Levels Of Distress Research Articles

The emotional burden of type 1 diabetes: A cross-sectional study to understand associations between diabetes distress and glucose metrics in adulthood.

Advancements in type 1 diabetes (T1D) management, such as continuous glucose monitoring (CGM), have helped people achieve narrower glucose ranges, but associations between CGM and diabetes distress are unclear. Although higher HbA1c is associated with higher distress, associations with other glucose metrics are unknown. To better understand this relationship, we characterized diabetes distress in a sample of CGM users and compared differences in glucose metrics (measured via CGM) between those with higher versus lower distress. CGM users with T1D from the T1D Exchange Registry completed an online survey including diabetes distress (DDS-2) and shared CGM data (N = 199). CGM metrics were computed from all available data within 3 months prior to survey completion. Participants were grouped by distress level: lower (DDS-2 < 3, n = 120) or higher (DDS-2 ≥ 3, n = 79). Welch's t-tests were used to compare mean differences in CGM metrics between groups and MANCOVA was used to further probe mean differences. Approximately 39.7% participants reported higher diabetes distress. Welch's t-tests revealed participants with higher distress spent significantly more time in higher glucose ranges (above 180 mg/dL and above 250 mg/dL), less time in target glucose ranges (between 70 and 180 mg/dL and between 70 and 140 mg/dL) and had higher glucose management index values compared to those with lower distress (p < 0.01). MANCOVA models showed similar results. CGM users continue to experience diabetes distress. Moreover, higher distress appears to be associated with hyperglycaemia. These findings provide support for broader screening efforts for diabetes distress.

The impact of heart failure caregiver burden and patient heart failure severity: analysis of the needs assessment tool: advanced heart failure (NAT: PD-HF)

Abstract Background Not only patients with heart failure (HF), but also their caregivers have reported experiencing distress, depression, anxiety, social isolation, and health problems related to caring for a patient. Needs assessment tools have been used in clinical practice to identify patients' problems and needs from an early stage, however, their relationship with caregiver burden and the severity of the HF patients they care for has not been well investigated. Purpose The purpose of this study is to examine the relationship between distress and HF severity in patients and their caregivers using the Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD- HF). Methods We enrolled consecutive 106 chronic HF patients who were admitted to a university hospital and assessed needs by the NAT: PD-HF between February 2023 and July 2023. We also enrolled 95 of their caregivers. The NAT: PD-HF is administered by the health care provider in the form of an interview with the patient and their caregiver. The questionnaire consists of an assessment of the patient's well-being and an assessment of the caregiver's ability to care for the patient. The healthcare provider completes the tool by indicating the level of distress (none, mild, significant) for each section. The severity of the New York Heart Association (NYHA) functional classification is examined in each patient. Results The median age was 72 years (interquartile range 59-81), and 41% were in NYHA class III or IV. The most common relationship between patients and their primary caregivers was partners (53%), followed by children (26%), parents (8%), and siblings (5%). There were 100 patients (94%) with more than mild distress, 57 with NYHA I or II and 43 with NYHA III or IV (P = 0.037). There were also 84 (88%) caregivers with more than mild distress, 47 with NYHA I or II, and 37 with NYHA III or IV of the patients they cared for (P = 0.026). Twenty-four patients (22.6%) were in severe distress, of which 10 were NYHA I or II and 14 were NYHA III or IV (P = 0.044). Among caregivers, 18 (18.9%) were in severe distress, of whom 6 with NYHA I or II and 12 with NYHA III or IV for whom they are caring (P = 0.010). Conclusions Regardless of the severity of HF, caregivers were found to experience distress as similar rate as that in the HF patients they cared for. The proportion of patients and caregivers experiencing distress was found to increase with the severity of HF. It is important to introduce palliative care for HF from the early stage of the disease and to support not only the patient but also the caregivers by using screening tools to identify distress.

