Psychological Adjustment Of Patients Research Articles

Quality of life, distress and psychological adjustment in patients with colon cancer

PurposeThe purpose of this study was to investigate the relationships between distress, psychological adjustment, and quality of life in patients with colon cancer. MethodThis study employed a cross-sectional design and included 104 colon cancer patients treated at AHEPA Hospital, Thessaloniki, Greece. The assessment tools used encompassed the Distress Thermometer, MINI-MAC scale, and FACT-C to evaluate distress, psychological adjustment, and quality of life. Statistical analysis, conducted in SPSS software, encompassed correlation tests and linear regression to explore the interplay between these variables in colon cancer patients. ResultsCorrelation tests revealed that patients’ quality of life is positively correlated with a fighting spirit (r = 0.719, p < 0.001), cognitive avoidance (r = 0.634, p < 0.001), and fatalism (r = 0.518, p < 0.001), and negatively with helplessness and hopelessness (r = −0.756, p < 0.001), and anxious preoccupation (r = −0.679, p < 0.001). OLS regression findings verified these results partially for a significance level of 5% but indicated no statistically significant effect of cognitive avoidance and fatalism on quality of life, which was further found unaffected by total distress. ConclusionsThe intricate links between quality of life, distress, and psychological adjustment in colon cancer patients call for deeper investigation. A personalized approach in psycho-oncology care is essential for comprehensive treatment. These findings highlight the significance of addressing the psychological and emotional needs of colon cancer patients, as observed in the study's results.

PSYCHOLOGICAL ADJUSTMENT AND RELATED FACTORS IN PATIENTS WITH OSTOMY

Background: Ostomy has become a common therapy for treating gastrointestinal diseases such as colorectal cancer. Patients with ostomy experience many problems including appearance change, uncontrolled discharge and odour, sexual dysfunction, decreased social functioning, and difficulties taking care of themselves. Because of these problems, many patients with ostomies feel anxious, unconfident and afraid to participate in social activities. However, previous studies investigating psychological adjustment in patients with ostomies are scarce. Objectives: This study aimed to survey the level of psychological adjustment and to determine factors associated with the level of psychological adjustment in patients with ostomies. Materials and Method: A descriptive cross-sectional study was conducted on 77 patients with ostomies at Can Tho University of Medicine and Pharmacy Hospital. The Ostomy Adjustment Inventory-23 (OAI-23) scale was used to interview patients. Results: 61% of patients were male; the mean age of patients was 59.2 ± 14.3 years old, the majority of the Kinh ethnic group (96.1%); 50.6% of participants had a secondary or high school level and 43% of patients had a permanent ostomy. The psychological adjustment score was 40.4 ± 9.8 with 52% of patients assigned to a moderate level of psychological adjustment and 48% assigned to a low level of psychological adjustment. There was a relationship between psychological adjustment and gender (p=0.0001), duration of ostomy (p=0.003) and complication (p&lt;0.001). Patients who received all support related to ostomy care had a higher level of psychological adjustment (p=0.0004). There were no significant differences in psychological adjustment scores among patients with different age groups, residences, ethnicities, marital statuses, education levels, economic statuses, type of surgery, and comorbidities. Conclusions: Patients with ostomy had a moderate level of psychological adjustment. The results indicated a need for supporting programs for patients with ostomies so that they can have better mental health. This can help patients to have optimal treatment and quality of life.

Psychosocial distress and psychological adjustment in patients with ocular loss: a framework analysis

BackgroundPatients with ocular loss tend to have physical and psychosocial difficulties. Maxillofacial prosthetic specialists involved in the treatment should be trained with competence to manage psychological complications. However, due to the multifactorial origin of the psychosocial distress, designing such training activities can be challenging. This research aimed to construct a conceptual framework illustrating the effects of ocular loss on patients’ physical and psychosocial well-being and their coping strategies, to propose the learning content of training sessions.MethodsA semi-structured interview and a topic guide were employed to explore the perceptions from patients who were receiving their first custom ocular prosthesis, fabricated by maxillofacial prosthodontists. The participants were selected using a purposeful sampling up until data saturation. The data were analyzed using framework analysis.ResultsTwelve patients participated in this research. Four main themes emerged from the data analysis: (1) Impact of ocular loss, (2) Factors influencing psychosocial distress, (3) Psychological adjustment, and (4) Expected treatment outcomes. Each theme appeared to have influence on the other, rather than presenting itself independently. Although patients with ocular loss experienced both physical and psychosocial difficulties, psychological distress was greatly influenced by self-perceived disfigurement, etiology, and social status. Therefore, they needed to develop their coping strategies including rehabilitation with ocular prosthesis.ConclusionVarious forms of psychological adjustments were necessary in these patients with ocular loss to resume their daily lives. The specialist involved in the treatment should also partake in patients’ psychological adjustment and should be competent in psychological management skills, such as supporting patients to meet their expectations.

Influence of Disease Severity on Psychological Adjustment of Patients with Myasthenia Gravis

Influence of Disease Severity on Psychological Adjustment of Patients with Myasthenia Gravis

Psychotherapeutic Interventions to Improve Psychological Adjustment in Type 1 Diabetes: A Systematic Review.

Background: International clinical practice guidelines highlight the importance of improving the psychological and mental health care of patients with Type 1 diabetes mellitus (T1DM). Psychological interventions can promote adherence to the demands of diabetes self-care, promoting high quality of life and wellbeing. Methods: A systematic review was carried out to determine whether psychological treatments with a specific focus on emotional management have an impact on glycemic control and variables related to psychological adjustment. Comprehensive literature searches of PubMed Medline, Psycinfo, Cochrane Database, Web of Science, and Open Grey Repository databases were conducted, from inception to November 2019 and were last updated in December 2020. Finally, eight articles met inclusion criteria. Results: Results showed that the management of emotions was effective in improving the psychological adjustment of patients with T1DM when carried out by psychologists. However, the evidence regarding the improvement of glycemic control was not entirely clear. When comparing adolescent and adult populations, findings yielded slightly better results in adolescents. Conclusions: More rigorous studies are needed to establish what emotional interventions might increase glycemic control in this population.

