Acceptance Of Illness Research Articles

Dyadic Effects of Attachment on Illness Acceptance in Patients with Breast Cancer and Spousal Caregivers: Sense of Coherence as a Mediator.

Background: Attachment styles have been found to play a significant role in adjustment to cancer. Couples often cope with breast cancer through an interdependent approach to the disease rather than just acting as individuals, and a sense of coherence is an important factor that influences these relationships. This study examined how attachment styles and sense of coherence impact illness acceptance in couples facing breast cancer within a dyadic perspective. Methods: Data were analyzed from 145 women with recently diagnosed breast cancer and their 145 partners, who attended clinic appointments related to medical treatment. They completed self-report measures of attachment, sense of coherence, and illness acceptance. Results: Higher secure attachment and low insecure attachment scores were associated with a higher sense of coherence and better illness acceptance both in women and partners. Results of actor-partner interdependence mediation models indicated that most associations between attachment styles and illness acceptance were mediated by sense of coherence within both intrapersonal (actor-actor) and interpersonal (actor-partner) effects. Conclusions: The interdependence in attachment and sense of coherence brought noticeable benefits to couples' illness acceptance when facing breast cancer. In line with the salutogenic model, these relationships predominantly depended on the mediational function of comprehensibility, manageability, and meaningfulness, which determined cognitive and emotional reactions that influenced both patients' and spouses' acceptance of the disease.

Relationships between Religious Coping, Acceptance of Illness, and Diabetes Self-Efficacy in Patients with Type 2 Diabetes

This study aims to determine the relationships between religious coping, acceptance of illness, and diabetes self-efficacy in patients with type 2 diabetes. This descriptive and cross-sectional study was conducted with 606 patients with Type 2 diabetes who applied to Family Health Centers in a province center in eastern Turkey. Positive religious coping positively affects negative religious coping (t=3.887, p=0.001 R2=0.023). Negative religious coping positively affects diabetes self-efficacy (t=2.589, p=0.010, R2=0.010). Diabetes self-efficacy positively affects the level of acceptance of illness (t=9.865, p=0.010, R2=0.137). Model fits were found to be at satisfactory levels (x²/Sd=2.529, RMSEA=0.05, CFI=0.91, GFI=0.91, AGFI=0.88, IFI=0.91). The level of positive religious coping of individuals positively affects the level of negative religious coping. Negative religious coping levels positively affect diabetes self-efficacy. Diabetes self-efficacy positively affects the level of acceptance of illness.

Degree of acceptance of the disease and quality of life in women after mastectomy: a preliminary study

Background: The sudden change of life situation caused by a cancer diagnosis and mastectomy disturbs the psychosomatic balance and the functioning of a woman's previous life and leads to a reduced quality of life. Many women adapt to their new situation, but a very large group cannot adapt and cope with their illness.Aim of the study: Evaluation of disease acceptance and quality of life (QoL) in women after mastectomy.Material and methods: A total of 171 post-mastectomy women were studied. The study was conducted by means of a diagnostic survey using a questionnaire technique. The Acceptance of Illness Scale (AIS) and the Quality of Life Assessment Questionnaire (WHOQOL-BREF) were used.Results: The mean disease acceptability was 25.68 7.978. A group of 42.69% (72/171) had moderate disease acceptability, 32.75% (56/171) had high disease acceptability and 20.47% (35/171) had low disease acceptability. 4.09% (8/171) of the women had no acceptance of the disease. The mean value for the perception of QoL was 3.65 0.71. The best values were obtained for QoL in the psychological domain (14.1 3.1) and the worst in the physical domain (13.0; 2.7). Place of residence (p = 0.081) and education level (p = 0.196) did not significantly influence the acceptance of illness. Women living in village areas had a lower quality of life in the environmental domain (p = 0.036) than those living in the city. The absence of complications after mastectomy determined a higher level of QoL in the physical (p < 0.001), psychological (p = 0.029) and environmental (p = 0.010) domains, as well as greater acceptance of the disease (p = 0.001). Disease acceptance was associated with an improvement in the quality of life of women who had undergone a mastectomy, across all domains. Conclusions: It is important to increase interventions to support the adjustment process of women after mastectomy, as acceptance of the disease improves the QoL of these women.

Quality of Life after Cataract Surgery.