Changes in mental health and illness perception in patients with hypertrophic cardiomyopathy referred to hybrid cardiac telerehabilitation in comparison to usual care - a randomised-control trial

Abstract Purpose Hypertrophic cardiomyopathy (HCM) is a complex cardiac disorder, that influences patients' physical capacity and quality of life, as well as the risk of sudden cardiac death (SCD). Patients with HCM often experience emotional distress due to the uncertainty of their condition and have a threatening illness perception (the way individuals make sense of their illness, which can have a significant impact on adherence to treatment). Current studies suggest that some HCM patients could benefit from hybrid cardiac telerehabilitation (HCTR) in terms of somatic and psychological status. This study is part of a research project investigating the safety and effectiveness of hybrid cardiac telerehabilitation for HCM patients. The specific focus of this part is to evaluate the changes in mental health status and illness perception of HCM patients who have been referred for cardiac telerehabilitation compared to those receiving usual care. Methods An RCT study was conducted, with the inclusion criteria for the study of being above 18 y.o., HCM without LVOT obstruction, NYHA Class II or III, LVEF ≥ 50%, and having CIED. The study involved telerehabilitation (HCTR) and control (CG) groups. Both groups were completing questionnaires assessing illness perception (Brief IPQ) and overall psychosocial distress (GHQ-28) with its 4 domains: somatic symptoms, anxiety, social impairment, and depression. Psychological assessment was performed at the beginning and at the end of telerehabilitation/outpatient care, and at 3, 6 and 12 months after the end of care (T1/T2/T3/T4/T5). Results There was a significant improvement in the overall distress level in the HCTR group (p=0.003) but not in the CG (p=0.559). It remained significant in the HCTR group for the T2 (p&amp;lt;0.001), T3 (p=0.008), and T4 (p&amp;lt;0.001). The positive change was observed in somatic symptoms only in the HCTR group: for T2 (p=0.025) and T3 (p=0.032) compared to the T1. The gradual decrease in anxiety level was observed in the HCTR group, but not in the CG, with a significant difference for T4 (p=0.013) compared to T1. Although there was an improvement in social impairment in both groups (p=0.049 for the CG, and p=0&amp;lt;0.001 for the HCTR group), only in the HCTR group it held a stable pattern after the intervention (p&amp;lt;0.001 for T2; p=0.013 for T3; p=0.032 for T4). There were no changes in the level of depressive symptoms in either of the compared groups. There were also no significant differences in the illness perception (p=0.200 for the HCTR group and p=0.090 for the CG), although the HCTR group showed short-term improvement after three months of HCTR (T2) (p=0.032). Conclusions There are significant benefits of hybrid cardiac telerehabilitation for mental health, level of distress, and illness perception in HCM patients. It is worth noticing that this improvement is short-term, and prolonged effects might require providing additional support during extended care.overall distress in HCTR vs CGsubscales of GHQ_28 in HCTR vs CG

Gender Nonconformity, Minority Stress, and Psychological Distress Among Sexual Minority Adolescents.

Purpose: Sexual minority adolescents (SMAs) have disproportionate experiences of mental health symptoms during adolescence, and minority stress contributes to mental health inequities among SMAs. Gender nonconformity (GNC) could place SMAs at higher risk for minority stress and subsequent mental health symptoms. The current study was designed to examine associations between GNC, minority stress, and psychological distress among SMAs. Method: SMAs ages 12-17 years (n = 455; mean age = 15.52 years) in the United States completed a cross-sectional online survey from February to July 2022, including measures of GNC, peer victimization, family rejection, negative expectations, negative disclosure experiences, internalized homonegativity, and psychological distress. We conducted path analysis to examine associations between GNC, minority stressors, and psychological distress, including indirect effects of GNC on psychological distress via minority stress. Results: In multivariable path analysis adjusted for demographic characteristics, GNC was associated with higher levels of peer victimization and negative expectations and lower internalized homonegativity among SMAs. Higher levels of peer victimization and negative expectations were associated with higher psychological distress. GNC was indirectly related to higher levels of psychological distress via higher peer victimization. Conclusions: The current study is the first to document associations between GNC and multiple minority stress experiences among SMAs, and GNC was indirectly related to psychological distress among SMAs via peer victimization. Although all SMAs would benefit from interventions designed to reduce peer victimization and increase their capacity to cope with minority stress, such interventions may be particularly beneficial for SMAs who are gender nonconforming.

Occupational Stress, Psychological Distress, and Coping Strategies of First-Level Judges in the Philippines: Examining the Influence of Demographics and Caseloads

Judges worldwide face intense pressure from heavy workloads, emotionally charged cases, and limited resources, leading to burnout and decreased public trust in the justice system. While individual coping is important, systemic change is crucial. This descriptive-correlational study investigated occupational stress, psychological distress, and coping strategies among 357 first-level judges in the Philippines. The study employed three standardized instruments: the Occupational Stress Scale, the Kessler Psychological Distress Scale (K10), and the Filipino Coping Strategies Scale (FCSS). This study revealed that first-level judges in the Philippines experience high levels of occupational stress and psychological distress. However, they also utilize a range of coping strategies to manage these challenges. The study found no significant relationship between occupational stress, psychological distress, and coping strategies and the demographic profile of the first-level judges. This suggests that these challenges are inherent to the judicial role itself rather than influenced by individual differences. The study concludes that interventions and support systems tailored to the specific demands of the profession are needed to address these challenges. The findings served as the basis for the Wellness Program for the first-level court judges in the Philippines.

