Distress Factors Research Articles

Is disease activity associated with social support and psychological distress in Crohn’s disease patients? Results of a cross-sectional study in a Chinese hospital population

ObjectivesThis study aims to assess the relative of social support and psychological distress in disease activity among patients with Crohn’s disease (CD) in China, and explore whether sex moderates the...

2.2 Global Changes in Risk Factors for Child and Adolescent Mental Distress Through the Lens of Meta-Analytic Research

2.2 Global Changes in Risk Factors for Child and Adolescent Mental Distress Through the Lens of Meta-Analytic Research

Interpersonal problems as a predictor of outcome in psychotherapy for depressive and anxiety disorders: A multilevel meta-analysis.

Although interpersonal problems are assumed to play an important role in the treatment of depression and anxiety, meta-analytic attempts to explore the association between interpersonal problems and outcome in psychotherapy for these patients are missing. This study aims to conduct a systematic review and meta-analytic synthesis of the association between patients' baseline interpersonal problems and outcome in psychotherapy for depressive and anxiety disorders. We conducted a three-level meta-analysis (i.e., disaggregating sampling variance, within-study variance, and between-study variance) of the interpersonal problems-outcome prediction (IPOP; as measured by the total distress factor of Inventory of Interpersonal Problems). We found 40 effect sizes (ESs) nested within 21 primary studies. The three-level model showed a significant aggregated effect size of IPOP, r = -.13, SE = 0.02, 95% CI [-.18, -.09]; t(39) = -5.71, p < .001; d = -0.27, with greater interpersonal distress being associated with worse psychotherapy outcome. Results showed significant heterogeneity across effect sizes with considerable variability across studies (I² = .39) and to a lower extent across reported outcomes (I² = .19). Graphical measures did not show evidence of a substantial publication bias. This meta-analysis showed that baseline overall interpersonal problems are a small but robust negative predictor of psychotherapy outcome. Therapists might benefit from exploring patients' interpersonal problems at the beginning of therapy to enhance their prognostic inferences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient-Reported Distress and Acute Care Utilization for Cervical Cancer Patients Undergoing Concurrent Chemoradiation

Although concurrent chemo-radiation (CRT) and brachytherapy (BT) is curative for locally advanced cervical cancer (LACC), it requires complex coordination of care and is associated with treatment-related toxicity. Our objective was to evaluate patient-reported symptoms and social distress in LACC patients undergoing concurrent CRT and BT to determine whether they are predictive of unplanned acute care utilization. Patients with LACC treated with concurrent CRT and BT between 2013-2020 completed the Edmonton Symptom Assessment Scale-revised (ESAS-r; 9 cancer-related symptoms ranked 0-10) and the Social Difficulties Inventory-21 (SDI-21; 21 social issues ranked 0-3) at every visit as part of routine distress screening. Acute care utilization was defined as any unplanned visit to the radiation nursing clinic, urgent care clinic, emergency department or hospitalization within 1 year from starting treatment. A logistic regression model will be used to evaluate associations between ESAS-r and SDI-21 scores and acute care utilization. Among 151 LACC patients, a total of 354 ESAS-r and SDI questionnaires were completed longitudinally. Mean age at diagnosis was 49.9 years (30-90), 44% were FIGO 2B and overall treatment time was 53.6 days (32-135). At baseline, the most prevalent moderate to severe symptoms (ESAS-r score ≥4) were well-being (50%), anxiety (44%), tiredness (43%) and pain (36%). Post-treatment, these persisted in 42%, 27%, 38%, and 26%, respectively. The most common social distress at baseline was financial (33%). Financial distress post-treatment was significantly predictive of worse well-being (OR = 5.80, p<0.06), anxiety (OR = 3.33, p<0.04) and depression (OR = 4.76, p<0.01). Use of acute care within 1 year after starting treatment occurred in 103 patients (68%) for a total of 617 visits: radiation nursing clinic 71.3%, urgent care clinic 4.4%, emergency department 8.3%, hospitalization 16%. On average there were 6.6 visits/patient (0-31), with the average number of days between treatment start and first acute care visit being 17.9 (0-74). Cervical cancer patients undergoing concurrent CRT report prevalent financial distress and moderate to severe symptoms that persist post-treatment. Acute care utilization commonly occurred during treatment, highlighting a time when additional support is needed. Predictive modelling for distress factors resulting in acute care utilization is now underway.

