Demoralization syndrome and its impact factors among cancer patients in China

The Mediating Effect of Emotional Regulation Between Psychological Resilience and Psychological Distress in Young and Middle-Aged Lymphoma Patients

Background

Psychological distress is common among young and middle-aged lymphoma patients. Psychological resilience and emotion regulation are key factors in coping with cancer, but their interrelationships remain unclear. Clinical psychologists play a crucial role in addressing psychological resilience and distress by providing therapeutic interventions that enhance coping mechanisms and emotion regulation. This study examines the mediating role of difficulties in emotion regulation between psychological resilience and psychological distress.

Methods

A cross-sectional study was conducted among lymphoma patients at Northern Jiangsu People's Hospital from January to December 2023. Psychological resilience, distress, and emotion regulation were assessed using standardized scales. SPSS 26.0 was used for descriptive statistics and spearman correlation analysis. PROCESS 4.0 was used to calculate the significance of the mediating effects of the variables.

Results

Patients had a psychological resilience score of 5.72 ± 2.31, a difficulties in emotion regulation score of 95.22 ± 8.86, and a psychological distress score of 5.72 ± 2.31. Psychological resilience was negatively correlated with both difficulties in emotion regulation (r = -0.28, P < 0.01) and psychological distress (r = -0.31, P < 0.01), while difficulties in emotion regulation were positively correlated with distress (r = 0.29, P < 0.01). Mediation analysis confirmed that difficulties in emotion regulation fully mediated the link between resilience and distress (effect size = -0.310, 95% CI: -1.195, -0.136).

Conclusion

Difficulties in emotion regulation partially mediate the relationship between psychological resilience and distress. Enhancing resilience and improving emotion regulation may help alleviate distress, emphasizing the need for targeted psychological interventions in young and middle-aged lymphoma patients.

Incidence and Influencing Factors of Demoralization Syndrome in Elderly Maintenance Hemodialysis Patients: A Multi-Center Cross-Sectional Study

Objective

This observational study aimed to investigate the prevalence and influencing factors of demoralization syndrome (DS) in elderly maintenance hemodialysis (MHD) patients, with a focus on improving their psychological distress levels.

Methods

Convenient sampling was used to select 350 MHD patients aged 60 or older from three tertiary hospitals in China. Data was collected using questionnaires, including the Chinese version of the DS Scale. Statistical analysis was conducted using SPSS 26.0 software.

Results

Single factor analysis revealed that sex, average monthly household income, living alone, dialysis duration, complications, and self-care abilities were significant influencers of DS levels. The average DS score was moderately high, with 59.4% of patients scoring in the high range. Multivariable linear regression identified average monthly household income, dialysis duration, complications, and self-management abilities as independent factors impacting DS.

Conclusion

The study highlighted the importance of addressing complications, enhancing social support, improving self-management skills, and tailoring individualized hemodialysis plans to reduce DS levels and alleviate psychological distress in elderly MHD patients. These findings provide valuable insights for healthcare providers aiming to enhance patient well-being in this population.

Factors correlated with demoralization among cancer patients: A systematic review and meta-analysis

OBJECTIVES

Demoralization isa common psychological problem in cancer patients. The purpose of this study is to systematically evaluate the correlated factors of demoralization among cancer patients. We also summarized the available evidence, effect estimates, and the strength of statistical associations between demoralization and its associated factors.

METHODS

We systematically searched PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, PsycINFO, and 2 electronic databases to identify studies published up to October 2023 with data on the correlates of demoralization. Two researchers independently reviewed references, extracted data, and assessed data quality. Meta-analysis was performed using R4.1.1 software.

RESULTS

Thirty-eight studies were included in this meta-analysis. For the most studied sociodemographic correlates, demoralization was negatively correlated with income (z = -0.29, 95% CI: -0.51, -0.02), education (z = - 0.11, 95% CI: - 0.16, -0.05), and age (z = -0.45, 95%CI: -0.75, -0.01). For the most studied clinical correlates, demoralization was positively correlated with symptom burden (z = 0.37, 95% CI: 0.22, 0.50) and negatively correlated with quality of life (z = -0.40, 95% CI: -0.54, -0.24). For the most studied psychosocial correlates, demoralization was negatively correlated with social support (z = -0.39, 95% CI: -0.51, -0.26) and positively correlated with anxiety (z = 0.65, 95% CI: 0.56, 0.73), depression (z = 0.61, 95% CI: 0.54, 0.67), and suicidal ideation (z = 0.48, 95% CI: 0.34, 0.60).

SIGNIFICANCE OF RESULTS

Demoralization showed either positive or negative associations with sociodemographic, clinical, and psychological variables. More research is needed to explore the underlying mechanisms to develop effective interventions. This review provides information on the factors associated with demoralization in cancer patients, which can be used to inform strategies for clinical care providers.

Existential distress and associated factors in advanced cancer patients: A cross-sectional study

BACKGROUND

Advanced cancer patients often experience existential distress (ED). However, the factors associated with ED remain unclear. This study investigated the current state of ED and identified the associated factors in Chinese patients with advanced cancer.

METHODS

A cross-sectional study was conducted among 352 advanced cancer patients from 3 tertiary hospitals in Fujian, China. Participants were invited to complete the Existential Distress Scale, Number Rating Scale, Self-Perceived Burden Scale, Quality of Life Concerns in the End-of-Life Questionnaire, and Hospital Anxiety and Depression Scale.

OBJECTIVES

This study aimed to investigate the level of existential distress among advanced cancer patients in China and identify the associated factors.

RESULTS

A total of 352 advanced cancer patients were recruited for this study. The average score for ED was 8.48 ± 7.12 among the advanced cancer patients. Multiple regression showed that the associated factors included depression (β = 0.32, p = 0.000), self-perceived burden (SPB) (β = 0.18, p = 0.001), the presence of a spouse (β = -0.10, p = 0.050), and reception of government subsidies (β = 0.17, p = 0.001). The factors accounted for 30.1% of the total variance in ED (F = 8.472, p < 0.001).

SIGNIFICANCE OF RESULTS

Among the advanced cancer patients queried, ED was found to be positively influenced by depression, SPB, and reception of government subsidies and negatively influenced by the presence of a spouse. Depression was the most important risk factor, and thus future ED interventions should target depression.