Vitamin C intake, psychological distress and health outcomes in patients with heart failure

Abstract Background Patients with heart failure (HF) have lower dietary vitamin C intake than healthy adults, which may increase oxidative stress and worsen important patient-reported health outcomes (functional status and quality of life [QOL]). Patients with HF are more likely to have higher levels of psychological distress (anxiety and depressive symptoms). However, it is not known whether psychological distress is a link in the association of dietary vitamin C with health outcomes. Objective To examine the inter-relationships among dietary vitamin C intake, psychological distress (anxiety and depressive symptoms), and health outcomes (functional status and QOL) in patients with HF. Method We performed a secondary analysis of baseline data from 206 adults with HF (female: 33%, age: 61±12, NYHA class III/IV: 44%) with complete data on dietary vitamin C intake, anxiety, depressive symptoms, functional status, and QOL. Dietary vitamin C intake was assessed using a 4-day food diary and analyzed using the Nutrition Data System for Research software program. Low dietary vitamin C intake was defined as averaged daily intake below the estimated average requirement (EAR) from the Institute of Medicine of 75 mg/day for men and 60 mg/day for women. Anxiety was assessed using the Brief Symptom Inventory Anxiety subscale. Depressive symptoms were assessed using the Beck Depression Inventory II. Functional status was measured using the Duke Activity Status Index. Quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. Linear regression was conducted using the PROCESS macro in SPSS. Results Eighty-four patients (41%) had low dietary vitamin C intake based on the EAR standard. In bivariate analyses, patients with low dietary vitamin C intake had higher levels of anxiety, depressive symptoms, poorer functional status, and worse QOL (all p &amp;lt;.005). In the mediation regression model, low dietary vitamin C intake was directly associated with higher levels of anxiety, but not with depressive symptoms. Depressive symptoms were directly associated with functional status and QOL. Dietary vitamin C intake was not directly associated with functional status or QOL. Low dietary vitamin C intake was indirectly associated with poor functional status through higher levels of anxiety and depressive symptoms (Figure 1). Similarly, low dietary vitamin C intake was indirectly associated with worse QOL (Figure 2). Conclusion Anxiety and depressive symptoms link the relationship between dietary vitamin C intake and functional status and between dietary vitamin C intake and QOL. Our findings highlight the importance of including interventions to enhance diet quality and psychological well-being as part of HF treatment to improve health outcomes.Vitamin C and functional statusVitamin C and quality of life

Psychological Distress and Quality of Life Among Military Trauma Patients.

Military trauma has a significant impact on soldiers, affecting many aspects of their lives, with the highest impact on their quality of life and psychological wellness. This study aimed to measure psychological distress and its relationship with the quality of life among Jordanian military trauma patients. A descriptive cross-sectional study was conducted in The Hashemite Protection Departments for military causalities in Amman, Irbid, and Al-Karuk. The authors used the WHO Quality of Life Scale-Brief and Trauma Symptoms Checklist-40 scales for assessing the quality of life and psychological distress among Jordanian military trauma patients. A total of 145 trauma survivors participated in the study and responded to all questionnaires out of 173 distributed. The study was approved by the institutional review board of Al-Zaytoonah University. The result of this study revealed that military trauma survivors had high levels of psychological distress with a mean of 85.66 (SD = 19.418). The subscale of "Dissociation symptoms" had the highest rating (M = 19.92, SD = 5.096), while the "sleep disorders" subscale had the lowest rating (M = 10.000, SD = 3.501). On the quality of life scale, a moderate level of quality of life resulted among the participants with a mean of 61.620 (SD = 17.190). The "general health" subscale scored the highest among the other domains (M = 18.241, SD = 5.434), while the "physical health" domain scored the lowest (M = 4.910, SD = 2.078). Furthermore, a statistically significant negative relationship between psychological distress and quality of life was reported (r =-0.178, P < .05). Jordanian injured military persons had a moderate quality of life level and high level of psychological distress. A structured follow-up program is required to be developed to improve those patients' health and quality of life. Furthermore, additional research is needed to investigate the impact of military trauma and services on soldiers in Jordan and the Middle East.

