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ESMO Open Jun 2024Cancer patients with minor children but also their families suffer from significant psychological distress and comorbidity. Protective factors predicting successful...
BACKGROUND
Cancer patients with minor children but also their families suffer from significant psychological distress and comorbidity. Protective factors predicting successful coping are well known. Corresponding systematic interventions are rare and limited by access barriers. We developed a comprehensive family-centered intervention for cancer patients with at least one dependent minor.
PATIENTS AND METHODS
Family-SCOUT represents a multicentric, prospective, interventional, and controlled study for families with parental cancer and their minor children. In the intervention group (IG), all family members were addressed using a care and case management approach for nine months. Families in the control group (CG) received standard of care. Participating parents were asked to complete the Hospital-Anxiety-Depression-Scale (HADS) questionnaire at enrolment (T0) and after 9 months (T2). The primary outcome was a clinically relevant reduction of distress in at least one parent per family, measured as minimal important difference (MID) of ≥1.6 in the HADS total score. The percentage of families achieving MID is compared between the IG and CG by exact Fisher's test, followed by multivariate confounder analyses.
RESULTS
T0-questionnaire of at least one parent was available for 424 of 472 participating families, T2-questionnaire after 9 months was available for 331 families (IG n = 175, CG n = 156). At baseline, both parents showed high levels of distress (HADS total: sick parents IG: 18.7 ± 8.1; CG: 16.0 ± 7.2; healthy partners: IG: 19.1 ± 7.9; CG: 15.2 ± 7.7). The intervention was associated with a significant reduction in parental distress in the IG (MID 70.4% in at least one parent) compared with the CG (MID 55.8%; P = 0.008). Adjustment for group differences from specific confounders retained significance (P = 0.047). Bias from other confounders cannot be excluded.
CONCLUSIONS
Parental cancer leads to a high psychosocial burden in affected families. Significant distress reduction can be achieved through an optimized and structured care approach directed at the family level such as family-SCOUT.
Topics: Humans; Female; Male; Neoplasms; Prospective Studies; Child; Adult; Parents; Adaptation, Psychological; Surveys and Questionnaires; Stress, Psychological; Adolescent; Child, Preschool; Middle Aged
PubMed: 38848662
DOI: 10.1016/j.esmoop.2024.103493 -
Medicine Jun 2024This study aimed to investigate the different impacts of sensorial and mobility frailty on overall and domain-specific cognitive function. Further, the independent... (Observational Study)
Observational Study
This study aimed to investigate the different impacts of sensorial and mobility frailty on overall and domain-specific cognitive function. Further, the independent associations between other intricate capacity (IC) dimensions, including vitality and psychological dimensions, and overall and domain-specific cognitive function were investigated. A total of 429 participants (mean age, 72.91 ± 7.014 years; 57.30% female) underwent IC capacity assessment. Other covariates, such as demographics, health-related variables were also assessed. Overall or domain-specific cognitive impairment was used as a dependent variable in logistic regression analyses adjusted for demographic, health-related, and psychosocial confounders. After adjustment for demographic, health-related, and psychosocial confounders, individuals with sensorial frailty (odds ratio [OR] = 0.435; 95% confidence interval [CI] = 0.236-0.801; P = .008) had a significantly lower risk of mild cognitive impairment (MCI), marginally low delayed memory impairment (OR = 0.601, 95% CI = 0.347-1.040; P = .069), and language impairment (OR = 0.534, 95% CI = 0.305-0.936; OR = 0.318, P = .029; OR = 0.318,95% CI = 0.173-0.586; P < .001) by Boston naming and animal fluency tests than did those with both sensorial and mobility frailty or mobility frailty only. Depressive symptoms had a significant negative influence on executive function. Cardiovascular disease and non-skin malignancy were independent determinants of MCI, and diabetes mellitus was independently associated with processing speed, attention, and executive function. Sensorial and mobility frailty were independent risk factors for cognitive impairment. Mobility frailty had a greater negative influence on the overall cognitive function and memory and language function than did sensorial frailty. The reserve decline in the psychological dimension of IC and chronic diseases also had a significant adverse influence on overall and domain-specific cognition function.
Topics: Humans; Female; Male; Aged; Cognitive Dysfunction; Independent Living; China; Cognition; Frailty; Frail Elderly; Aged, 80 and over; Geriatric Assessment; Cross-Sectional Studies; Mobility Limitation; East Asian People
PubMed: 38847667
DOI: 10.1097/MD.0000000000038500 -
JACC. Advances May 2024Adult congenital heart disease (ACHD) can negatively impact quality of life (QOL). Strengthening resilience may improve this and other psychosocial outcomes important...