Background: The impact of medical intervention on a patient's quality of life (QoL) is more and more important. Treatment success is defined not only in terms of the success of the procedure performed but also with regard to its impact on different areas of the patient's life. The aim of the study was to assess the QoL of patients after cataract surgery and identify factors that affect it. Methods: Between January and March 2018, a survey was carried out among 100 patients who had undergone cataract surgery with intraocular lens implantation at the 'Spektrum' Clinical Ophthalmology Centre in Wrocław. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire and Illness Acceptance Scale (AIS) were used. Results: Most respondents (67%) rated their overall health as very good. The median score on the AIS was 34 (31.5-39), indicating a high level of illness acceptance. There was no statistically significant relationship (p > 0.05) between sex and QoL nor between the level of illness acceptance and QoL. We found no statistically significant relationships between place of residence and QoL (p > 0.05) nor between place of residence and AIS. Conclusions: The respondents reported the highest QoL scores for the environment domain and the lowest QoL scores for the social relationships domain. QoL had a positive impact on illness acceptance among the study patients. Younger patients (aged 50 or under) reported significantly higher scores for all the domains of QoL. Being employed was found to be associated with better QoL and greater illness acceptance.

Impact of Sociodemographic and Psychological Factors on Adherence to Glaucoma Treatment - A Cross-Sectional Study.

Glaucoma is a group of eye diseases characterized by progressive and irreversible damage to the optic nerve. The aim of the study was to examine the impact of sociodemographic and psychological factors on adherence to glaucoma therapy. The study was carried out among 190 adults treated for glaucoma at the Ophthalmology Outpatient Clinic of the University Teaching Hospital in Wroclaw between January 2019 and September 2019. Treatment adherence was measured using the Adherence to Refills and Medications Scale (ARMS). We used the Acceptance of Illness Scale (AIS), the Revised Life Orientation Test (LOT-R) and the Satisfaction with Life Scale (SWLS). 58.9% patients reported low treatment adherence. Educated females aged 68 or under living in cities had higher adherence. The regression analysis showed an association between dispositional optimism and glaucoma treatment adherence. The higher the level of dispositional optimism, the better the adherence. Higher dispositional optimism is directly associated with a sense of self-esteem and self-efficacy and a feeling of internal control. Patients reporting a high level of illness acceptance were found to have 2.5 times higher odds of adhering to glaucoma therapy. Illness acceptance is an indicator of the degree of adaptation to an illness and is positively correlated with a sense of self-esteem and self-efficacy and engagement in healthy behavior. More than half of patients with glaucoma have low adherence. Sociodemographic characteristics (female gender, age 68 or under, tertiary education and living in an urban area) and psychological characteristics (high level of illness acceptance, dispositional optimism and satisfaction with life) are significant predictors of high adherence.

The Relationship between Illness Acceptance and Health Literacy in Patients with Type 2 Diabetes

Introduction: To adopt healthy lifestyles for managing chronic diseases and ensure self-management and control of illness, individuals must accept their illness and have good health literacy knowledge. Aim: This paper investigated the correlation between health literacy and illness acceptance in patients with Type 2 diabetes. Method: The research was carried out as a cross-sectional study in Türkiye between December 2019 and April 2020. The sample consisted of 406 participants diagnosed with Type 2 diabetes admitted to a public hospital. Data were collected with an the “Information Form”, the “Acceptance of Illness Scale (AIS)”, and the “European Health Literacy Survey (HLS-EU)”. Results: Participants had a mean AIS score of 26.21 ± 7.11. They had a mean HLS-EU score of 92.25 ± 15.76. Health literacy (HL), age, gender, people living together, smoking status, hospitalization, knowing about chronic complications, the presence of other chronic illnesses, foot care, and blood glucose monitoring were predictors of the acceptance of illness. A positive correlation was observed between AIS and HLS-EU (r = 0.46; p < 0.001). Conclusions: Participants demonstrated high levels of both HL and illness acceptance. The level of illness acceptance increased with the level of HL. It is necessary to develop educational content and materials tailored to the needs and HL levels of the patients to enhance their health literacy.

