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Zhou X, Jiang H, Zhou YP, Wang XY, Ren HY, Tian XF, Zhang QQ. Mediating role of social support in dysphoria, despondency, and quality of life in patients undergoing maintenance hemodialysis. World J Psychiatry 2024; 14:409-420. [PMID: 38617988 PMCID: PMC11008395 DOI: 10.5498/wjp.v14.i3.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/30/2023] [Accepted: 01/23/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis (MHD) that significantly affect their quality of life (QOL). High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD. Currently, there is limited research on how social support mediates the relationship between dysphoria, despondency, and overall QOL in patients undergoing MHD. It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD, ultimately enhancing their overall QOL. AIM To investigate the mediating role of social support in relationships between dysphoria, despondency, and QOL among patients undergoing MHD. METHODS Participants comprised 289 patients undergoing MHD, who were selected using a random sampling approach. The Social Support Rating Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and QOL Scale were administered. Correlation analysis was performed to examine the associations between social support, dysphoria, despondency, and QOL in patients undergoing MHD. To assess the mediating impact of social support on dysphoria, despondency, and QOL in patients undergoing MHD, a bootstrap method was applied. RESULTS Significant correlations among social support, dysphoria, despondency, and quality in patients undergoing MHD were observed (all P < 0.01). Dysphoria and despondency negatively correlated with social support and QOL (P < 0.01). Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD (P < 0.05). The direct effect of dysphoria on QOL was statistically significant (P < 0.05). Social support mediated the relationship between dysphoria and QOL, and this mediating effect was significant (P < 0.05). Similarly, the direct effect of despondency on QOL was significant (P < 0.05). Moreover, social support played a mediating role between despondency and QOL, with a significant mediating effect (P < 0.05). CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria, despondency, and QOL in patients undergoing MHD.
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Affiliation(s)
- Xiang Zhou
- Department of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Kidney Disease, Urumqi 832000, Xinjiang Uygur Autonomous Region, China
| | - Hong Jiang
- Department of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Kidney Disease, Urumqi 832000, Xinjiang Uygur Autonomous Region, China
| | - Yi-Peng Zhou
- Department of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Kidney Disease, Urumqi 832000, Xinjiang Uygur Autonomous Region, China
| | - Xiao-Yu Wang
- Department of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Kidney Disease, Urumqi 832000, Xinjiang Uygur Autonomous Region, China
| | - Hai-Yan Ren
- Department of Endocrinology and Metabolism, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 832000, Xinjiang Uygur Autonomous Region, China
| | - Xue-Fei Tian
- Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Qing-Qing Zhang
- Department of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Kidney Disease, Urumqi 832000, Xinjiang Uygur Autonomous Region, China
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Kisomi ZS, Taherkhani O, Mollaei M, Esmaeily H, Shirkhanloo G, Hosseinkhani Z, Amerzadeh M. The moderating role of social support in the relationship between death anxiety and resilience among dialysis patients. BMC Nephrol 2024; 25:100. [PMID: 38493124 PMCID: PMC10943903 DOI: 10.1186/s12882-024-03533-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) who receive social support can cope with the challenges. Therefore, this study determined the moderating role of social support in the relationship between death anxiety and resilience among dialysis patients in Qazvin City. METHODS This cross-sectional study used a descriptive-analytical approach on 347 dialysis patients in Qazvin City. The data collection tools included several questionnaires. The convenience sampling method was employed. The data were analyzed using SPSS software version 22 and mplus software version 7.2, employing descriptive statistics, such as mean and standard deviation for continuous variables and using counts and percentages for categorical/nominal variables. Regression analysis and tests were used to examine the relationships between variables. Structural Equation Modeling (SEM) analysis was employed to determine direct and indirect relationships between independent and dependent variables. RESULTS The prevalence of death anxiety was high (48.3%) among the patients. The mean resilience score was 62.59 ± 15.69, and the mean social support score was 52.23 ± 10.21. There was a significant association between resilience and social support (P < 0.001), as well as between resilience and death anxiety (P < 0.001). Furthermore, a significant relationship was observed between social support and death anxiety (p = 0.015). In the analysis of SEM, both the direct and indirect relationships between resilience and death anxiety were significant through the mediating variable of social support. CONCLUSION This study demonstrates that there is a relationship between death anxiety and resilience, and social support significantly moderates the relationship between death anxiety and resilience.
