Self-care behavior, hope, and social support in Taiwanese patients awaiting heart transplantation

Exploration of Hope Among Young Adults with Cancer in Malaysia

Purpose: Hope is vital for cancer patients to cope with their illnesses. It is positively associated with better health outcomes, quality of life, and daily functioning. However, restoring hope after a cancer diagnosis can be challenging, especially for young adult cancer patients. This research aimed to investigate hope among young adults with cancer throughout their cancer experience and the exploration of hope preservation in these individuals. Methods: This qualitative study involved 14 young adults recruited from a closed Facebook group. The median age of the participants was 30.5 years (range 20-39 years), and their median survival year was 3 years (range 1-18 years from the date of diagnosis). Semistructured interviews and a thematic analysis were performed to identify the major themes that emerged from these interviews. Results: The findings identified that young adults expressed hopes for cancer advocacy, good physical and mental health, ease in the afterlife, and uncertain hopes due to thoughts of death. Three areas that influenced their hope are: (1) active hope with cancer peers; (2) cancer prognosis and hope; and (3) hope comes from prayer. Their cultural and religious beliefs influenced the various forms of hope and affected their experiences with cancer. In addition, this study discovered that not all positive communication with their physician resulted in hope. Conclusion: These findings provide important insight to health care professionals (HCPs) by encouraging young adults to discuss hope and improving the existing oncology social work-based intervention. This study suggests that hope is essential for chronic illness patients and should be supported continuously during and after treatments.

Meaning in life, goals, and adherence to antiretroviral treatment in people living with HIV

Patients living with HIV who do not adhere to antiretroviral treatment (ART) have a high viral load, increasing the risk of developing AIDS, as well as new treatment-resistant strains. There are several psychological factors that must be studied to understand the reasons for non-adherence to ART. We studied whether the goals reported by patients with HIV, as well as their sense of meaning in life, influence ART adherence in a sample of adult patients attending HIV outpatient care in Mexico. Participants completed the Antiretroviral Treatment Adherence Assessment Questionnaire, the Dimensional Scale of Meaning in Life and were asked to write both short-term and long-term goals. The most frequent goals reported were those categorized as "personal development," followed by "being healthy." Participants with the highest adherence had more short-term "personal development" goals. Moreover, they showed the lowest levels of existential vacuum (lack of meaning in life). These variables predicted treatment adherence. We conclude that the design of programs to improve ART adherence should promote the establishment of personal development goals and offer tools that allow having a sense of meaning in life to reduce AIDS-related complications.

Mediating Role of Hope Between Social Support and Self-Management Among Chinese Liver Transplant Recipients: A Multi-Center Cross-Sectional Study

This study aimed to investigate the common status of self-management in liver transplant recipients and to explore the mediating role of hope in the relationship between social support and self-management. Two hundred and ten liver transplant recipients from two tertiary hospitals were included. Questionnaires were used for general demographic information, the Perceived Social Support Scale, the Herth Hope Index, and the Self-Management Questionnaire for Liver Transplantation Recipients. Lifestyle management of liver transplant recipients was good, while the communication with physicians, cognitive symptom management, and exercise dimensions were less than satisfactory. Minimal assurance of family and education levels were significantly associated with self-management. Social support was positively correlated with self-management and hope (r = .31, p < .01; r = .40, p < .01). Hope was positively correlated with self-management (r = .39, p < .01). Additionally, the effect of social support on self-management was partially mediated (β = .17, p < .01) by hope. The proportion of mediation of hope was 40.09%. Therefore, well-designed interventions that boost both social support and hope may help improve self-management behavior in liver transplant recipients.

Assessing the adherence to treatment among patients with cardiovascular diseases in Kermanshah, Iran

Background: The present study aimed to investigate the psychological determinants of adherence to treatment among patients with cardiovascular diseases (CVDs) referring to Imam Ali Hospital in Kermanshah, Iran.

Methods: This cross-sectional study was conducted on 227 patients (mean age=58.10, SD = 13.44) with CVDs, randomly selected amongst those admitted to Imam Ali cardiovascular center of Kermanshah in 2018. Data were collected through Meaning in Life Questionnaire (MLQ), the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE), the Illness Perception Questionnaire (IPQ), and Adherence to Treatment Questionnaire. The relationships between the criterion and predictor variables were assessed using Pearson correlation coefficient and linear regression (stepwise method) in IBM SPSS Statistics-23.

Results: The adherence to treatment was associated with meaning in life (r=0.367), patients’ perceptions of physician empathy (r=0.218), and illness perception (r=-0.238), at the 0.01 level. Meaning in life, patient’s perceptions of physician empathy, and illness perception explained 18.6% of the variance in adherence to treatment. Meaning in life (beta=0.367 and P≤0.001) was the most influential predictor of adherence to treatment. Additionally, there was a significant difference in the score of adherence to treatment by gender (23.46±4.42 for female vs. 24.77±3.53 for male, P = 0.030).