Factors affecting the quality of life in pregnant women with diabetes: the mediating effect of illnesses acceptance

IntroductionGestational diabetes, as a disorder of carbohydrate metabolism, is considered one of the most common metabolic complications in pregnancy. The diagnosis of diabetes in pregnancy leads to changes in lifestyle, and the treatments employed can affect various aspects of pregnant women’s lives, including their quality of life. The present study aimed to investigate the relationship between self-efficacy and the mediating effect of illness acceptance on the quality of life in pregnant women diagnosed with diabetes during pregnancy.Materials and methodsThis cross-sectional study was conducted on 240 pregnant women diagnosed with diabetes who were selected by convenience sampling method. Quality of life tools (SF12), the Acceptance of Illness Scale (AIS), and the Sherer self-efficacy scale were used to collect data.ResultsThe mean (SD) of quality of life, self-efficacy, and disease acceptance were 57.36 (6.63), 51.75 (7.44), and 29.07 (7.69), respectively. In the single-variable regression analysis, self-efficacy and disease acceptance variables could predict 20.6% (β = 0.457, P < 0.001) and 14.4% (β = 0.385, P < 0.001) of the variations in quality of life, respectively. In the multiple regression model, by entering the two main variables (self-efficacy and Acceptance of Illness), demographic characteristics, three disease knowledge variables, health status from an individual perspective, and type of treatment, the variables could explain 25% of the changes of the quality of life (R2adj 0.25, P < 0.001=). Income status and self-efficacy had the highest impact among the variables. According to the results of path analysis, the total effect of self-efficacy on the quality of life of pregnant women with diabetes was 0.711.ConclusionThe overall quality of life in women with diabetes was moderate, and self-efficacy, illness acceptance, and income status were predictors of overall quality of life. Self-efficacy can influence the quality of life by affecting disease acceptance. The findings highlight the importance of designing educational programs and providing midwifery services to increase self-efficacy and illness acceptance to improve the quality of life of pregnant women with diabetes.

The role of illness acceptance and social support in assessing readiness for hospital discharge following myocardial infarction

Abstract Introduction The hospital discharge process refers to the patient's readiness to return to proper daily functioning. It is important to note that the discharge process is not solely based on physical readiness. It also includes psychological capacity, social support, and the provision of information and knowledge. Purpose The purpose of this study was to examine the correlation between readiness for hospital discharge and acceptance of illness and social support following myocardial infarction. Materials and Methods The study included 100 patients (56 women, mean age M±SD 64.95 y/o) who had experienced a myocardial infarction. The study employed a socio-demographic and clinical survey, as well as standardized measures including the Readiness for Hospital Discharge After Myocardial Infarction Scale (RHD-MIS), Acceptance of Illness Scale (AIS), and The Multidimensional Scale of Perceived Social Support (MSPSS). The statistical analysis includes a significance level of 0.05. Therefore, all values of p&amp;lt;0.05 were interpreted as indicating significant relationships. Results The majority of respondents were in a relationship (73%), lived in an urban area (70%) and had a secondary education (56%). The overall RHDS-MIS score showed that 46% of patients had a low level of readiness for discharge. There is a significant negative correlation (r=-0.228, p=0.022) between patient age and subjective knowledge score (p&amp;lt;0.05). The respondents reported a moderate level of acceptance towards their illness, with a mean score of 26.38 points. The AIS was shown to correlate significantly (p&amp;lt;0.05) and positively (r&amp;gt;0) with the RHDS-MI (r=0.525, p&amp;lt;0.001) and with all subscales: (1) subjective (r=0.405, p&amp;lt;0. 001) and (2) objective (r=0.538, p&amp;lt;0.001) assessment of patient knowledge about the disease, and (3) patient expectations (r=0.386, p&amp;lt;0.001). The analysis of the impact of social support on patients' readiness for discharge after MI revealed a significant positive correlation (r &amp;gt; 0, p &amp;lt; 0.05) between family support and readiness for discharge (r = 0.281, p = 0.005), subjective (r = 0.251, p = 0.012), and objective (r = 0.421, p &amp;lt; 0.001) assessment of knowledge. Conclusions Patients who have suffered from MI are at risk of experiencing adverse cardiovascular events, such as complications or hospital readmission. The level of hospital discharge readiness in patients after MI is correlated with the degree of acceptance of illness and social support. Assessing a patient's readiness for hospital discharge after an MI can help identify their educational and therapeutic needs. Involving the patient's family in the discharge readiness process is crucial as they can actively participate in the therapeutic process by providing support to the patient.