The relationship between teamwork and moral distress among NICU nurses

BackgroundIn the demanding environment of the neonatal intensive care unit (NICU), quality nursing care hinges on effective teamwork and communication among nurses. However, this requirement for close cooperation can expose nurses to significant levels of moral distress. This study aims to explore the connection between the quality of teamwork and the experience of moral distress among NICU nurses.MethodsEmploying a cross-sectional, multicenter descriptive correlational design, this study surveyed female NICU nurses across the cities of Khorramabad and Semnan. Census sampling was utilized over five months, from July to November 2023, resulting in the participation of 190 nurses. Tools for data collection included demographic questionnaires, the Team-STEPPS Teamwork Perception Questionnaire (T-TPQ), and the Moral Distress Scale-Revised (MDS-R) for nurses.ResultsThe findings revealed an average teamwork score of 3.73 ± 0.78, denoting an acceptable level, and an average moral distress score of 91.2 ± 56.7, indicating a low level. In multiple linear regression, marital status showed a direct positive correlation (β = 38.5, SE (β) = 9.3, p < 0.001), while the number of children (β = -14.6, SE (β) = 4.9, p = 0.003) and the teamwork score (β = -1.1, SE (β) = 0.12, p < 0.001) were inversely correlated with moral distress.ConclusionThe study’s results suggest that stronger teamwork among nurses correlates with reduced moral distress. Enhancing teamwork within NICUs could lead to policy development focused on the safety and quality of newborn care, also potentially alleviating moral distress experienced by nurses.

Fear of recurrence and its association with mental health outcomes after spontaneous coronary artery dissection (SCAD)

Abstract Background Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction, predominantly affecting younger women with few traditional cardiac risk factors. The condition is characterised by relatively high rates of recurrence. Recent qualitative studies demonstrate that SCAD survivors often experience fears about the future, particularly relating to SCAD recurrence and death. Research in psycho-oncology demonstrates that experiencing fear of cancer recurrence predicts worse outcomes for mental health and quality of life, an association that is also likely in cardiac patients. To date, no quantitative research has investigated fear of recurrence and its association with mental health in SCAD survivors. Purpose The aim of this study was to investigate the prevalence of fears relating to SCAD recurrence and the association of fear of recurrence with mental health outcomes. Methods 293 SCAD survivors completed an online questionnaire assessing the psychosocial impacts of SCAD. Participants rated whether they experienced these impacts ‘not at all’, ‘a small amount, ‘a moderate amount’ or ‘a large amount’ within the first six months of their SCAD. Items related to fears about the future, recurrence, and death were extracted for analysis. Participants also completed measures of anxiety (Generalised Anxiety Disorder-7), depression (Patient Health Questionnaire-9), distress (Cardiac Distress Inventory - Short Form), and mental health related quality of life (Short Form 12, mental health component). Results In the six months following their SCAD, 97.6% of survivors experienced some level of worry about having another SCAD, 95.6% were concerned about triggering another SCAD, 95.6% experienced fear of the future, and 82.6% experienced fear of dying. Reports of experiencing ‘a large amount’ of fear in these areas were 54.6%, 45.1%, 42.7%, and 30.4% respectively. The amount of worry reported about having another SCAD was significantly associated with increased levels of anxiety, depression, and cardiac distress, and reduced mental health quality of life. Conclusions Almost all SCAD survivors reported fears, worries, and concerns related to recurrence. Worry about SCAD recurrence was significantly associated with important mental health outcomes. Cardiac health professionals should monitor fears of recurrence in their patients, as a large amount of worry may be indicative of poor mental health, and referral to psychology services may be appropriate.Rates of fears of SCAD recurrence

Prevalence and Risk Factors of Psychological Distress in Patients With Early-Stage Lung Cancer During Preoperative Period: A Cross-Sectional Study.

