcomes about respiratory and cardiac assessments, as well as for state anxiety and positive affections, in comparison with the baseline and the control group. Conclusions: Study results suggest that relaxation has a potential to produce improvements in respiratory and cardiac functions, together with a positive emotional effect and a reduction of anxiety. Trial registration ClinicalTrials.gov ID: NCT02698904. Record Registration: February 2016.