The experience of the body image for patients with left ventricular assist device

Abstract Background Improvements in LVAD technology and the survival of LVAD-supported patients led to more extensive use of LVADs also among patients with relative contraindications to HTx as a bridge-to-decision option or as a permanent treatment: destination therapy LVADs have been demonstrated to prolong HF patients' survival and to improve their quality of life. LVAD implantation has been demonstrated to have a considerable effect on patients' body image. Patients feel it hard to accept the device as an extension of their body, especially the driveline. Purpose The study aimed to examine the relationships between anxiety and depressive symptoms, acceptance of illness, beliefs about pain control, and quality of life with body image among LVAD-implanted patients. Material and methods The cross-sectional study included 54 conveniently recruited LVAD-implanted patients who completed the Body Image Scale, SF-12, Acceptance of Illness Scale, The beliefs about Pain Control Questionnaire, NRS, and HADS. The associations between the research variables were examined with multiple regression analyses. Results The mean age of the participants was 59.64 (SD=9,63), and 96.3% were men. The mean scores were: Body Image Scale – 28,33 (SD=5,91); Acceptance of Illness Scale- 25,51 (SD=5,92); The beliefs about Pain Control: Internal factors -15,85(SD=4,96), Influence of physicians-17,57 (SD=3,15), Random events-14,37(SD=3,32), NRS=2,80(SD=1,86), HADS anxiety -5,33 (SD=4,12), HADS depression-4,66 (SD=3,10), SF12MCS-45,49(SD=6,48), SF-12PCS-41,33 (SD=6,48). Patients' age (p=0,04), presence of depressive symptoms (p&amp;lt;0,05) and acceptance of illness (p=0,02) significantly predicted body image concerns. Conclusions Healthcare professionals should be aware of challenges regarding body image faced by LVAD-implanted patients and address related factors.

In Search of Variables Affecting Mental Adjustment and Acceptance of Cancer among Urological Patients.

Background/Objectives: Genitourinary cancers are now considered a major problem in modern medicine. In urological oncology, the most frequently occurring diseases are prostate, bladder and renal cancer. Any cancer has a profound effect on the life of a patient. Therefore, disease acceptance and mental adjustment to the condition are the key elements in coping with cancer. Aim: The main aim of the study was the determination of the level of acceptance of illness and mental adjustment to cancer in urological patients undergoing surgical treatment and the assessment of the effect of mental adjustment on disease acceptance. Material and Methods: The study group comprised 150 patients treated at the Department of Urology and Urological Oncology at the Independent Public Clinical Hospital No 2 in Szczecin. The study made use of the diagnostic survey method with the original questionnaire and standardized research tools: Acceptance of Illness Scale (AIS) and Mental Adjustment to Cancer Scale (Mini-MAC). Results: The analysis of mental adjustment to cancer according to Mini-MAC revealed that the respondents most frequently adopted the fighting spirit strategy (M; 22.22). Slightly less frequently adopted strategies were positive re-evaluation (M; 21.28) and anxious preoccupation (M; 17.07). The least frequently adopted strategy was the helplessness-hopelessness strategy (M; 13.14). The analysis of data showed a statistically significant negative correlation (r = -0.245; p = 0.003) between disease acceptance according to AIS and age. The data analysis revealed a statistically significant positive correlation with helplessness-hopelessness and destructive style (p < 0.05). Conclusions: Mental adjustment to cancer was found to affect the acceptance of illness. When providing comprehensive care to cancer patients, it is equally crucial to consider the physical as well as mental health aspect, taking into account the aforementioned factors which affect both acceptance as well as adjustment to disease.

Community perspectives to inform the development of a radio program to destigmatize mental illness in rural Uganda: a qualitative study

Background The stigma attached to mental illness impedes diagnosis, treatment, and access to care for people with mental illness. Scalable interventions are needed to enhance attitudes towards seeking treatment, foster community support, and promote acceptance of individuals experiencing mental illness. We worked with community health workers in the Busoga region of eastern Uganda to develop a radio program aimed at reducing mental illness stigma. We piloted the radio program in focus groups, purposively sampling people with families affected by mental illness and people with families unaffected by mental illness, to understand their perspectives about the program’s acceptability and potential effectiveness. Methods The 45-minute radio program was adapted from a previously studied community-led theater intervention, produced by community health workers, that demonstrated an individual’s recovery from mental illness. Afterward, we conducted 2 focus group discussions, each involving six participants: n=12; and 17 one-on-one, in-depth interviews. We employed the framework method to inductively identify themes and sub-themes. Results Participants reported greater understanding of causes of mental illness, treatment options, and greater acceptance of those with mental illness as a result of listening to the program. Conclusions This radio program intervention showed potential to change healthcare seeking behavior for mental illness and to decrease mental illness stigma in rural Uganda. Further investigation is needed to assess the broader applicability of this approach.

