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Nursing Ethics Sep 2021Ethical climate and moral distress have been shown to affect nurses' ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still...
BACKGROUND
Ethical climate and moral distress have been shown to affect nurses' ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field.
RESEARCH AIM
To investigate paediatric oncology nurses' perceptions of ethical climate and moral distress.
RESEARCH DESIGN
In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey-Shortened and the Swedish Moral Distress Scale-Revised. Data analysis includes descriptive statistics and non-parametric analyses.
RESPONDENTS AND RESEARCH CONTEXT
Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey.
ETHICAL CONSIDERATIONS
According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate.
RESULTS
Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated.
DISCUSSION
Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress.
CONCLUSION
Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.
Topics: Attitude of Health Personnel; Child; Cross-Sectional Studies; Humans; Medical Oncology; Morals; Neoplasms; Surveys and Questionnaires
PubMed: 33706607
DOI: 10.1177/0969733021994169 -
Indian Journal of Endocrinology and... 2018Diabetes is a chronic metabolic disorder that impacts physical, social and mental including psychological well-being of people living with it. Additionally, psychosocial... (Review)
Review
Diabetes is a chronic metabolic disorder that impacts physical, social and mental including psychological well-being of people living with it. Additionally, psychosocial problems that are most common in diabetes patients often result in serious negative impact on patient's well-being and social life, if left un-addressed. Addressing such psychosocial aspects including cognitive, emotional, behavioral and social factors in the treatment interventions would help overcome the psychological barriers, associated with adherence and self-care for diabetes; the latter being the ultimate goal of management of patients with diabetes. While ample literature on self-management and psychological interventions for diabetes is available, there is limited information on the impact of psychological response and unmanaged emotional distresses on overall health. The current review therefore examines the emotional, psychological needs of the patients with diabetes and emphasizes the role of diabetologist, mental health professionals including clinical psychologists to mitigate the problems faced by these patients. Search was performed using a combination of keywords that cover all relevant terminology for diabetes and associated emotional distress. The psychological reactions experienced by the patient upon diagnosis of diabetes have been reviewed in this article with a focus on typical emotional distress at different levels. Identifying and supporting patients with psychosocial problems early in the course of diabetes may promote psychosocial well-being and improve their ability to adjust or take adequate responsibility in diabetes self-management - the utopian state dreamt of by all diabetologists !.
PubMed: 30294583
DOI: 10.4103/ijem.IJEM_579_17 -
Behavioral Sciences (Basel, Switzerland) May 2021We examined longitudinal differences in the severity of distress, depression, anxiety, and concerns and behaviors related to COVID-19 during the first two months of this...
We examined longitudinal differences in the severity of distress, depression, anxiety, and concerns and behaviors related to COVID-19 during the first two months of this pandemic, correlations between these variables, and interactions of distress with significant sociodemographics across waves. A longitudinal online survey was conducted in the State of Mexico, from 8 April to 27 May, 2020, in a sample of men and women between 18 and 60 years old, using: Impact of Event Scale-6, Patient Health Questionnaire-9, General Anxiety Disoder-7, and a questionnaire of concerns and behaviors related to COVID-19. Six hundred seventy participants were analyzed. Only a mild difference in distress was observed between the two waves and mild correlations of this variable with contagion in oneself and in a relative. Having a high-risk medical condition proved a considerable effect on distress within both waves. Perception of usefulness of preventive measures, concerns of contagion in a relative, and financial and security situations scored high within our questionnaire but did not change in the follow-up. We hypothesize that habituation to distressful events in the Mexican population (emergent resilience) might explain the absence of meaningful differences. Our research adds to the monitoring of mental health in Mexicans during the COVID-19 pandemic; its findings can serve to perform comparisons in other studies and for further meta-analyses.
PubMed: 34068274
DOI: 10.3390/bs11050076 -
Frontiers in Psychology 2022The aim of this study was to investigate whether the quality of the sibling relationship moderates the association between parental psychological distress and child...
The aim of this study was to investigate whether the quality of the sibling relationship moderates the association between parental psychological distress and child maladjustment (i.e., internalizing and externalizing problems). We extended previous literature by studying mothers and fathers separately and by including an observational measure of the quality of the sibling relationship. Participants were 52 two-parent families from a community sample who had at least two children living at home. Only one child (aged 6-10 years) was targeted for the study and studied in relation to his/her siblings. Mothers and fathers completed a self-reported questionnaire on their psychological distress and individually assessed their child's social-emotional maladjustment. The targeted child's interactions with his/her siblings were observed by independent judges during a home-visit. Results indicate that both maternal and paternal psychological distress are significant predictors of child social-emotional maladjustment. Moderation analyses reveal that children of distressed fathers are at lower risk of social-emotional maladjustment when they engage in highly positive interactions with their siblings. analyses suggest that only sibling empathy (not teaching nor companionship) is a significant moderator of the association between paternal psychological distress and child maladjustment. The results of this study provide further evidence of the influence that fathers have in their child's development and highlight the importance of using a systemic family approach to promote children's social-emotional adaptation in the context of parental distress.