Exploring Risk Factors of Psychological Distress among Chinese Medical Workforce

As the pioneer in responding COVID-19 pandemic in 2019, many problems were exposed in the health system, which was concealed and neglected before the pandemic, especially mental health wellness among health workers. This paper focused on the risk factor in the health work environment, to find the external reasons for health workers as this is the most obvious and examinable way to target the association. Different risk factors in the Chinese health workplace indicated one risk factor which influences health workers in one circumstance, could also exist in other contexts. In conclusion, there is not only one risk factor associated with mental health problems, but various factors work together to trigger the bad influence. The suggestion is to pay more attention to health workers mental health wellness by monitoring their mental health status constantly, therefore, implement the intervention timely. Research and policy reviews are required for providing health workers with better circumstances, to support and sustain their mental health and well-being. Further studies are required in the Chinese rural context, as there are more challenging treatments that still require the intervention of medical professionals, and the risk factors present in remote areas may be different from those in urban medicine, so the reasons for affecting the mental health of medical staff may be different.

Time course and correlates of psychological distress post spinal surgery: A longitudinal study

Psychological distress post lumbar spine surgery is associated with poorer outcomes. There is a scarcity of studies devoted to analyzing the risk factors associated with psychological distress in patients who have undergone lumbar fusion surgery. The purpose of this study was to (1) describe the time course and severity of psychological distress using the STarT Back Tool (SBT) and (2) determine the demographic and clinical predictors of SBT score post lumbar spine fusion surgery. This retrospective longitudinal study analyzed 227 subjects with 1- and 2-level lumbar fusion surgery who underwent standardized assessment preoperatively and at 4 and 12 weeks postoperatively. Preoperative variables collected were demographic, clinical, and psychological variables. Postoperative psychological distress was measured by self-reported SBT. Risk factors for SBT over time were identified using ordinal and mixed-effects modelling. Although the trajectory of SBT levels declined postoperatively over time, at week-12, 20% of patients had moderate to high SBT. Postoperative SBT scores at week-4 time point was significantly greater than SBT scores at week-8 (OR=2.7, 95% credible interval [CrI]; 1.8-3.9). Greater SBT scores at week-4 were strongly associated with greater SBT scores throughout 12 weeks of follow-up (OR=7.3, [95% CrI; 1.2-31.4]). Greater postoperative SBT levels over time were associated with being male (OR=2.2, 95% CrI; 1.0-3.9), greater preoperative back or leg pain intensity (OR=2.2; 95% CrI: 1.0-4.4), greater preoperative leg weakness (OR=4.2, 95% CrI: 1.7-7.5) and higher preoperative depression levels (OR=4.8; 95% CrI: 1.6-10.4). Postoperative SBT levels declined nonlinearly over time. However, a sizable proportion of patients had moderate to high psychological distress at week-12 postsurgery. Greater preoperative back or leg pain intensity, leg weakness and depression levels, and male gender were risk factors of greater psychological distress postsurgery. Although requiring validation, our study has identified potential modifiable risk factors which may give an opportunity to provide early (preoperative) and targeted strategies to optimize postoperative psychosocial outcomes in patients undergoing lumbar fusion surgeries.

Orthorexia nervosa versus healthy orthorexia: Anxiety, perfectionism, and mindfulness as risk and preventative factors of distress.