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Affiliation(s)
- Zahra Shafiei Kisomi
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Taherkhani
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mina Mollaei
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hoda Esmaeily
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
- Department of Healthcare Management, School of Public Health, Qazvin University of Medical Sciences (QUMS), Qazvin, Iran.
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Zhang Q, Liu Q, Zhang L, Jin Y, Xiang X, Huang X, Mai J, Zhao T, Cui W. The mediating effect of family resilience between coping styles and caregiver burden in maintenance hemodialysis patients: a cross-sectional study. BMC Nephrol 2024; 25:83. [PMID: 38443869 PMCID: PMC10916256 DOI: 10.1186/s12882-024-03520-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Primary caregivers of hemodialysis patients suffer from varying degrees of stress from their patients. Caring for hemodialysis patients can expose caregivers to many problems, leading to an increased burden of care and even impacting the quality of care. The purpose of our study was to examine whether family resilience could be a mediating variable moderating the relationship between patient coping styles and caregiver burden. METHODS The study was a cross-sectional and descriptive-analytical study that interviewed 173 pairs of hemodialysis patients and their caregivers at a blood purification center in a public hospital in China. The Brief Coping Styles Scale (Chinese version) was used to assess individuals' coping styles for disease and treatment. From the caregiver's perspective, the Family Resilience Assessment Scale (Chinese version) was used to understand the resilience of families, and the Zarit Caregiver Burden Scale was used to capture the caregiver's subjective experience of burden. Statistical analyses were conducted using SPSS version 23 and Amos version 26 to analyze the relationships between variables to examine for correlation and construct mediated effects models. RESULTS Coping styles showed a significant positive correlation with family resilience (r = 0.347, P < 0.01) and a negative correlation with caregiver burden (r = -0.379, P < 0.01). A significant negative correlation was found between family resilience and caregiver burden (r = -0.503, P < 0.01). In the mediation model, patient coping styles directly impacted caregiver burden significantly (95% CI [-0.372, -0.058]), and coping styles indirectly impacted caregiver burden by family resilience in a significant way (95% CI [-0.275, -0.098]). CONCLUSIONS Patient coping styles directly affect caregiver burden. Family resilience is a mediating variable between patients' coping styles and the burden on caregivers.
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Affiliation(s)
- Qianjun Zhang
- School of Nursing, College of Medicine, Shantou University, Shantou, China
| | - Qiaoling Liu
- School of Nursing, College of Medicine, Shantou University, Shantou, China
- Department of Nursing, Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, China
| | - Li Zhang
- Department of Office, First People's Hospital of Foshan, Foshan, China.
| | - Yabin Jin
- Department of Office, First People's Hospital of Foshan, Foshan, China.
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, China.