BACKGROUND
Adult congenital heart disease (ACHD) can negatively impact quality of life (QOL). Strengthening resilience may improve this and other psychosocial outcomes important for living a meaningful life.
OBJECTIVES
The purpose of this study was to describe resilience and key psychosocial health outcomes in ACHD and evaluate the associations between resilience and these outcomes.
METHODS
We conducted a prospective cohort study of outpatients with moderate or complex ACHD between May 2021 and June 2022. Participants completed surveys at baseline and 3 months, evaluating resilience (Connor-Davidson Resilience Scale-10), health-related QOL (EQ5D-3L, linear analog scale), health status (Euroqol visual analog scale), self-competence (Perceived Competence Scale), and psychological symptom burden (Hospital Anxiety and Depression Scale) and distress (Kessler-6).
RESULTS
The mean participant age (N = 138) was 41 ± 14 years, 51% were female, and 83% self-identified as non-Hispanic White. ACHD was moderate for 75%; 57% were physiologic class B. Mean baseline resilience score (Connor-Davidson Resilience Scale-10) was 29.20 ± 7.54. Participants had relatively good health-related QOL, health status, and self-competence, and low psychological symptom burden and distress. Higher baseline resilience was associated with better values of all outcomes at 3 months (eg, 1 point higher resilience was associated with 0.92 higher linear analog scale; 95% CI: 0.52-1.32) with or without adjustment for demographics. After further adjusting for the baseline psychosocial measure, only the association between resilience and QOL measures at 3 months remained statistically significant.
CONCLUSIONS
Resilience is positively associated with health-related QOL for outpatients with moderate or complex ACHD, though relationships are small in magnitude. Study findings can guide the application of resilience-building interventions to the ACHD population.
PubMed: 38846320
DOI: 10.1016/j.jacadv.2024.100917 -
Alternative Therapies in Health and... Jun 2024This study investigated the impact of the use of a family-based delivery room on primiparous women's clinical outcomes and psychological well-being during childbirth. It...
Comparison of Clinical Outcomes and Postpartum Psychological Status Scores in Primiparous Women Delivered with Family Members in a Family-Based Room vs Women Delivered in a General Ward.
BACKGROUND
This study investigated the impact of the use of a family-based delivery room on primiparous women's clinical outcomes and psychological well-being during childbirth. It addressed the growing interest in family-centered care and assessed the effectiveness of a family-based room in providing a supportive environment for delivery.
OBJECTIVE
We aimed to compare the clinical outcomes and postpartum scores regarding the psychological status of primiparous women who delivered with their families in a home-based labor ward and women who delivered in a general labor ward.
METHODS
In this retrospective study, 158 primiparous women, recruited between October 2021 and July 2022, were categorized into 2 groups based on their choice of delivery room: a family group (n=77) and a general group (n=81). Baseline data, indicators related to maternal role adjustment, pregnancy outcomes, psychological status, self-efficacy and quality of life (QoL) data were collected and compared between the 2 groups.
RESULTS
More women in the family group were well- and generally adapted than in the general group, and fewer were poorly adapted than in the general group (P < .05). There were more spontaneous deliveries in the family group than in the general group, and fewer cesarean deliveries, postpartum hemorrhages and cases of neonatal asphyxia than in the general group; lower postpartum Numerical Rating Scale (NRS) scores and higher Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores than in the general group, with notably better pregnancy outcomes in the family group (P < .05). Postpartum State Anxiety Inventory (S-AI) and Edinburgh Postnatal Depression Scale (EPDS) scores in the family group (50.25±1.58 and 8.02±0.35, respectively) were remarkably lower than in the general group (59.89±1.98 and 9.84±0.69, respectively) (P < .05). The family group exhibited a postpartum score of self-efficacy higher compared with the general group (P < .05). The QoL score in the family group was noticeably higher than in the general group (P < .05). The time of colostrum secretion in the family group was significantly earlier compared with the control group, and milk production within 48 hours postpartum was significantly higher in the family group (P < .05).
CONCLUSION
The family-based delivery room model significantly enhanced maternal role adaptation, increased the rate of spontaneous delivery, reduced the risk for cesarean conversion and diminished adverse maternal and infant outcomes. In addition, it substantially improved postpartum psychological status and positively influenced maternal self-efficacy and QoL. These findings hold significant reference value for maternal care practices.
PubMed: 38836737
DOI: No ID Found -
Korean Journal of Medical Education Jun 2024The decision to enroll in medical school is largely influenced by extrinsic motivation factors. It is necessary to explore the factors that affect pre-med students'...
PURPOSE
The decision to enroll in medical school is largely influenced by extrinsic motivation factors. It is necessary to explore the factors that affect pre-med students' motivation to enter medical school and their college adjustment, and to develop measures to help them adjust.