Conclusion: The patients’ perceptions of physician empathy, meaning in life, and illness perception were important factors to predict adherence to treatment in patients with CVDs. Gender was a significant predictor of the adherence to treatment.

Meaningful Living to Promote Complete Mental Health Among University Students in the Context of the COVID-19 Pandemic

Maintaining positive mental health can be challenging during the COVID-19 pandemic which undoubtedly caused devastating consequences on people’s lives. There is need to determine factors contributing to mental health of people during the pandemic. The current study aims to examine the effect of meaning in life on complete mental health, which represents the presence of positive functioning and the absence of psychopathological symptoms. The participants of the study included 392 (70.9% female) undergraduate students, ranging in age from 18 to 43 years (M = 20.67 years, SD = 3.66) and they have predominantly been imposed stay-at-home orders for coronavirus right after announcement of COVID-19 restrictions in Turkey. Latent variable path analyses demonstrated significant paths from meaning in life to all components of psychological distress, positive mental health, and subjective well-being. Multi-group analysis showed significant gender differences across the study variables. These findings corroborate the critical role of meaning in life in promoting complete mental health and shed further light on why people high in meaning in life tend to have better mental health than those low in meaning in life within the context of COVID-19.

Multiple mediation effects of health locus of control and hope on the relationship between stroke patients’ social support and self-management

Objective

This study aimed to identify the mediation effects of health locus of control (HLC) and hope between stroke patients’ social support and self-management.

Methods

A cross-sectional study was conducted. A total of 300 Chinese stroke patients were recruited by convenient sampling from the acupuncture department of two Chinese Traditional Medical Hospitals in Tianjin Province from June to September 2018. The self-report questionnaires include Social Support Assessment Scale, Herth Hope Index, Mental Health Locus of Control Scale, Stroke Self-management Behavior Scale, and personal information questionnaires. All the survey data were entered in Excel and analyzed using the SPSS 24.0 program. Mediation was tested with Bootstrapping in AMOS 23.0 program.

Results

The result showed that internal health locus of control (IHLC), chance health locus of control (CHLC) and hope were the mediators between social support and self-management. The direct, indirect, and total effects of social support on self-management behavior were 0.306 P < 0.01), 0.109 (P < 0.01), and 0.415 (P < 0.01), respectively.

Conclusions

Social support can directly influence self-management, and it can also indirectly influence self-management through IHLC, CHLC, and hope.

The Influence of Age, Gender and Religion on Willingness to be an Organ Donor: Experience of Religious Muslims Living in Sweden

The transplantation of organs is one of the most successful medical advances in recent decades, and transplantation is the treatment of choice for severe organ failure worldwide. Despite this situation and the general acknowledgment of organ donation (OD) as a global priority, the demand for organs outstrips the supply in virtually every country in the world. The study aims to elucidate whether age, gender and religion influence decision-making about organ donation in religious Muslims living in Sweden Data were collected through three group interviews using open-ended questions and qualitative content analysis. Twenty-seven participants, 15 males and 12 females from four countries, participated in the focus group interviews. The analysis of the collected data resulted in three main categories: "Information and knowledge about organ donation," "The priorities when deciding about organ donation" and "The religious aspects of organ donation," including a number of subcategories. Good information about and knowledge of OD, priorities in OD, importance of the fact that religion must be studied and taught daily and religious education were only a few of the factors informants emphasized as predictors of the total and successful donation of organs. Age, gender or religion did not have an impact on organ donation. High levels of education through religious education and good information via various media, as well as a good knowledge of the Swedish language, are predictors of improved OD. In order to overcome religious ideology as a source of misinformation relating to OD and to promote increased OD in the future, specific intervention studies and the improved involvement of religious communities and education in schools and the healthcare system are vital and must be a starting point for improved OD.