| | - Xia Xiang
- Department of Nursing, First People's Hospital of Foshan, Foshan, China
| | - Xuefang Huang
- Hemodialysis Center, First People's Hospital of Foshan, Foshan, China
| | - Jiezhen Mai
- Department of Hepatopancreatic Surgery, First People's Hospital of Foshan, Foshan, China
| | - Tingfen Zhao
- College of Nursing, Zunyi Medical University, Zhuhai, China
| | - Wen Cui
- College of Nursing, Zunyi Medical University, Zhuhai, China
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Şanli ME, Dinç M, Öner U, Buluş M, Çiçek İ, Doğan İ. The Role of Spirituality in Anxiety and Psychological Resilience of Hemodialysis Patients in Turkey. JOURNAL OF RELIGION AND HEALTH 2023; 62:4297-4315. [PMID: 37354376 DOI: 10.1007/s10943-023-01855-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/26/2023]
Abstract
Chronic kidney disease (CKD) is a significant health problem that affects millions of people worldwide and its end-stage manifestation requires hemodialysis treatment, which can have a considerable impact on patients' mental health and quality of life. This study aims to examine the relationship between spirituality and anxiety, as well as spirituality and psychological resilience among hemodialysis patients using the iterative weighted least squares method. Participants included 91 hemodialysis patients, consisting of 49 females and 42 males, whose ages ranged from 20 to 82 years, with a mean age of 48 (SD = 14). The data were collected using the Beck Anxiety Inventory, Spirituality Scale, and Brief Psychological Resilience Scale. Results indicated a weak positive relationship between spirituality and psychological resilience (t = 1.35, P = .183) and a moderate negative relationship between spirituality and anxiety (t = -2.84, P = .006). Furthermore, spirituality accounted for a 1% variance in psychological resilience and a 5% of the variance in anxiety. Additionally, patients' education level, gender, and whom they live with were relatively stronger correlates of psychological resilience, while the patient's education level, gender, marital status, whom they live with, presence of another patient at home receiving hemodialysis treatment were strong correlates of anxiety. This study emphasizes the need for comprehensive care that addresses both physical and psychological aspects of CKD management to improve patient outcomes and quality of life.
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Affiliation(s)
| | - Mahmut Dinç
- Batman University, Health College, Batman, Turkey
| | - Uğur Öner
- Batman University, Health College, Batman, Turkey
| | - Metin Buluş
- Faculty of Education, Dr. Adıyaman University, Adıyaman, Turkey
| | - İlhan Çiçek
- Batman University, Health College, Batman, Turkey.
| | - İdris Doğan
- Health Vocational School, Batman University, Batman, Turkey
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Abuelaish I, Yousufzai S. Resilience under protracted conflict and siege: a new paradigm shift. Med Confl Surviv 2023; 39:369-388. [PMID: 37722406 DOI: 10.1080/13623699.2023.2258325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/09/2023] [Indexed: 09/20/2023]
Abstract
This study sought to explore the relationship between resilience as perceived within the Palestinian context, and individual, contextual, and psychosocial factors among adults living in the Gaza Strip. Secondly, this study applies the Connor-Davidson Resilience Scale to the Palestinian population within the context of the challenges they are facing while living under extended sieges, in order to examine the generalizability of the resilience scale. Gender-specific bivariate analyses and multivariate linear regression were conducted to examine links between resilience, and diverse psychosocial and contextual factors. Males scored higher in resilience than females. Consistent predictors of higher resilience included, being male, employed, income, not living in a peaceful area, higher life satisfaction, and the Palestinian idea of resilience (Sumud). For the overall sample and males, hardiness was a positive predictor of higher resilience. For the overall sample and females, post-secondary education was a positive predictor of resilience. Psychosocial factors may act synergistically to foster resilience in the face of adversity, low socioeconomic status, and fear of living in a non-peaceful area. Our findings add to a limited body of literature calling for attention to contextual and psychosocial influences on gender differences in measuring and defining the dynamic nature of resilience.
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Affiliation(s)
- Izzeldin Abuelaish
- Global Health/Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Susan Yousufzai
- Global Health/Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Wang L, Huang S, Feng Z, Lin Y, Zhang Y. Chain mediation model of consultation empathy, resilience and resignation coping on depression: a cross-sectional study among patients with COVID-19 in China. BMJ Open 2023; 13:e079050. [PMID: 37940162 PMCID: PMC10632825 DOI: 10.1136/bmjopen-2023-079050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES This study aimed to explore the mediating role of resilience and resignation coping in the relationship between consultation empathy and depression in patients with COVID-19. DESIGN Cross-sectional study. SETTING Participants were recruited from a tertiary hospital in Guangzhou, Guangdong province. PARTICIPANTS A total of 215 patients were recruited for this study. OUTCOME MEASURES A total of 215 patients completed the Consultation and Relational Empathy Measure, Connor-Davidson Resilience Scale, Medical Coping Modes Questionnaire and Hospital Anxiety and Depression Scale. PROCESS 4.1 model 6 was used to analyse the moderated mediating effects. RESULTS Consultation empathy had a positive correlation with resilience (r=0.34, p<0.001), and a negative correlation with resignation (r=-0.288, p<0.001) and depression (r=-0.379, p<0.001). Resilience had a negative correlation with resignation (r=-0.463, p<0.001) and depression (r=-0.605, p<0.001). Resignation had a positive correlation (r=0.547, p<0.001) with depression. In the moderated mediating model, consultation empathy had significant indirect predictive effects on depression through resilience (95% CI -0.093 to -0.030) or resignation (95% CI -0.043 to -0.005). Consultation empathy had significant indirect predictive effects on depression through both resilience and resignation (95% CI -0.030 to -0.008). CONCLUSIONS Consultation empathy not only predicted depression directly, but also indirectly predicted depression through the chain mediating effects of resilience and resignation coping.