This study aims to investigate the prevalence of significant psychological distress and identify risk factors associated with it among early-stage lung cancer patients in the preoperative period. Lung cancer is a major cause of cancer deaths worldwide, with low survival rates and significant psychological distress. While much research has focused on distress in advanced-stage patients, less is known about the prevalence and risk factors of psychological distress in early-stage lung cancer patients before surgery. A cross-sectional study. The study included 427 early-stage lung cancer patients preparing for surgery. Researchers used a study-specific questionnaire to gather general information and employed the Distress Management Screening Measurement, Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 to assess personal situations and psychological distress levels. Statistical analyses investigated distress across various patient characteristics and examined correlations with anxiety and depression. Binary logistic regression identified significant predictors of psychological distress. The study found that 41.9% of early-stage lung cancer patients experienced significant psychological distress preoperatively, with an average score of 3.31 ± 2.18. Psychological distress was significantly positively correlated with depression (r = 0.474, p < 0.001) and anxiety (r = 0.591, p < 0.001). Significant risk factors for psychological distress included pulmonary nodules (OR = 2.884, 95% CI: 1.496-5.559), smoking history (OR = 2.092, 95% CI: 1.016-4.306) and chronic diseases (OR = 2.013, 95% CI: 1.073-3.776). Early-stage lung cancer patients often experience a high incidence of clinically significant psychological distress during the preoperative period, strongly associated with depression and anxiety. Adverse factors contributing to psychological distress include multiple indeterminate pulmonary nodules, smoking history and concurrent chronic diseases. Routine screening for psychological distress in these patients is recommended, along with personalised interventions and self-management strategies to help alleviate their distress during the perioperative period.

Trauma-informed acceptance and commitment therapy with peer coaching for college students: A pilot randomized controlled trial.

The current pilot randomized controlled trial evaluated the acceptability, feasibility, and preliminary efficacy of a mental health promotion intervention for college students based on trauma-focused acceptance and commitment therapy (Harris, 2021). This hybrid intervention combined web-based modules with peer coaching in a research lab setting. Seventy-eight students were randomized to either the intervention group, "Present and Open for Values" training, or an active control group, "Crash Course" training. Psychological distress and life satisfaction levels were assessed at baseline, postintervention, and 3 months postintervention. Open-ended feedback, rating scales, and completion rates suggested that both conditions were well-received and feasible. Longitudinal mixed-effects regression models with subject-specific intercepts were used to examine intervention effects. Participants in the Present and Open for Values condition reported significantly greater reductions in psychological distress levels compared to the control group, both at the end of the intervention and 3-month follow-up. Additionally, they reported significantly greater improvements in life satisfaction levels at these same intervals compared to baseline measurements. No significant changes in these outcomes were observed for the control condition. These findings suggest that the Present and Open for Values intervention with peer coaching is a promising approach for addressing mental health issues among college students, with the potential to be scaled up for broader implementation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Feasibility and pilot study of Indonesia’s first telehealth support program for gynecological cancer survivors undergoing chemotherapy

Most Indonesian gynecological cancer survivors experience chemotherapy side effects on their physical and mental health as they face unmet needs of supportive care, which increases the likelihood of discontinuing treatment. Interventions in telehealth assist survivors in resolving these issues. The aim of this pilot study was to determine the feasibility of fighting distress, self-efficacy, health effects, and sexual (FoRSHE-X) interventions and evaluate their potential impact on distress level, side effects knowledge and management, self-efficacy, and sexual quality of life. The study involved gynecological cancer survivors who underwent chemotherapy and participated in ten weeks of individual social media-based education, tele-coaching, and teleconsultations, from September 2023 to June 2024. The study feasibility and pilot outcomes were evaluated using descriptive statistics and qualitative thematic analysis. Of the twelve women recruited, six (50%) completed the study, filled out pre- and post-intervention questionnaires, and participated in interviews. Fifty-four virtual education, coaching, and consultation sessions were performed individually. The statistical results indicated that participants were highly satisfied with the telehealth program, which significantly increased their knowledge (p=0.02), health practices (p=0.04), and self-efficacy (p=0.01). The qualitative analysis highlighted participants' and coaches' perspectives on the study’s acceptance, barriers, and recommendations. In conclusion, this pilot study suggests that a definitive trial to assess the FoRSHE-X interventions is feasible, acceptable, and can be applied not only to gynecological cancer survivors but also to other types of cancer, thereby broadening the potential impact of the study.