METHODS
A total of 407 pre-med students were surveyed regarding their motivation to enter medical school, fear of failure, and college adjustment. We analyzed the latent profiles of extrinsic motivation factors using latent profile analysis. One-way analysis of variance was conducted to examine the differences in fear of failure and adaptation to university life according to the latent groups.
RESULTS
After analyzing the latent profiles of entrance motivation, three latent profiles were selected. They were divided into high, medium, and low extrinsic motivation groups. Three profiles scored the highest on job security, followed by good grades and social status. Sophomores were more likely to be high extrinsic motivators than freshmen were. Fear of failure was high in the group with high extrinsic motivation, and adaptation to college life was highest in the group with low extrinsic motivation.
CONCLUSION
Job security was the most important extrinsic motivator for entering medical school, and extrinsic entrance motivation influenced fear of failure and college adjustment. Given the high level of extrinsic motivation among medical students, it is meaningful to analyze the extrinsic motivation profile of entering medical students and how it affects failure motivation and college adjustment.
Topics: Humans; Motivation; Male; Female; Students, Medical; Fear; Schools, Medical; Young Adult; Surveys and Questionnaires; Adult; Universities; Adaptation, Psychological; School Admission Criteria; Education, Medical, Undergraduate
PubMed: 38835312
DOI: 10.3946/kjme.2024.296 -
BMC Medical Education Jun 2024Medical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of...
BACKGROUND
Medical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of stressful life events on medical students' academic adjustment, focusing on the mediating roles of depression and anxiety. It also differentiated the impacts between at-risk students (those with academic failures) and their peers respectively.
METHODS
This case-control study involved 320 at-risk medical students and 800 other students from a university in western China. Participants anonymously completed the scales of stressful life events, depression, anxiety, and academic adjustment. T-tests, ANOVA, Pearson correlation, and structural equation modeling were employed for statistical analysis.
RESULTS
Depression and anxiety were significantly more prevalent in at-risk students (46.8% and 46.1%, respectively) than in controls (34.0% and 40.3%, respectively). Notably, at-risk students had poorer academic adjustment (t = 5.43, p < 0.001). The structural equation modeling had good fit indices and the results indicated that depression and anxiety fully mediated the effects of stressful life events on academic adjustment. For at-risk students, stressful life events significantly decreased academic adjustment through increased depression and anxiety (p < 0.001). Conversely, anxiety had a positive effect on academic adjustment in other students.
CONCLUSION
Targeted interventions focusing on depression and anxiety could reduce the negative impact of stressful life events on medical students' academic adjustment. However, educators have to distinguish the differences between at-risk students and others.
Topics: Humans; Students, Medical; Female; Male; China; Depression; Case-Control Studies; Anxiety; Stress, Psychological; Young Adult; Life Change Events; Adaptation, Psychological; Adult
PubMed: 38834998
DOI: 10.1186/s12909-024-05601-0 -
BMC Geriatrics Jun 2024This study investigates the relationship between hukou conversion and the psychological integration of rural older migrants, exploring the mediating role of...
OBJECTIVE
This study investigates the relationship between hukou conversion and the psychological integration of rural older migrants, exploring the mediating role of accessibility to health resources.
METHODS
The 3,963 valid samples of rural older migrants included in the study were sourced from the 2017 China Migrants Dynamic Survey (CMDS). The study established a multiple linear regression model for estimation and utilized inverse probability-weighted regression adjustment (IPWRA) method to correct for the selection bias of hukou conversion.
RESULTS
Compared to older migrants with rural hukou, merit-based (β = 0.384, 95% CI: 0.265 to 0.504), family-based (β = 0.371, 95% CI: 0.178 to 0.565) and policy-based (β = 0.306, 95% CI: 0.124 to 0.487) converters have significantly higher psychological integration. These findings remain robust even after addressing the potential issue of endogenous selection bias using the IPWRA method. Bootstrap mediating effect tests indicate that hukou conversion can indirectly affect psychological integration through the mediator role of health resources accessibility.
CONCLUSION
Accessibility of health resources mediates the association between hukou conversion and psychological integration. Policymakers should enhance the implementation of hukou conversion, strengthen the health resource guarantee system, and achieve a deeper psychological integration among rural older migrants.
Topics: Humans; Male; Aged; Female; Rural Population; Transients and Migrants; China; Health Services Accessibility; Middle Aged; Health Resources
PubMed: 38834968
DOI: 10.1186/s12877-024-05110-1 -
Supportive Care in Cancer : Official... Jun 2024To explore the resources, parents with cancer and their partners draw upon to sustain their family resilience through the cancer experience.
PURPOSE
To explore the resources, parents with cancer and their partners draw upon to sustain their family resilience through the cancer experience.