Orthorexia nervosa is a recently conceptualised pathological entity presenting as an obsessive focus on healthy eating with associated psychosocial impairment. The present study investigated the differential associations between orthorexia nervosa and healthy orthorexia with distress and impairment. With a community sample (N = 268) multiple measures of orthorexia nervosa and health orthorexia were compared as explanatory variables in mediation structural equation modelling (SEM). Outcome variables assessed and investigated were psychological distress while demographic variables were controlled. The mediating roles of perfectionism and health anxiety on orthorexia nervosa were examined with further preventative mediation role of mindfulness on distress. Distinctive to other eating disorders, gender showed no significant effects on orthorexia nervosa and healthy orthorexia. Signalling measurement issues for this disorder, the different measures of orthorexia nervosa resulted in mixed findings regarding body mass index and age. Findings supported perfectionism and health anxiety as risk factors, as well as mindfulness acceptance as a preventative factor in both orthorexia nervosa and healthy orthorexia. Orthorexia nervosa and healthy orthorexia assessed by most measures, contrary to the expectations, had significant positive associations with psychological distress indicated by stress, anxiety, and depression. The complexity in differentiating orthorexia nervosa from healthy orthorexia calls for further investigation. This research effort should serve to substantiate the status of orthorexia nervosa as a distinct clinical disorder.

PIM-COVID study: protocol for a multicentre, longitudinal study measuring the psychological impact of surviving an intensive care admission due to COVID-19 on patients in the UK

IntroductionPsychological distress is common in intensive care unit (ICU) survivors and is anticipated in those who were treated for severe COVID-19 infection. This trainee-led, multicentre, observational, longitudinal study aims to...

Predicting pavement condition index based on the utilization of machine learning techniques: A case study

Pavement management systems (PMS) are used by transportation government agencies to promote sustainable development and to keep road pavement conditions above the minimum performance levels at a reasonable cost. To accomplish this objective, the pavement condition is monitored to predict deterioration and determine the need for maintenance or rehabilitation at the appropriate time. The pavement condition index (PCI) is a commonly used metric to evaluate the pavement's performance. This research aims to create and evaluate prediction models for PCI values using multiple linear regression (MLR), artificial neural networks (ANN), and fuzzy logic inference (FIS) models for flexible pavement sections. The authors collected field data spans for 2018 and 2021. Eight pavement distress factors were considered inputs for predicting PCI values, such as rutting, fatigue cracking, block cracking, longitudinal cracking, transverse cracking, patching, potholes, and delamination. This study evaluates the performance of the three techniques based on the coefficient of determination, root mean squared error (RMSE), and mean absolute error (MAE). The results show that the R2 values of the ANN models increased by 51.32%, 2.02%, 36.55%, and 3.02% compared to MLR and FIS (2018 and 2021). The error in the PCI values predicted by the ANN model was significantly lower than the errors in the prediction by the FIS and MLR models.

Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran.

Although various surveys have been conducted for sexual problems, there is a lack of population-based studies on sexual distress in Iran. Thus, we sought to determine the prevalence and predictive factors of sexual distress in this population. Overall, 1000 married women aged 16-49 years were enrolled in this study using the two-stage cluster sampling method. To identify sexual distress, the female sexual distress scale-revised (FSDS-R) was completed. The predictive factors were assessed using a checklist. A total of 318 women (31.8%) suffered from sexual distress. Among socio-demographic factors, satisfaction with marriage (p = 0.001), among personal factors history of infertility and fear of contracting sexually transmitted infections (p < 0.01), and among sexual and interpersonal factors satisfaction with the level of sexual desire (p = 0.01), pain during sexual intercourse (p < 0.01), premature ejaculation disorders in the partner (p < 0.05), and sexual satisfaction (p < 0.001) were significantly associated with sexual distress. Clinicians should evaluate sexual distress comprehensively and consider all the related dimensions. The high overall prevalence of sexual distress, with or without an identifiable dysfunction, signals the importance of health professionals being adequately prepared to discuss sexual health concerns.