PubMed: 36092045
DOI: 10.3389/fpsyg.2022.968985 -
Circulation. Cardiovascular Quality and... Nov 2023Although disparities in cardiac rehabilitation (CR) participation are well documented, the role of community-level distress is poorly understood. This study evaluated...
BACKGROUND
Although disparities in cardiac rehabilitation (CR) participation are well documented, the role of community-level distress is poorly understood. This study evaluated the relationship between community-level distress and CR participation, access to CR facilities, and clinical outcomes.
METHODS
A retrospective cohort study was conducted on a 100% sample of Medicare beneficiaries undergoing inpatient coronary revascularization between July 2016 and December 2018. Community-level distress was defined using the Distressed Community Index quintile at the beneficiary zip code level, with the first and fifth quintiles representing prosperous and distressed communities, respectively. Outpatient claims were used to identify any CR use within 1 year of discharge. Beneficiary and CR facility zip codes were used to describe access to CR facilities. Adjusted logistic regression models evaluated the association between Distressed Community Index quintiles, CR use, and clinical outcomes, including one-year mortality, all-cause hospitalization, and acute myocardial infarction hospitalization.
RESULTS
A total of 414 730 beneficiaries were identified, with 96 929 (23.4%) located in the first and 67 900 (16.4%) in the fifth quintiles, respectively. Any CR use was lower for beneficiaries in distressed compared with prosperous communities (26.0% versus 46.1%, <0.001), which was significant after multivariable adjustment (odds ratio, 0.41 [95% CI, 0.40-0.42]). A total of 98 458 (23.7%) beneficiaries had a CR facility within their zip code, which increased from 16.3% in prosperous communities to 26.6% in distressed communities. Any CR use was associated with absolute reductions in mortality (-6.8% [95% CI, -7.0% to -6.7%]), all-cause hospitalization (-5.9% [95% CI, -6.3% to -5.6%]), and acute myocardial infarction hospitalization (-1.3% [95% CI, -1.5% to -1.1%]), which were similar across each Distressed Community Index quintiles.
CONCLUSIONS
Although community-level distress was associated with lower CR participation, the clinical benefits were universally received. Addressing barriers to CR in distressed communities should be considered a significant priority to improve survival after coronary revascularization and reduce disparities.
Topics: Aged; Humans; United States; Cardiac Rehabilitation; Retrospective Studies; Architectural Accessibility; Inpatients; Medicare; Myocardial Infarction
PubMed: 37855157
DOI: 10.1161/CIRCOUTCOMES.123.010148 -
Social Psychiatry and Psychiatric... Sep 2022Growing evidence demonstrates that daily stressors such as family violence, unemployment, and living conditions play an important part in causing psychological distress....
PURPOSE
Growing evidence demonstrates that daily stressors such as family violence, unemployment, and living conditions play an important part in causing psychological distress. This paper investigates the impact of distressing events and day-to-day living conditions on psychological distress in the fragile context of Sierra Leone.
METHODS
A cross-sectional survey was conducted with 904 adults (454 men, 450 women) in 5 districts of Sierra Leone. The survey questionnaire comprised the Sierra Leone Psychological Distress scale and measures of demographic variables and personal characteristics, current life circumstances and potentially distressing events.
RESULTS
Multiple regression results identified three factors to be the greatest contributors to psychological distress: family conflict (β = 0.185, p < 0.001) and inability to afford basic needs (β = 0.175, p < 0.001). Gender differences were evident: factors predicting men's psychological distress included severe sickness or injury (β = 0.203, p < 0.001) and being unable to afford basic needs (β = 0.190, p < 0.001); for women, predicting factors were family conflict (β = 0.212, p < 0.001), perceived poor health (β = 0.192, p < 0.001) and inability to afford basic needs (β = 0.190, p < 0.001).
CONCLUSION
Initiatives to promote good mental health and psychosocial wellbeing in Sierra Leone should focus on enhancing income-generating and employment opportunities, promoting access to education, and strengthening family relationships.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Mental Health; Psychological Distress; Sierra Leone; Social Determinants of Health
PubMed: 35441330
DOI: 10.1007/s00127-022-02278-y -
The Journal of Sexual Medicine May 2022The Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised-herein called the Sexual Distress Scale (SDS and SDS-R)-are among the most widely used...
BACKGROUND
The Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised-herein called the Sexual Distress Scale (SDS and SDS-R)-are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date.
AIM
The current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems.
METHODS
A sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R.
OUTCOMES
Participants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress.