Effect of social support on the treatment adherence of hypertension patients

This descriptive study was conducted to determine the effect of social support on drug treatment adherence in patients with hypertension. The sample of this study consisted of 259 patients who met the research criteria, agreed to participate in the research, and admitted to the cardiology clinic of a university hospital in Turkey between January and June 2017. Data were collected by "Patient Information Form", "Adherence to Drug Treatment Self-Efficacy Scale", and "Multidimensional Perceived Social Support Scale". It was determined that 48.3% of the patients participating in the study were in the 61-75 age group, 58.7% were female, 91.9% were married, and 66.4% were living in the city. It was also found that 71% of the patients had at least one relative or person with hypertension in the family, 79.2% were using at least one blood pressure medication, 61% adhered to his/her diet, and 72.2% adhered to the disease. The average score of the Medication Adherence Self-Efficacy Scale was calculated as 64.24 ± 16.89, whereas the total score average of the Multidimensional Perceived Social Support Scale was calculated as 53.74 ± 23.30. Besides, a statistically significant positive correlation was found among Medication Adherence Self-Efficacy Scale score average, Multidimensional Perceived Social Support Scale total score, and all subgroup score averages (P = .000).In conclusion, in this study, treatment adherence and social support levels of the patients were found to be substantially good; besides, adherence to drug treatment was found to increase positively as the social support of patients with hypertension increase.

The Unsteady Mainstay of the Family: Now Adult Children's Retrospective View on Social Support in Relation to Their Parent's Heart Transplantation

The needs for support among children with a seriously ill parent, who is waiting for heart transplantation, are unknown today. The aim was to describe now adult children's experiences of social support in relation to a parent's heart transplant during childhood. Nine females and four males were interviewed. The median age for the children was 18 at the transplantation and their parents had been ill before for 18 months (median) and on waiting list for 161 days (mean). Three categories emerged: health care professionals' approaches, family and friends' approaches, and society approaches. Our results show that there was lack of support for children of heart transplantation patients. Support in the shape of information was in most cases provided by the sick or healthy parent. It is of great clinical importance to develop psychosocial support programs for children with a seriously ill parent waiting for heart transplantation (before, during, and after surgery).

Waiting for a heart or lung transplant: Relatives' experience of information and support

OBJECTIVES

To describe the relatives' experiences of information and support while heart or lung transplant candidates were waiting for a transplantation.

METHODOLOGY/DESIGN

The critical incident technique was used. Incidents were collected via interviews with 18 relatives (28-73 years old) of heart or lung transplant patients within four weeks of the patients being accepted onto the transplant waiting list.

FINDINGS

A total of 286 important events, both positive and negative, were identified and divided into two main areas: "Experiencing information and support" and "Reflecting upon information and support." "Experiencing information and support" was associated with "dissatisfaction with the health-care system", "being relatively satisfied", "supporting patients" and "the role of social networks." "Reflecting upon information and support" was associated with "finding strength" and "uncomfortable with emotions". Relatives experiences suggest that needs can be met through specific targeted information and support for them as well as mediating contact to previously transplanted persons.

CONCLUSION

The findings indicate a gap between the information and support that relatives need and receive, and that more attention should be paid to information and support for this group. By increasing awareness among healthcare professionals and the community, interventions can be developed that benefit relatives.

Psychological Differences of Patients and Relatives according to Post-Transplantation Anxiety

The aim of this investigation is to analyze the psychological differences of patients and their relatives according to the formers' post-transplantation anxiety. We used two groups of participants: transplant patients (n = 166) and close relatives (n = 166). Four questionnaires were applied: a Psychological Survey (to both groups), the Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire (to the transplant patients), and the Leeds Scales for the Self-Assessment of Anxiety and Depression (to the relatives). Participants were assessed twice: post-Intensive Care Unit (ICU; when patients were moved from the ICU to the Transplantation Unit) and post-hospital (one year after transplant). Results showed that high anxiety in patients just after organ transplant was related to an increase of anxiety and depression symptoms both in patients and relatives one year after transplant; it was also related to a decrease in the quality of life of these patients.

The relationships among satisfaction with social support, quality of life, and survival 5 to 10 years after heart transplantation

BACKGROUND

Despite the fact that social support has been found to be important to cardiovascular health, there is a paucity of information regarding the relationship between social support and outcomes long-term after heart transplantation (HT).

OBJECTIVES

Therefore, the purposes of our retrospective analyses of a prospective, longitudinal study were to examine (1) the relationship between satisfaction with social support and post-HT health-related quality of life (HRQOL) and survival and (2) whether 2 types of social support (emotional and tangible) were predictors of survival and HRQOL.

METHODS

Data were collected from 555 HT patients over a 5-year period (78% male, 88% white; mean age, 53.8 years at time of transplantation) at 4 US medical centers using the following instruments: Social Support Index, Quality of Life Index, Heart Transplant Stressor Scale, Jalowiec Coping Scale, and medical records review. Statistical analyses included t tests, correlations, Kaplan-Meier survival actuarials, and linear and multivariable regression.