Experiences of mental health and poverty in high-income countries during COVID-19: A systematic review and meta-aggregation

Systematic reviews have been published that explore the experiences of living in poverty, yet there are no known studies that have synthesized the findings of research exploring the experiences of mental health and wellbeing of persons living in poverty during COVID-19. To address this gap, we conducted a systematic review and meta-aggregation of qualitative evidence using the method described by the Joanna Briggs Institute (JBI) following the PRISMA guidelines. Of 8391 titles and abstracts screened, we included 23 studies in our review and meta-aggregation. In conducting our meta-aggregation, we generated three synthesized findings: 1) magnification of inequities and marginalization during COVID-19; 2) difficulty accessing resources during the lockdown; and 3) the lockdown causing changes in mental health and wellbeing. The findings of this review suggest that persons living in poverty experienced increased difficulties with mental health and well-being during COVID-19. This was largely influenced by the presence of pandemic restrictions and increasing financial precarity that resulted in rising levels of psychosocial distress. Research regarding the plight of persons living in low income is needed to inform policy and practice for future pandemics in order to decrease the vulnerability of this population. Implementing evidence-informed policies and practices that mitigate the negative psychological effects of physical distancing restrictions on persons living in poverty are needed, and these can be identified through future research efforts.

Socio-demographic, psychosocial, and suicidal behavior correlates of stigma among people with physical disabilities in Northwest Ethiopia

BackgroundPeople with physical disability may experience stigma in various ways, including social avoidance, negative attitudes and discrimination. Stigma among people with physical disability can vary based on study participants’ socio-demographic, behavioral and psychosocial factors. Therefore, identifying the socio-demographic, behavioral and psychosocial correlates of stigma is important because the findings of the study can help inform future interventions aimed at reducing stigma among individuals with a physical disability.ObjectiveThis study aimed to assess the psychosocial, suicidal behavior, and socio-demographic correlates of stigma among people with physical disabilities in the University of Gondar communities, northwest Ethiopia.MethodData collection was conducted among 269 participants who had a physical disability within University of Gondar communities in Northwest Ethiopia. The participants, who included students and employees at the University completed the stigma scale for chronic illness (SSCI-8), which was used to measure stigma. The participants also completed four other questionnaires, including the perceived social support, the Kessler − 10, and the WHODAS. We used independent sample t-tests and ANOVA to examine group differences in stigma, while Pearson correlation analysis identified the correlates of stigma with other continuous variables.ResultThe overall mean stigma score among people with a physical disability was 14.68 with 95% CI (13.98, 15.38). About 90.71% of people with physical disability had stigma. Stigma varied along socio-demographic variables, including marital status (single) with a mean (SD) score of 15.17 ± 5.64, educational level (diploma and above) with a mean (SD) score of 14.99 ± 5.89, and occupational status with a mean (SD) score of 15.54 ± 5.79 (p < 0.001). In addition, stigma varied among participants with suicidal ideation with a mean (SD) score of 16.93 ± 7.43 and attempt (18.74 ± 8.41), levels of psychological distress (severe) with a mean (SD) score of 20.88 ± 6.94 (p < 0.001), low perceived social support with a mean (SD) score of 18.60 ± 7.54 (p < 0.001), and moderate/severe level of functional impairment with a mean (SD) score of 21.76 ± 7.34 (p < 0.001). Moreover, stigma was positively correlated with psychological distress (r = 0.42, p < 0.001) and WHO Disability Assessment Schedule (r = 0.5, p < 0.001). Conversely, it was negatively correlated with perceived social support (r=-0.31, p < 0.001).ConclusionOur findings indicate that stigma is prevalent among people with physical disabilities, with variations observed based on marital status, occupation, and education level. Additionally, stigma showed significant correlations with functional impairment, psychological distress, perceived social support, and health related quality of life. Therefore, addressing stigma, promoting social support and providing appropriate interventions can help improve the psychological well-being and quality of life of individuals with physical disabilities.

Exploding Head Syndrome among Patients Seeking Help for Tinnitus and/or Hyperacusis at an Audiology Department in the UK: A Preliminary Study.