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Affiliation(s)
- Lujie Wang
- Department of Psychiatry, Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology;The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuling Huang
- Department of Internal Medicine-Cardiovascular, Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhiyi Feng
- Medical Section, Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology;The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuhui Lin
- Department of Internal Medicine-Cardiovascular, Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuan Zhang
- Department of Geriatric, Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Mirzaei-Alavijeh M, Hamzeh B, Omrani H, Esmailli S, Khakzad S, Jalilian F. Determinants of medication adherence in hemodialysis patients: a cross-sectional study based on capability-opportunity-motivation and behavior model. BMC Nephrol 2023; 24:174. [PMID: 37316774 DOI: 10.1186/s12882-023-03231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Medication adherence is a key component of successful dialysis in end-stage renal disease (ESRD). The aim of this study was to use the Capability-Opportunity-Motivation and Behavior (COM-B) model in order to identify the most important determinants of medication adherence among ESRD patients. METHODS This research was a cross-sectional design that was conducted in two steps in 2021. In the first step, COM-B components of patients undergoing hemodialysis (HD) therapy were extracted through literature review. The second step was a cross-sectional study among 260 ESRD patients referred to the dialysis unit from Kermanshah, in the west of Iran. Data was collected using a written questionnaire by interviews. The data was analyzed in SPSS version 16 software. RESULTS The mean age of respondents was 50.52 years [95% CI: 48.71, 52.33], ranged from 20 to 75 years. The mean score of medication adherence was 11.95 [95% CI: 11.64, 12.26], ranged from 4 to 20. Medication adherence is higher among patients with higher education (P = 0.009) and those who were employed (P < 0.001) and was significantly related to income (r = 0.176), while it was inversely and significantly related to the medication duration (r=-0.250). Motivation (Beta: 0.373), self-efficacy (Beta: 0.244), and knowledge (Beta: 0.116) are stronger determinants of medication adherence. CONCLUSION COM-B model can be proposed as an integrated framework in predicting medication adherence among ESRD patients. Our findings provide theory-based recommendations that can help future clinical and research decision-making for the development, implementation, and evaluation of treatment adherence interventions in Iranian ESRD patients. The use of COM-B model can provide a comprehensive explanation about medication adherence in ESRD patients. Future research should be focus on increasing motivation, self-efficacy and knowledge of Iranian ESRD patients in order to increasing medication adherence.