METHODS
Fifteen participants who were parents of children aged 8 to 25 years completed phone, audio-recorded, and semi-structured interviews. Of these participants, 11 were parents diagnosed with cancer, and four were partners of a parent diagnosed with cancer. Interview questions aimed to increase understanding about how families communicate, connect, and face challenges from the cancer experience. Interview data was analysed using inductive thematic analysis to provide scope to generate themes from parent's experiences rather than to test pre-existing frameworks.
RESULTS
The thematic analysis of interview transcripts generated three key themes related to family resilience: (1) adaptability to changes in roles and routines, (2) open communication within the family, and (3) accepting support from others.
CONCLUSION
This study found that parents' ability to use personal resources when faced with significant challenges helped to improve the resilience of parents' family system. Further research is needed to understand the factors that influence family resilience when a parent is diagnosed with cancer. Implications for the development of targeted interventions that provide support to not only the patient, but their whole family system will be discussed.
Topics: Humans; Resilience, Psychological; Female; Male; Neoplasms; Child; Adult; Adolescent; Parents; Adaptation, Psychological; Young Adult; Middle Aged; Social Support; Communication; Interviews as Topic; Qualitative Research
PubMed: 38834818
DOI: 10.1007/s00520-024-08608-x -
Global Health Action Dec 2024Family interactions, which are always multi-faceted, are complicated further by family members with disabilities. In resource-poor settings, policies and programmes that...
BACKGROUND
Family interactions, which are always multi-faceted, are complicated further by family members with disabilities. In resource-poor settings, policies and programmes that address the needs of and challenges faced by families are often inaccessible or unavailable. Approximately 13% of the families in Tanzania have at least one member with a disability, yet family-centred research on caring for disabled children and adolescents is scarce in this context.
OBJECTIVE
The aim is to explore the needs and challenges faced by families that care for children and adolescents with physical disabilities in the Kilimanjaro Region of north-eastern Tanzania.
METHODS
This qualitative study had a constructivist grounded-theory design. In-depth interviews, using a semi-structured interview guide based on the social-capital framework, were conducted with 12 female participants aged between 24 and 80. A conceptual model of family needs, inspired by Maslow's hierarchy of needs, informed the analysis.
RESULTS
Challenging needs were grouped into five categories, which were linked to Maslow's hierarchy of needs and related to the central concept of 'adaptive adjustment': (1) 'barely surviving'; (2) 'safety needs in jeopardy'; (3) 'sociocultural protection'; (4) 'self-esteem far beyond reach', and (5) 'dreaming of self-actualisation'.
CONCLUSION
Families caring for children and adolescents with physical disabilities in north-eastern Tanzania have needs that extend beyond the available and accessible resources. Families can adjust and adapt by avoiding certain situations, accepting the reality of their circumstances and exploring alternative ways of coping. A sustainable support system, including social networks, is essential for meeting basic needs and ensuring safety.
Topics: Humans; Tanzania; Adolescent; Female; Child; Disabled Children; Grounded Theory; Adult; Adaptation, Psychological; Qualitative Research; Middle Aged; Young Adult; Aged; Interviews as Topic; Family; Caregivers; Disabled Persons; Male; Health Services Needs and Demand
PubMed: 38832537
DOI: 10.1080/16549716.2024.2354009 -
Scandinavian Journal of Pain Jan 2024Inflammatory bowel disease (IBD) is a chronic, gastrointestinal tract condition, in which pain is one of the most widespread and debilitating symptoms, yet research...
OBJECTIVES
Inflammatory bowel disease (IBD) is a chronic, gastrointestinal tract condition, in which pain is one of the most widespread and debilitating symptoms, yet research about how individuals make sense of their IBD pain is lacking. The current study aimed to explore how individuals with IBD understand their pain.
METHODS
Twenty participants, recruited via the Crohn's & Colitis UK charity, were interviewed about their understanding of their IBD pain using the Grid Elaboration Method that elicits free associations on which it invites elaboration. Thematic analysis was used to organise transcribed verbatim data.
RESULTS
Three related themes - and - comprising seven sub-themes, illustrated the ways in which participants made sense of pain experientially, multi-dimensionally, and in the broader context of IBD and its symptoms. The psychological impact of pain was evident across all interviews.
CONCLUSIONS
The findings are consistent with other research in IBD pain, demonstrating the importance of pain in IBD. Sense-making underpins both emotional and practical responses to pain and ideally is constructed as an integral part of clinical care of IBD.
Topics: Humans; Qualitative Research; Inflammatory Bowel Diseases; Male; Female; Adult; Middle Aged; Pain; Aged; Young Adult
PubMed: 38830082
DOI: 10.1515/sjpain-2024-0006