Exploding head syndrome (EHS) is characterized by hearing a sudden loud noise or experiencing a sense of explosion in head during the transition of sleep-wake or wake-sleep. The experience of EHS shares similarities with tinnitus, where an individual perceives a sound without any external sound source. To the authors' knowledge, the possible relationship between EHS and tinnitus has not been explored. Preliminary assessment of prevalence of EHS and its related factors among patients seeking help for tinnitus and/or hyperacusis. Retrospective cross-sectional study. A total of 148 consecutive patients who sought help for tinnitus and/or hyperacusis at an audiology clinic in the United Kingdom. The data regarding demographics, medical history, audiological measures, and self-report questionnaires were collected retrospectively from the patients' records. Audiological measures comprised of pure-tone audiometry and uncomfortable loudness levels. The self-report questionnaires which were administered as a part of standard care comprised of the Tinnitus Handicap Inventory, numeric rating scale of tinnitus loudness, annoyance, and effect on life, hyperacusis questionnaire, Insomnia Severity Index, Generalized Anxiety Disorder scale 7, and Patient Health Questionnaire (PHQ-9). To establish presence of EHS, participants were asked "Do you ever hear a sudden, loud noise, or feel a sense of explosion in your head at night?" EHS was reported by 8.1% of patients with tinnitus and/or hyperacusis (12 out of 148). The patients with and without EHS were compared, but no significant relationships were found, between the presence of EHS and age, gender, tinnitus/hyperacusis distress, symptoms of anxiety or depression, sleep difficulties, or audiological measures. The prevalence of EHS in a tinnitus and hyperacusis population is similar to that in the general population. While there does not seem to be any association with sleep or mental factors, this might be due to the limited variability in our clinical sample (i.e., most patients exhibited high level of distress regardless of EHS). Replication of the results in a larger sample with more variety of symptom severity is warranted.

Symptom- and function-based trajectories of patients with dementia in hospital and community palliative care settings in the last two weeks of life: a retrospective cohort study

BackgroundThe prevalence of dementia is increasing worldwide and many people with the condition require some level of palliative care. However, the trajectories of function and symptom burden in palliative care services at the end of life remain unclear. This study aimed to describe and compare the longitudinal trajectories of function and symptom burden among patients with dementia between hospital versus palliative community care services in the last two weeks of life.MethodsA retrospective cohort study used data from the Australian Palliative Care Outcomes Collaboration. Patients with dementia who died between 1 January 2013 and 31 December 2020 from the Australian Palliative Care Outcomes Collaboration. Four validated clinical instruments were used to collect outcomes on each individual’s function and symptom distress and severity. Multilevel models were used to estimate the differences in clinical trajectories between hospital and community-based palliative care in the last two weeks of life.ResultsPatients with dementia tended to have low levels of distress for most symptoms but increasing levels of functional impairment. There were no or only marginally significant differences in the symptom trajectories between the community and hospital groups (OR ranged from 0.57 to 1.97). Although clinical trajectories of function were relatively similar between two groups, statistically higher functional indicators were observed for people when admitted to community palliative care services (OR = 0.42 and 2.27, respectively).ConclusionsOur findings suggest that community-based palliative care services can be as effective as hospital-based care for many patients with dementia nearing the end of life. With appropriate support for families, community-based care could serve as a viable alternative to hospital-based care for some patients in the final stages of dementia.

Telephone-Based Acceptance and Commitment Therapy for Caregivers of Persons with Dementia: Results of a Randomized Controlled Trial

ABSTRACT Objectives Family caregivers of persons with dementia (PwD) experience high levels of distress. We used a randomized-controlled trial to investigate the effects of telephone-based acceptance and commitment therapy (tbACT) for family caregivers. Methods Caregivers were randomly allocated to an intervention group (tbACT, n = 41) or an untreated control group (CG, n = 40). The intervention consisted of eight weekly sessions of tbACT. Depression and anxiety (primary outcomes), physical symptoms, pre-death grief, care-related thoughts, acceptance (secondary outcomes), quality of life, coping and well-being (well-being/coping outcomes) were assessed pre- and post-assessment. A 6-month follow-up was conducted. Results Compared to CG participants, tbACT participants had at post-assessment significantly lower depressive symptoms; fewer physical symptoms (rheumatic pain); better physical health; more resource utilization (coping with daily hassles, social support); better coping with the care situation and better emotional well-being. During the six-month follow-up, tbACT participants showed less pre-death grief, fewer physical symptoms, and more utilization of resources related to coping with daily hassles. Conclusions tbACT is a feasible and promising psychotherapeutic intervention for family caregivers of PwD. Because of small sample size our results are preliminary. Clinical Implications Most of the effects of tbACT were not maintained 6 months after the intervention, suggesting that booster sessions may be helpful.