Dimensional distress and orbitofrontal thickness in anxiety patients

Thickness of the medial orbitofrontal cortex (mOFC) was assessed as it varied with reported symptoms of anxiety and depression in a large sample of anxiety patients. A principal component analysis identified a primary factor of transdiagnostic dimensional distress that predicted 24% of the mOFC variance. Severity of distress symptomology was associated with thinning of the mOFC in both hemispheres for both men and women, regardless of the primary DSM diagnosis. Taken together, the data indicate that mOFC thickness might be useful as an objective measure of disorder severity as well as to assess pharmacological or psychological treatment outcome.

Prevalence and Risk Factors for Moral Distress in Pediatric Oncology Health Care Professionals.

Moral distress (MoD) is prevalent among health care professionals (HCPs) in oncology and is associated with burnout. The objectives of this study were to quantify MoD among pediatric oncology healthcare professionals (HCPs) at a Canadian quaternary care hospital, identify root causes, and evaluate change over time. Eligible pediatric oncology HCPs were identified, and consenting participants completed the Measure of Moral Distress-Healthcare Professionals (MMD-HP) and MoD Thermometer (MDT) at baseline, followed by biweekly MDTs over 12 weeks. A total of 139 HCPs participated. The mean MMD-HP score was 123 ± 57.0, range 9-288. Demographic risk factors identified for elevated MMD-HP scores were female sex (female 127.1 and male 83.6, P = .01) and nursing role (nurse 136.3 and most responsible physician 85.3, P = .02). Higher MMD-HP scores were found in HCPs who were currently considering resigning because of MoD compared with those who were not (169.9 v 115.4, P < .001). Situations involving administration of treatment to children with poor prognosis cancers that was perceived to be overly aggressive were ranked as the greatest environmental contributor to MoD. Baseline and mean MDT scores over time strongly correlated with MMD-HP scores (P < .0001 and P = .0003, respectively), with mean MDT scores showing no significant fluctuation over the 12-week period. MoD was common among pediatric oncology HCPs. Risk factors for elevated levels of MoD included both demographic and environmental factors. Implementation of systems to improve team communication and decision making, especially in the care of patients with poor prognosis cancers, may affect HCP MoD.

EFFECTS OF LOADING MASS ECCENTRICITIES ON UNSPRUNG MASS ROTATIONAL DYNAMIC RESPONSES OF HEAVY VEHICLE ON IRREGULAR ROAD PAVEMENT

Using individual independent unsprung masses in suspension system modeling is not a realistic reflection of vehicle dynamics in response to eccentric wheel kinematics and asymmetric heavy vehicle loading. This is because the use of such masses does not accurately represent the unsprung mass system's influence on heavy vehicles' dynamics, including its impact on the sprung masses or wheel pavement dynamic loading. This study aims to examine how heavy vehicle asymmetric loading and wheels' eccentric kinematic excitation affect the rotational dynamic response of the unsprung masses. A total of 450 models were used to investigate various asymmetrical cases, from which 9 3D 24 DOF heavy vehicles' 4 DOF rear tandem drive axle suspension systems were selected for analysis using SIMWISE 4D. These vehicles were tested for a pothole depth of 25 mm and a vehicle translational speed of 60 km/h. The study found that the nature of the pavement distress factor (kinematic excitation) determines the suspension's rotational dynamic response and, consequently, the sprung mass. Moreover, the load distribution on the sprung mass also affects the rotational dynamic response of the tandem beams

Moral distress in nurse leaders—A scoping review of the literature

Nurse leaders face immense organizational pressures exacerbating their distress, which has not been prioritized as much as frontline nurses. This review synthesized the literature to examine theoretical models, measures, contributing factors, outcomes, and coping strategies related to moral distress in nurse leaders. PubMed, Embase, CINAHL, and PsycINFO were searched, and 15 articles—2 quantitative and 13 qualitative studies were extracted. The scoping review identified one study using a theoretical model and two measures—the ethical dilemmas questionnaire and the Brazilian moral distress scale. Contributing factors of moral distress include internal and organizational constraints, increased workload, and lack of support impacting physical and emotional well-being and intention to quit. This review did not yield any intervention studies emphasizing the need for research to identify specific predictors of moral distress and examine their relationship to nurse leader retention, so organizations can explore targeted interventions to promote coping and mitigate distress.