RESULTS

Patients were very satisfied with overall social support from 5 to 10 years after HT (0 = very satisfied, 1 = very dissatisfied), which was stable across time (P = .74). Satisfaction with emotional social support (P = .53) and tangible social support (P = .61) also remained stable over time. When stratified into low, medium, and high levels of satisfaction, satisfaction with social support was not related to survival (P = .24). At 5 years, overall satisfaction with social support was a predictor of HRQOL (r = 0.59, P < .0001), and satisfaction with emotional social support was a predictor of HRQOL at 10 years after HT (r = 0.66, P < .0001).

CONCLUSIONS

Patients were very satisfied over time with emotional and tangible social support. While social support explained quality of life outcomes, it did not predict survival. Knowledge of relationships among social support, stress, and outcomes may assist clinicians to address social support needs and resources long-term after HT.

Heart or lung transplanted patients' retrospective views on information and support while waiting for transplantation

AIMS AND OBJECTIVES

To describe the patients' retrospective experiences of the information and support they received while on the heart or lung transplant waiting list.

BACKGROUND

Patients differ in the way that they cope with the time spent waiting for a heart or lung transplant. Patients must already before the transplantation be taught about a new lifestyle, risk factors, medication, food restrictions and exercise, so they can take an active role and responsibility for disease management after transplantation. Little is known about patients' experiences of information and support in these situations.

DESIGN

Qualitative descriptive design.

METHODS

Sixteen patients (16-67 year) were strategically selected from one transplant centre in Sweden and interviewed six months after heart or lung transplantation. Using content analysis, transcribed data were organised into subcategories that reflected emerging categories.

RESULTS

Three categories that describe patients' experiences of information and support have been identified: 'Achieving confidence and trust by information and support', 'Experiencing a lack of input and understanding' and 'Struggling with a life-threatening illness and an insecure future'. Each category consists of different subcategories.

CONCLUSIONS

Information and support in connection to heart or lung transplantation are a complex and multifaceted issue involving patient-related, family-related, disease-related and treatment-related factors as well as experiences related to the social situation, the healthcare system and society. Transplant patients are very vulnerable, and a deeper understanding of patients' experiences should help healthcare providers in optimising the care for these very sick patients.

RELEVANCE TO CLINICAL PRACTICE

A holistic approach to the patient is necessary in meeting the needs of patients with chronic illness, especially patients with children at home, as well as the needs of their families. An important implication is the necessity to enhance awareness about transplant patients in society in general, in particular in other institutions, by sharing knowledge and by improving cooperation.

Recently accepted for the waiting list for heart or lung transplantation - patients' experiences of information and support

The aim of the study was to describe the patients' experiences of the information and support they received after being placed on the waiting list for a heart or lung transplant. The design was qualitative, and the critical incident technique was used. Incidents were collected via interviews with 21 patients. A total of 357 important events, both positive and negative, were identified and divided into two main groups: Body and mind and Information and support. The following subgroups emerged: chronic illness affects the patients, attitudes towards the future, impact of information, support from public organizations, and support from the private sphere. The patients showed knowledge of and involvement in the upcoming transplantation, which indicates that healthcare professionals managed to convey information and support effectively. By identifying the importance of factors such as body and mind and information and support for patients recently accepted for heart or lung transplantation, healthcare professionals are able to make specific improvements in the information and support that they provide. An important implication is to enhance the knowledge regarding transplant patients in other institutions and improve cooperation. Specific support programs to assist patients who have dependent children should be developed. Society needs to become more enlightened about organ donation and transplantation patients.

Extracorporeal membrane oxygenation bridge to adult heart transplantation

Extracorporeal membrane oxygenation (ECMO) can rescue some critical patients with circulatory collapse when intra-aortic balloon pump (IABP) and ventricular assist devices (VAD) are not suitable. A subset of these patients can use ECMO for direct bridging, or indirect double bridging via VAD to heart transplantation (HTx). For these patients, we identified risk factors for unsuccessful ECMO bridging, with survival to receiving either HTx or VAD as the measure of success. The characteristics evaluated were age, sex, body mass index, pre-ECMO cardiopulmonary resuscitation (CPR), IABP use, dialysis use, sequential organ failure assessment (SOFA) score, and the etiology of cardiomyopathy. From January 1995 to August 2007, there were 70 adult ECMO patients with the intent to bridge to HTx (male: 55, age: 46 +/- 14 yr). Thirty-one patients (44%) were successful in bridging. A stepwise multivariate logistic regression analysis found that age > 50 yr (p = 0.003), pre-ECMO CPR (p = 0.001) and SOFA score > 10 at ECMO initiation (p = 0.018) were significant independent predictors of unsuccessful bridging. Direct VAD implantation, if possible, is preferable to double bridging in patients over 50 yr. Also, elective ECMO support before hemodynamic deterioration to cardiac arrest or multiple organ dysfunction would improve rates of successful ECMO bridging.