'Food doesn't control me anymore!' psychosocial experiences during dietary management in adults with inflammatory bowel disease: A qualitative study.

To explore the psychosocial experiences during dietary management among Chinese adults with inflammatory bowel disease. Qualitative phenomenological design. Eighteen adults diagnosed with inflammatory bowel disease for more than 6 months were recruited using purposive sampling from June to December 2023. Two trained researchers used van Manen's approach to analyse the data. The three themes with multiple subthemes emerged: facing the unknown: at a loss and aggrieved, trying to cope: uncertain and distressed, and growing in adaptation: relieved and transcendent. The first theme included unknown relapses, overlooking diet management and the absence of dietary rules. The second theme showed different coping situations, like complex dietary information and ever-closing worlds. The third theme explores how participants adapted to disease and their eating patterns. The psychosocial experiences during dietary management are complex. The accumulation of diet-related experience, acceptance of illness and social support facilitate patients in overcoming negative emotions and adhering to dietary management. Nurses should provide tailored dietary guidance and appropriate psychological interventions to promote healthy eating in patients. This study may enhance healthcare professionals' understanding, particularly those in China, of the diet-related experiences among patients. The Consolidated Criteria for Reporting Qualitative Research checklist. Participants contributed by sharing their first hand experiences.

Relationship between cognitive and emotional domains of prognostic awareness with quality of life and psychological distress in patients with advanced cancer.

11106 Background: Prognostic awareness, a measure of patients’ cognitive and emotional perception of their illness and prognosis, allows individuals to align their medical decision-making with their goals and values. Prior studies have shown mixed findings regarding the relationship between prognostic awareness with better quality of life (QOL) and less psychological distress in patients with advanced cancer. However, studies have not investigated whether it is the cognitive or the emotional aspects of patients’ awareness of their prognosis that are associated with QOL and psychological distress in patients with advanced cancer. Methods: We conducted a cross-sectional study of patients with metastatic solid malignancies not being treated for curative intent at a single academic center from 11/2019-6/2022. We used the Prognostic Awareness Questionnaire (PAIS) to measure the cognitive (i.e., the capacity to understand one’s prognosis characterized by the accurate perception that a cancer is curable or not) and emotional coping with prognosis (i.e., the capacity to emotionally process prognostic uncertainty and terminal prognosis). We used the Functional Assessment of Cancer Therapy-General (FACT-G), Hospital Anxiety and Depression scale (HADS), and the Peace, Equanimity and Acceptance in the Cancer Experience (PEACE) scale to measure, QOL, psychological distress, and acceptance of illness, respectively. We used multivariate regression models controlling for age, gender, and cancer type to assess the relationship between the cognitive and emotional prognostic awareness domains and patient-reported outcomes. Results: Overall, 632 participants (age 65 years (SD=11.3), 51% female, 76% married or living with a partner) were enrolled in the study. In multivariate models, higher cognitive understanding of prognosis was not associated with QOL (b=-2.134; p=0.069), psychological distress (i.e., anxiety: b=0.331; p=0.232 and depression; b=0.233; p=0.368), or peaceful acceptance of terminal illness (b=-0.045; p=0.838). However, emotional coping of prognosis was associated with better QOL (b=1.981; p&lt;0.001), less anxiety (b=-0.516; p&lt;0.001) and depression (b=-0.370; p&lt;0.001) symptoms, and more peaceful acceptance of terminal illness (b=0.438; p&lt;0.001). Conclusions: Patients’ emotional coping with their prognosis, rather than their cognitive understanding of their terminal prognosis, was associated with their QOL, psychological distress, and acceptance of their illness. These findings underscore the importance of examining prognostic awareness and its association with patient-reported outcomes by domains. We also highlight the need to develop supportive care interventions to promote effective coping strategies for patients after prognostic disclosure.

Acceptability and feasibility of a theatre-based wellness programme to support people living with long COVID: a single-arm feasibility study

ObjectivesTo determine acceptability and feasibility of a theatre-based wellness programme to support the health and well-being of people with long COVID.DesignSingle-group, repeated-measures feasibility study.SettingCommunity centre and online.ParticipantsAdults with diagnosed long...