Surgeons' mental distress and risks after severe complications following radical gastrectomy in China: a nationwide cross-sectional questionnaire.

This study was designed to investigate incidences of surgeons' mental distress following severe complications after radical gastrectomy. A cross-sectional survey was conducted between 1 June 2021 and 30 September 2021 among Chinese general and/or gastrointestinal surgeons who experienced severe complications after radical gastrectomy. The clinical features collected in the questionnaire included: (i) feeling burnout, anxiety, or depression; (ii) avoiding radical gastrectomy or feeling stress, slowing down the process during radical gastrectomy operations; (iii) having physical reactions, including heart pounding, trouble breathing, or sweating while recalling; (iv) having urges to quit being a surgeon; (v) taking psychiatric medications; and (vi) seeking psychological counselling. Analyses were performed to identify risk factors of severe mental distress, which was defined as meeting three or more of the above-mentioned clinical features. A total of 1062 valid questionnaires were received. The survey showed that most of the participating surgeons (69.02%) had at least one clinical feature of mental distress following severe complications after radical gastrectomy, and more than 25% of the surgeons suffered from severe mental distress. Surgeons from non-university affiliated hospitals, the junior surgeons, and existing violent doctor-patient conflicts were recognized as independent risk factors for surgeons' severe mental distress related to the severe complications after radical gastrectomy. About 70% of surgeons had mental health problems following severe complications after radical gastrectomy, and more than 25% of the surgeons suffered from severe mental distress. More strategies and policies are needed to improve the mental well-being of these surgeons after such incidences.

Personality predicts pre-COVID-19 to COVID-19 trajectories of transdiagnostic anxiety and depression symptoms.

This study aimed to characterize within-person pre-COVID-19 and coronavirus pandemic (COVID-19) transdiagnostic anxiety and depression symptom trajectories in emerging adults and determine the roles of neuroticism and behavioral activation in predicting these COVID-19-related changes. We recruited a sample of 342 emerging adults (aged 18-19 at baseline) who were screened on neuroticism and behavioral activation and completed symptom questionnaires on multiple occasions before and after the start of the pandemic. We examined estimates of the symptom factors of General Distress, Anhedonia-Apprehension, and Fears at each wave. The stress amplification model predicts a multiplicative neuroticism-adversity interaction with those high on neuroticism showing the greatest symptom increases to the pandemic. The stably elevated negative affect model is an additive model and predicts that persons high on neuroticism will display elevated symptoms at every wave. General Distress and Anhedonia-Apprehension showed large increases from the pre-COVID-19 to COVID-19 transition then decreased thereafter. The increase brought the average General Distress score to clinical levels at the first COVID-19 wave. There was a small decrease in Fears from the pre-COVID-19 to COVID-19 transition followed by a large increase. Thus, COVID-19 was associated with both increases in psychological symptoms and some resilience. Neuroticism positively predicted the pre-COVID-19 to COVID-19 transition change in Fears but was associated with a dampening of increases in General Distress and Anhedonia-Apprehension. The results disconfirmed the stress amplification model of neuroticism but partially supported the stably elevated negative affect model. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association between residential greenness and severe psychological distress and the moderating role of ‘stay-at-home’ status: a population-based cross-sectional study during the COVID-19 pandemic in Japan

ObjectiveThere is a need for public health strategies to address the negative psychological consequences of the COVID-19 pandemic, and the role of residential green exposure has gained prominence, particularly in...