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Affiliation(s)
- Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamidreza Omrani
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sharareh Esmailli
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Khakzad
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzad Jalilian
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Associations between Mental Health and COVID-19 Status among 18- and 19-Year-Old Adolescents: A Multi-Country Study. ADOLESCENTS 2023. [DOI: 10.3390/adolescents3010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The aim of this study was to describe the mental health status of 18- and 19-year-old adolescents who were infected or affected by COVID-19 during the first wave of the COVID-19 pandemic. This was a secondary analysis of a dataset collected from 152 countries between July and December 2020. Dependent variables were anxiety, depression, and post-traumatic stress symptoms. The independent variable was COVID-19 status (tested positive for COVID-19, had COVID-19 symptoms but did not test, had a close friend who tested positive for COVID-19, knew someone who died from COVID-19). Three multivariable logistic regression analyses were conducted to determine the associations between the dependent and independent variables while adjusting for confounding variables (sex—male, female, and country income level). Data of 547 participants were extracted, and 98 (17.9%) had experienced depression, 130 (23.8%) had experienced anxiety, and 219 (40.0%) had experienced post-traumatic stress symptoms. Knowing someone who died from COVID-19 was associated with significantly lower odds of having post-traumatic stress symptoms (AOR: 0.608). Having COVID-19 symptoms but not getting tested was associated with significantly higher odds of having anxiety symptoms (AOR: 2.473). Results indicate diverse mental health responses among adolescents aged 18–19-years old as a sequela of COVID-19. This needs to be studied further.
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Wang S, Wang X, Liu X, Zhao C, Duan J. Moderating effects of humanistic care and socioeconomic status on the relationship among pain intensity, psychological factors, and psychological function in adults with cancer pain from a province of China: A cross-sectional study. Front Psychiatry 2023; 14:928727. [PMID: 37082761 PMCID: PMC10110900 DOI: 10.3389/fpsyt.2023.928727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 03/07/2023] [Indexed: 04/22/2023] Open
Abstract
Objective The objective of this study is to explore whether humanistic care practiced by clinical pharmacists and socioeconomic status moderate the associations among pain intensity, psychological factors (catastrophizing and resilience), and psychological function (depression and anxiety) in cancer patients with low levels of education and income in the Shanxi province in the Northwest of China. Methods Our sample comprised 123 adult inpatients with cancer pain. Demographic variables were obtained from the Hospital Information System of The Second Hospital of Shanxi Medical University. Pain intensity, psychological factors, and psychological functions were evaluated with four scales, and humanistic care was practiced with a part of the patients by clinical pharmacists. First, univariate analyses were conducted, followed by moderating effect models. Results The incidence of depression and anxiety in patients with cancer pain in our sample were 48.78 and 41.46%, respectively. Low levels of psychological resilience (63.37, SD 21.74) were in this study. Pain intensity was significantly associated with humanistic care and anxiety. Humanistic care practiced by clinical pharmacists moderated not only the association between resilience and pain intensity but also the association between pain intensity and anxiety. Education levels moderated the relationship between pain intensity and the psychological factors of catastrophizing and resilience. Income levels moderated the association between resilience and anxiety. Conclusion Humanistic care is essential in moderating the association among pain intensity, psychological factors, and psychological functions in Chinese cancer patients, especially those from lower-level counties and rural areas. Furthermore, socioeconomic statuses, such as education level and income, cannot easily change quickly. Still, proper humanistic care can relieve pain more effectively, reminding us that medical staff should implement effective personalized interventions to reduce patients' pain intensity.
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Affiliation(s)
- Shuyun Wang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xuyan Wang
- School of Traditional Chinese Medicine and Food Engineering, Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, China
| | - Xiaohong Liu
- Department of Pharmacy, Yangquan First People's Hospital, Yangquan, Shanxi, China
| | - Chenxing Zhao
- Department of Pharmacy, Linfen People's Hospital, Linfen, Shanxi, China
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- *Correspondence: Jinju Duan,
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Hu S, Yu F, Jiang H, Shang W, Miao H, Li S, Zhao J, Xiao H. Periodontal Inflamed Surface Area Is Associated With Increased Gestational Blood Pressure and Uric Acid Levels Among Pregnant Women From Rural North China. Front Cardiovasc Med 2022; 9:830732. [PMID: 35299983 PMCID: PMC8921456 DOI: 10.3389/fcvm.2022.830732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background Periodontal disease has been associated with gestational complications and both conditions have a high prevalence in rural populations from developing regions. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy. Methods Three hundred and thirty-five rural women aged 20–34 years, with normal body mass index (BMI) were examined in a cross-sectional study during their third trimester of gestation. Exclusion criteria were history of pregnancy complications, multiple pregnancy, smoking habits, diabetes, hypertension or any known infectious disease. Socio-demographic variables, including age and socioeconomic status (SES), systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings, serum UA levels, and PISA values were recorded. A structural equation model was implemented with two constructed latent variables including “Dem” (comprising of age and SES category to represent unobserved demographic variables) and, “BP” (comprising of SBP and DBP to account for measurement error and lack of multiple BP readings). The model accounted for co-variance of BP and UA, and implemented simultaneous regressions for BP and UA as outcomes, upon Dem and PISA values as exogenous variables. Results The median PISA score was 1,081.7 (IQR = 835.01), reflecting high levels of periodontal inflammation in the sample. SEM showed a significant association of PISA with BP (estimate = 0.011, 95% CI = 0.009–0.012 p < 0.001) and UA (estimate = 0.001, 95% CI = 0.001–0.001, p < 0.001). Conclusion Higher PISA values were significantly associated with higher blood pressure and uric acid levels among rural pregnant women in a cross-sectional sample from a center in North China after accounting for a latent demographic construct derived from age and SES.