Meme kanseri tanısı alan hastalarda hastalık kabulü ve yaşam kalitesinin incelenmesi

Amaç: Araştırma meme kanseri tanısı alan hastalarda hastalık kabulü ve yaşam kalitesinin belirlenmesi amacı ile yapılmıştır. Yöntemler: Araştırma tanımlayıcı ve kesitsel türdedir. Çalışmaya ülkemizdeki bir üniversite hastanesinin genel cerrahi kliniği meme polikliniği’ne daha önce meme kanseri tanısı ile ameliyat olan ve kontrol muayenesine gelen 154 hasta dahil edildi. Veriler kişisel bilgi formu, Hastalığı Kabul Ölçeği, Avrupa Kanser Araştırma ve Tedavi Teşkilatı Yaşam Kalitesi (EORTC QLQ-C30) ve Meme Kanserine Özgü Yaşam Kalitesi (EORTC QLQ-BR23) ölçekleri, Kısa Form-12 (SF-12) ile toplandı. Tanımlayıcı istatistikler, tek değişkenli analizler ve Spearman korelasyon analizi verilerin analizinde kullanıldı. Bulgular: Araştırmaya katılan hastaların yaş ortalamasının 53,70±11,44 yıl olduğu belirlendi. Araştırma grubunun %57,8’inin sol memede kanser ve %44,8’inin Evre I’de ve ameliyattan sonra geçen süre ortalamasının 26,92±10,79 ay olduğu bulundu. Hastaların %39,0’ına meme koruyucu cerrahi yapıldığı, %35,7’sine ameliyat sonrası radyoterapi ve kemoterapi uygulandığı belirlendi. Hastalık Kabulü Ölçeği puan ortalaması 30,54±7,59, SF-12 fiziksel özet skor: 43,39±6,85, zihinsel özet skor: 39,44±10,05’tir. Hastaların EORTC QLQ-C30 fonksiyonel skala alt boyut puanları yüksek, semptom skalası alt boyut puanları düşük olarak saptandı. EORTC QLQ-BR23 ölçeği fonksiyonel skala (cinsel haz ve gelecek beklentisi hariç) ve semptom skalası alt boyutlarından düşük puan aldıkları belirlendi. Sonuç: Araştırma sonucunda meme kanserli hastaların hastalığı kabul düzeylerinin yüksek, kansere bağlı fonksiyonel durumlarının iyi olduğu, semptomları daha az hissettikleri ancak genel yaşam kalitelerinin düşük olduğu saptandı.

Love beyond gluten: self-esteem, illness identity, and social support in romantic rejection concerns among adolescents with celiac disease.

Fear of stigmatization, high perceived partner burden, or refraining from self-disclosure may manifest in romantic rejection concerns among adolescents with celiac disease (CD), potentially impacting their health-related quality of life (HRQOL). This study examined the prevalence, predictors, and consequences of romantic rejection concerns among adolescents and young adults with CD. A cross-sectional online survey was conducted among 165 German adolescents and young adults (aged 14-22) with self-reported CD. Participants completed measures of romantic rejection concerns, illness identity, self-esteem, peer support, and CD-specific HRQOL. Participants reported moderate levels of concerns about the impact of CD on their romantic relationships, with no significant gender differences. Participants involved in romantic relationships expressed lower concerns of rejection, but similar preference for a "gluten-free partner." Hierarchical regression analysis revealed that higher illness acceptance and peer support predicted lower rejection concerns. Significant interactions emerged between self-esteem and illness acceptance, and between self-esteem and peer support. Higher illness acceptance predicted fewer rejection worries only among those with high self-esteem, while peer support played a mitigating role only for those with low self-esteem. Romantic rejection concerns significantly predicted lower CD-specific HRQOL across all domains. Anxieties about CD's impact on romantic relationships are prevalent among adolescents and may hinder their HRQOL. The findings highlight the complex interplay between self-esteem, illness identity, and social support in shaping romantic concerns. Targeted interventions focusing on peer support and fostering positive illness identity are recommended to alleviate rejection fears and improve HRQOL among youth with CD.