Prevalence of psychological distress: a scientific approach towards the mental health and wellbeing of population during the SARS-COV-2 outbreak

Background The global challenge of the novel coronavirus has led to an unprecedented downturn, adversely affecting the health and mental wellbeing of communities worldwide. The objective of this study is to assess mental health and psychological distress levels within the general population of Peshawar, Pakistan amidst the ongoing COVID-19 pandemic. Method A cross-sectional online survey was conducted among 715 residents of Peshawar, Pakistan. The questionnaire collected data on demographics, socioeconomic status, and residential area. The Modified K10 Kessler Psychological Distress Scale was used to measure mental well-being. Descriptive statistics, including means and standard deviations, were calculated, and statistical analyses were performed using SPSS (IBM, USA, version 22). Results A total of 715 responses were collected. The comprehensive psychological distress score was identified as 25.55, signifying moderate stress levels. Among the respondents, 53.3% were females, 46.7% had completed a bachelor’s degree, 41% were employed, 78.7% were single, 93.1% were non-smokers, and 69.4% resided in urban areas. The study revealed that both gender (p=0.001) employment status (p=0.018) were linked to a more pronounced psychological impact of the outbreak. Conclusions This study highlights age, gender, employment status, and urbanization as influential factors contributing to psychological distress during the COVID-19 outbreak. As we face the challenges of the new normal, it is essential for policymakers to address these mental health concerns through targeted support and interventions, ensuring that mental health resources are accessible and responsive to the needs of affected populations.

Evaluating psychological distress in Chinese patients with head and neck squamous cell carcinoma planned for radiotherapy: a cross-sectional study using the distress thermometer.

We aim to estimate the prevalence of baseline clinically significant distress in Chinese patients with head and neck squamous cell carcinoma (HNSCC) before receiving the first radiotherapy and assess factors predictive of distress. One hundred and sixty-eight patients were enrolled to complete a set of questionnaires including Distress Thermometer (DT) and Hospital Anxiety and Depression Scale (HADS). Of these, 131 questionnaires were available for the final analysis. The accuracy of DT was validated using HADS as the gold standard, and receiver operating characteristic (ROC) curves were employed to identify the optimal cutoff score of DT. Distress was reported in sixty-two patients (47%). Patients who were visited in the last week (p = 0.022) and those with medical-related occupations (p = 0.017) were less likely to suffer from psychological distress. Additionally, religious belief was negatively associated with both the DT and HADS-T scores, indicating that patients with religious beliefs were less likely to report high levels of distress (odds ratio (OR) for DT ≥ 4 = 0.291, p = 0.039; OR for HADS-T ≥ 15 = 0.316, p = 0.047). Factors such as age, gender, marital status, education and residency did not contribute to distress levels. DT was significantly correlated with HADS-T (Correlation coefficient (r) = 0.624, p < 0.001) and the best cutoff score of DT was 4 in screening distress. DT was a brief and effective tool to screen distress among HNSCC patients.

Clinical, functional and neuropsychological status of joint replacement patients

Introduction The number of hip and knee replacement surgeries is increasing annually in Russia and worldwide. The majority of patients receiving joint arthroplasties are elderly women.The objective was to assess the clinical, functional and neuropsychological status of patients undergoing total knee or hip replacement.Material and methods The study included 448 patients admitted for elective surgery of total knee or hip replacement at the Department of Traumatology and Orthopedics of the Federal Center for High Medical Technologies (CHMT, Kaliningrad Region). Anthropometric parameters of the patients were measured, the medical history and concomitant diseases recorded. Common blood count and biochemistry test were evaluated preoperatively. Neuropsychological examination included assessment of cognitive and executive functions, levels of distress, depression, anxiety and somatization.Results Almost all patients studied were found to have varying degrees of obesity. A typical combination of concomitant pathology in volunteers was stage 2 hypertension, risk degree 2–3, and chronic gastritis in remission. Half of the volunteers showed moderate and high levels of distress, depression, anxiety and somatization. A significant number of volunteers showed moderate to high levels of cognitive decline. Age- and sex-related blood counts were slightly different from the normal ranges for a CBC and biochemistry. Changes in leukocyte count were detected.Discussion Leukocyte counts indicated the osteoarthritis induced inflammatory process in most patients. Mitochondrial dysfunction and aging of the immune system contributed to the “proinflammatory status.” The high rate of cognitive impairment in volunteers was associated with age and comorbidity, cardiovascular conditions, in particular. Distress and anxiety were associated with emotional reactions to surgery.Conclusion The factors reported can affect the duration and course of rehabilitation. The “pro-inflammatory status” of patients can complicate the healing of a postoperative wound. Neuropsychological disorders noted during postoperative rehabilitation can have a significant impact on physical recovery, social and professional adaptation.