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Affiliation(s)
- Shaonan Hu
- Innovation Center Computer Assisted Surgery, Leipzig University, Leipzig, Germany
| | - Feifan Yu
- School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Hong Jiang
- Department of Obstetrics and Gynecology, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, Chengdu, China
| | - Wei Shang
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Hui Miao
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Simin Li
| | - Jianjiang Zhao
- Shenzhen Stomatological Hospital, Southern Medical University, Shenzhen, China
- Jianjiang Zhao
| | - Hui Xiao
- Stomatological Hospital, Southern Medical University, Guangzhou, China
- Hui Xiao
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Wei W, Yang R, Zhang J, Chen H, Ye J, Su Q, Liao J, Xiao Z. The Mediating Roles of Family Resilience and Social Support in the Relationship Between Illness Severity and Depressive Symptoms Among Primary Caregivers of Children With Epilepsy in China. Front Neurol 2022; 13:831899. [PMID: 35265030 PMCID: PMC8899194 DOI: 10.3389/fneur.2022.831899] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/31/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study was designed to assess the effects of epilepsy severity, family resilience, and social support on depression in primary caregivers of children with epilepsy (CWE), and to test the mediating roles of family resilience and social support in this relationship. METHOD Two hundred fifty-two caregivers of children with epilepsy were recruited from October 2020 to May 2021. The questionnaire contained sociodemographic characteristics, Epilepsy Severity, Chinese-Family Resilience Assessment Scale (C-FRAS), Social Support Rating Scale (SSRS), Beck Depression Inventory (BDI). Structural equation models were used to evaluate whether family resilience and social support as mediators between epilepsy severity and depression. RESULTS In this study, the prevalence of depressive symptoms among primary caregivers of CWE in China was 69.84%. Epilepsy severity was positively associated with depression. Family resilience and social support were negatively correlated with depressive symptoms (both p < 0.01). Furthermore, the fitness indices of structural models were satisfactory. The direct effect of epilepsy severity on depression was 0.266 (95% CI 0.064-0.458), this pathway explained 62.88% variance of depression. The indirect effect of family resilience and then social support was 0.069 (95% CI 0.025-0.176), indicating that the serial multiple mediation was significant. The serial mediation pathway explained 16.31% variance of depression. CONCLUSIONS The high incidence of depression among primary carers of CWE deserves more attention. They should be screened routinely, especially those parents of children with severe epilepsy. Family resilience and social support could be protective factors for caregivers' mental adjustment. Therefore, future psychosocial interventions for enhancing family resilience and social support should be implemented, in order to reduce their depression.
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Affiliation(s)
- Wenjing Wei
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Rongrong Yang
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Jie Zhang
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Haili Chen
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Jinghua Ye
- Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Qiru Su
- Department of Clinical Research, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Jianxiang Liao
- Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
- *Correspondence: Jianxiang Liao
| | - Zhitian Xiao
- Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
- Zhitian Xiao
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