Health locus of control and symptom distress: The mediating role of illness acceptance and symptom severity in acute leukemia patients

ObjectiveThis study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients. MethodsFrom June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study. ResultsAll participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (β=0.087, 95%CI 0.030–0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (β=0.131, 95%CI 0.008–0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (β=0.027, 95%CI 0.001–0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress. ConclusionThere is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model. Impact on nursing practiceIt is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

Patient concerns and palliative psychology interventions within an inpatient palliative care service

Multi-professional inpatient palliative care services are increasingly complementing palliative care in hospitals alongside palliative care units. The present study aims to investigate the nature and frequency of patient concerns and palliative psychological interventions in the context of palliative psychological work, as well as the perceived quality of outcomes in an inpatient palliative service. Palliative psychological interventions for terminally ill patients at the inpatient palliative care service at Leipzig University Hospital were investigated in a prospective follow-up evaluation study. Psychological distress (distress thermometer) as well as the perceived quality of the results of the palliative psychological support (from the therapist`s perspective) were recorded. Patient concerns and psychological conversation topics and interventions were recorded. Descriptive and regression analytic procedures were used. Over a year, 355 patients in the inpatient palliative care service received psychological support, 304 participated in the study (mean age 63.8 years, 55% male, 89% oncological disease). An average of 3 palliative psychological interviews were conducted; 64% of patients reported high psychological distress (M=6.5). The most common patient concerns and topics within the interviews were dealing with emotions (87%), resources (83%), conflicting care and autonomy issues (77%) and hope (76%); significantly less common were spiritual concerns (2%) or the patient's legacy (9%). The most frequently used palliative psychological interventions included: support in illness processing and acceptance (74%) or in emotional-relieving interventions (98%) as in normalisation (75%), active listening (97%) or emotional containment (95%). Regression analysis showed that an oncological (vs. non-oncological) disease, a high number of palliative psychological interviews and interventions, comprehensive information regarding the palliative dimension of the diagnosis as well as undisturbed contact in the initial interview had a positive effect on the perceived outcome quality. The study results show that palliative psychologists play an important role in inpatient palliative care teams and should be involved as early as possible in the course of the disease. There is a need for improvement, especially in the palliative psychological care of non-oncological patients.

The clinical complexity among patients with systemic, chronic diseases

ObjectivesThis study aimed to assess the clinical complexity of patients with chronic systemic diseases (systemic lupus erythematosus [SLE] and ANCA-associated vasculitis [AAV]) using the INTERMED Self-Assessment questionnaire (IMSA) to determine the most important factors responsible for this phenomenon in these patients. MethodsThis was a cross-sectional, observational study. Questionnaires were used to evaluate biopsychosocial complexity (IMSA), quality of life (Short Form Survey [SF-36]), mental state (General Health Questionnaire – 28 [GHQ-28] and Hospital Anxiety and Depression Scale [HADS]), and acceptance of illness (Acceptance of Illness Scale [AIS]). ResultsThe final analysis included 81 patients. There was a moderate correlation between clinical complexity (total IMSA score) and quality of life related to mental health (SF-36) and mental state (GHQ-28) in patients with SLE. However, in patients with AAV, clinical complexity had a strong relationship with physical health-related quality of life and a moderate relationship with mental health-related quality of life. Stepwise regression analysis showed that low mental health-related quality of life is a predictor of higher complexity in SLE. The predictors of high clinical complexity in AAV were low physical and mental health-related quality of life and aggravated depressive symptoms (HADS). Other principal factors of clinical complexity were employment status, place of residence, social functioning, and illness duration. ConclusionThis study confirmed the importance of holistic attitudes and complex healthcare among patients with chronic diseases.

Acne influences life-changing decisions among young adults.

Acne is a chronic inflammatory disease predominantly affecting young people. This study was undertaken to assess the impact of acne in young adults on their major life-changing decisions (MLCD), paying attention to the relationships between major life-changing decisions profile (MLCDP) and Quality of Life (QoL), feeling of stigmatization and acceptance of the disease. The study was performed on 213 young people diagnosed with acne. A variety of questionnaires were employed to measure the clinical and psychological aspects of acne. The majority of patients (N.=148, 73.3%) reported at least one MLCD that acne affected in any way (mean number 2.9±3.2, range: 0-18). The most common MLCD influenced by acne appeared to be a decision of changing eating habits (N.=132, 65.3%), followed by changing habits associated with smoking and alcohol (N.=85, 42.1%) and deciding to be more active physically (N.=61, 30.2%). The total score of MLCDP ranged from 0 to 33 points (mean 5.41±6.23 points). MLCDP total score significantly correlated with clinical acne severity (P=0.006), QoL (P<0.001), stigmatization (P<0.001) and illness acceptance (P<0.001). Acne has an important impact on life-changing decisions in young adults. MLCDP correlates with impaired QoL, level of stigmatization and degree of illness acceptance. This should be taken into consideration in the holistic approach to acne patients.