RESULTS
Results indicated that the Portuguese SDS and the SDS-R assess 1 general domain of sexual distress and showed good evidences of validity based on content and on relations with other variables. Sexual distress was associated with poorer sexual function, satisfaction, and quality of life, with higher psychological distress, and lower dyadic adjustment. Internal consistency and test-retest (1 month) reliabilities were excellent. Tests of differential functioning of items indicated that the SDS and SDS-R scores can be used to compare women and men on sexual distress, but the SDS/SDS-R scores flagged differential functioning of items and test (DFIT) between participants with and without distressing sexual problems.
CLINICAL TRANSLATION
Clinicians and researchers can now make use of the SDS and of the SDS-R in the Portuguese population, facilitating the assessment of sexual distress in clinical settings.
STRENGTHS & LIMITATIONS
The Portuguese SDS/SDS-R scores can be compared between women and men, providing information on sexual distress independently of sexual function. With the current evidence, comparisons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former.
CONCLUSION
This study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19:834-845.
Topics: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Portugal; Psychometrics; Quality of Life; Reproducibility of Results; Sexual Behavior; Young Adult
PubMed: 35370102
DOI: 10.1016/j.jsxm.2022.02.026 -
International Archives of Occupational... May 2021The current study's main objective was to measure the prevalence of psychological distress and its associated factors among Egyptian physicians during the COVID-19...
OBJECTIVE
The current study's main objective was to measure the prevalence of psychological distress and its associated factors among Egyptian physicians during the COVID-19 pandemic. Perceived stressors and coping strategies were also explored.
METHODS
A cross-sectional study on 714 physicians was carried out using an online administered questionnaire. The questionnaire included sociodemographic and occupational data, data related to the current pandemic, Kessler psychological distress scale, and the brief resilient coping scale. Multivariable logistic regression analysis was performed to identify significant predictors.
RESULTS
About 50% of physicians had severe psychological distress. Among studied physicians, the significant predictors were being female, having a pre-existing illness, having an elderly family member, and being in close contact with a case (AOR 1.6, 1.6, 1.4 and 1.7, respectively). Meanwhile, significant occupational predictors were less experienced and frontline physicians (AOR 2.0 and 1.8, respectively). The most distressful concern was fear for families and personal health and safety, while religious coping was the most effective coping strategy.
CONCLUSION
During the current pandemic, Egyptian physicians have a high prevalence of psychological distress. Frontline, low-experienced, female, previously ill physicians are more likely to have severe psychological distress. Therefore, psychological preparedness and psychological support services should be implemented and made easily accessible during pandemics.
Topics: Adaptation, Psychological; Adult; COVID-19; Cross-Sectional Studies; Egypt; Female; Humans; Male; Middle Aged; Occupational Stress; Physicians; Prevalence; Psychological Distress; SARS-CoV-2; Surveys and Questionnaires; Workplace
PubMed: 33394181
DOI: 10.1007/s00420-020-01624-4 -
Journal of Psychosomatic Research Jul 2013Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients... (Review)
Review
OBJECTIVE
Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes.
METHODS
CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT.
RESULTS
There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement.
CONCLUSION
Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening.
Topics: Humans; Neoplasms; Stress, Psychological
PubMed: 23751231
DOI: 10.1016/j.jpsychores.2013.01.012 -
BMC Nursing May 2023Advanced knowledge, technology, and treatment approaches resulted in longer survival rates for patients suffering from chronic diseases. However, symptoms of these...
BACKGROUND
Advanced knowledge, technology, and treatment approaches resulted in longer survival rates for patients suffering from chronic diseases. However, symptoms of these diseases persist and affect the individual's entire life and normal functioning.
AIM
To assess symptoms prevalence, severity, distress, and management among patients with chronic obstructive pulmonary diseases (COPD), chronic heart failure (CHF), and end-stage renal disease (ESRD) in Oman.
DESIGN
A descriptive cross-sectional design was used.
SAMPLE AND SETTINGS
The study sample comprised 340 participants who were recruited between May and December 2021 from two referral hospitals and one large dialysis unit in the Sultanate of Oman, Muscat Governate using a convenience sampling technique.
RESULTS
The highly prevalent symptoms among patients with selected chronic diseases were lack of energy (60.9%), pain (57.4%), numbness (53.2%), difficulty sleeping (49.4%), and shortness of breath (45.9%). The most severe symptoms were shortness of breath (53.2%), problems with urination (51.9%), constipation (50.8%), difficulty sleeping (49.7%), and pain (46.2%). The symptom "problems with sexual interests or activity" was found to be the most frequently occurring and highly distressing symptom out of all reported symptoms.
CONCLUSIONS
The current study's findings showed that symptoms were prevalent and that some symptoms were frequent, severe, and highly distressing. In addition, patients perceived symptom treatment as inadequate. Psychological symptoms received less treatment attention compared with physical symptoms. One of the mainstays for managing symptoms can be the introduction of palliative care. Providing palliative care to these patients can alleviate their suffering and improve their quality of life. In addition, designing chronic disease self-management programmes can make a difference in patients' life.
PubMed: 37149599
DOI: 10.1186/s12912-023-01296-8