Corporate Governance and Financial Ratios of Manufacturing Companies on Financial Distress: The Main Board and Development Board of IDX

Financial distress is a condition where a company is unable to meet its obligations when they directed to bankruptcy. The purpose of this study was to analyze influence of corporate governance, profitability, liquidity, leverage and earning growth on financial distress. Research sample data used in this study were manufacturing companies listed on the main board and development board on the Indonesia Stock Exchange in 2016-2020. Logistic regression analysis had been applied to analyze data of study. The results show that the factors that influence Financial Distress in manufacturing companies on the main board and development board were different. For manufacturing companies on main board, influencing factors of financial distress were independent audit committee, liquidity, leverage, and earning growth. Meanwhile, board size, profitability, liquidity, leverage and earning growth were influencing factors of financial distress for manufacturing companies on development board.

Intolerance of uncertainty, pain catastrophizing, and symptoms of depression: a comparison between adults with and without chronic pain

ABSTRACT Recent evidence suggests that individuals living with chronic pain demonstrate reduced tolerance of uncertainty compared to healthy individuals. Intolerance of uncertainty often lead to excessive worry, which may be related not only to the tendency to catastrophize pain, but also to increased distress. However, the specific nature of these relationships remains largely unexplored. The present study sought to investigate the associations between intolerance of uncertainty, pain catastrophizing, and symptoms of depression, while exploring how they differ between adults with and without chronic pain. Questionnaires were administered electronically to a community sample of 160 adults. All variables were significantly and positively correlated in the chronic pain group (n = 80), while only intolerance of uncertainty and symptoms of depression were positively and strongly correlated in the pain-free group (n = 80). Individuals in the chronic pain group reported higher levels of pain catastrophizing and symptoms of depression compared to the pain-free group, but both groups exhibited similar levels of intolerance of uncertainty. Intolerance of uncertainty and pain catastrophizing were significant predictors of the severity of depression in both groups, even after controlling for age and gender. However, intolerance of uncertainty was no longer statistically significant in the chronic pain group once pain catastrophizing was considered. These findings suggest that intolerance of uncertainty serves as a general vulnerability factor for psychological distress in adults, while pain catastrophizing acts as a specific vulnerability factor for individuals living with chronic pain. Enhancing knowledge about the role of cognitive factors in depression among individuals with chronic pain could help improve the management of this debilitating condition.

Moral distress among critical care nurses when excecuting do-not-resuscitate (DNR) orders in a public critical care unit in Gauteng.

A critical care unit admits on a daily basis patients who are critically ill or injured. The condition of these patients' may deteriorate to a point where the medical practitioner may prescribe or decide on a 'do not resuscitate' (DNR) order which must be executed by a professional nurse, leading to moral distress which may manifest as poor teamwork, depression or absenteeism. To explore and describe factors contributing to moral distress of critical care nurses executing DNR orders. The explorative descriptive qualitative design was selected to answer the research questions posed. Critical care nurses of a selected public hospital in Gauteng Province were selected via purposive sampling to participate in the study, and data were collected through semi-structured interviews. A shift leader assisted with selection of participants who met the eligibility criteria. The mean age of the participants was 36 years; most of them had more than five years' critical care nursing experience. Twelve critical care nurses were interviewed when data saturation was reached. Thereafter two more interviews were conducted to confirm data saturation. A total of 14 interviews were conducted. Tesch's eight-step method was utilised for data analysis. The findings were classified under three main themes: moral distress, communication of DNR orders and unavailability of psychological support for nurses. The findings revealed that execution of DNR orders is a contributory factor for moral distress in critical care nurses. National guidelines and/or legal frameworks are required to regulate processes pertaining to the execution of DNR orders. The study further demonstrated the need for unit-based ethical platforms and debriefing sessions for critical care nurses. The main contribution of this study was to explore and describe the factors contributing to Moral distress when executing a DNR order. This study raised awareness amongst healthcare providers on the factors contributing to moral distress amongst critical care nurses. This study highlighted the importance of developing national guidelines and legal frameworks pertaining to execution of DNR orders. This study alluded to the value of initiating debriefing sessions for critical care nurses involved in the execution of DNR orders.