More than Ownership: The Importance of Relationships with Companion Dogs for the Psychological Adjustment of Fibromyalgia Patients.

This study explored the role of companion dogs for psychological adjustment to pain in patients with fibromyalgia with different levels of social support. It also considered the potential moderating effects of the quality of the owner-dog relationship and the use of interactions with dogs as a coping strategy. A cross-sectional approach was followed using an online questionnaire. Linear regression analyses were performed on data obtained from 106 participants (dog owners and non-owners). Sub-analyses were performed on 64 dog owners. Complex associations were observed between human social support, dog ownership and anxiety/depression levels. For participants with low levels of social support, owning a dog was associated with higher levels of anxiety and depression. In contrast, for moderate and high levels of social support, owning a dog was associated with lower levels of anxiety and depression. Sub-analyses showed that participants in this study actively used interactions with companion dogs to manage their pain more frequently than other pain coping strategies. Among those interactions, patting and stroking the dog to cope with pain was associated with lower anxiety levels, even after adjusting for social support. Emotional closeness with the dog was associated with lower depression levels. Obtained results highlight the importance to go beyond mere ownership when addressing the effects of companion dogs and suggest that the development of emotional ties with companion dogs and the active use of interactions with these animals to cope with pain may contribute to better psychological adjustment in patients with fibromyalgia, regardless of human social support.

Concordance and non-compliance: a psychological perspective

Promoting concordance is a key element of all non-medical prescribing practise. However, more than half of medications prescribed are not taken properly or not taken at all. The reasons for a patient's non-compliance with prescribed medication is complex but the factors that promote compliance are becoming more clearly understood. This article considers what is now understood about the psychological impact prescribing medication has on patients and emphasising the need for prescribers to think about the role they adopt when prescribing. It recommends key communication skills that support the patient's psychological adjustment to change and acknowledges that the prescribing process often forms part of a larger process in which patients are adapting to significant life events. Concordance therefore hinges on skills like empathy and ensuring a prescribers approach to prescribing is truly person centred.

Relationship between ego identity reform and social support in psychological adjustment of patients with head and neck cancer

Relationship between ego identity reform and social support in psychological adjustment of patients with head and neck cancer

Impact of the COVID-19 Pandemic on Health-Related Concerns, Quality of Life and Psychological Adjustment in Young Adults with Congenital Heart Disease

Background: The risk for a severe disease course in case of infection with SARS-CoV-2 in young adults with congenital heart disease is largely unknown, potentially leading to uncertainty and anxiety among affected patients. This study aims to investigate health-related concerns, health-related quality of life and psychological adjustment in patients with congenital heart disease compared to healthy peers during the COVID-19 pandemic. Methods: One-hundred patients with congenital heart disease and 50 controls (M = 29.7, SD = 3.8 years) were recruited. They completed an online survey including the assessment of health-related concerns regarding COVID-19, the 12-item Short Form Health Survey and the Brief Symptom Inventory. Results: Patients considered COVID-19 to be a more serious issue (Generalized odds ratio [GenOR] = 1.67, p = 0.04), were more concerned about becoming infected (GenOR = 2.93, p < 0.001) and expressed more fear about leaving their homes (GenOR = 1.81, p = 0.004) while general anxiety symptoms were not different between groups (p = 0.23). Patients relied more on family and friends for support (30% vs. 2% in controls, p < 0.001) and reported better compliance with protective measures (p = 0.03). Mental health-related quality of life and psychological adjustment were not different between groups (p = 0.17 and p = 0.68, respectively). Physical health-related quality of life was lower in patients compared to controls (p = 0.03). Conclusions: Young adults with congenital heart disease in Switzerland are more concerned about their health during the COVID-19 pandemic compared to healthy peers. These concerns, however, do not translate into generally impaired mental wellbeing. The impact of the easing of lockdown measures on long-term anxiety levels and quality of life requires further study

Biopsychosocial model of resilience in young adults with multiple sclerosis (BPS-ARMS): an observational study protocol exploring psychological reactions early after diagnosis

IntroductionMultiple sclerosis (MS), the most common neurological disease causing disability in young adults, is widely recognised as a major stress factor. Studies have shown that the first years after the...

Effect of group acceptance and commitment therapy on post-traumatic growth of patients with concomitant brain injury

Objective To investigate the effect of acceptance and commitment therapy intervention on post-traumatic growth of patients with concomitant brain injury in group context. Methods From January 2016 to January 2017, 40 patients with recovery from craniocerebral injury such as car accidents and work-related injuries were set as the control group, and regular health education and guidance were conducted twice a week for 6 times. From February to February 2018, 42 patients with recovery from craniocerebral injury such as car accidents and work-related injuries were set as observation groups. The observation group was given a 3-week group acceptance and commitment therapy intervention on the basis of the control group. Before and after the intervention, the simplified Chinese version of the post-traumatic growth rating scale was used for evaluation. Results After intervention, the total scores of life perception, personal strength, new possibility, relationship with others, self-transformation and post-traumatic growth were (18.68±3.86), (11.35±2.67), (10.49±2.48), (14.35±2.95), (10.49±2.32), (65.36±14.28) points in the observation group, and were (13.23±3.10), (9.46±2.41), (6.82±1.72), (11.81±2.06), (7.91±1.89), (49.23±11.18) points the control group, the difference between the two groups were statistically significant (t=7.325-8.289, both P<0.05). Conclusions Group acceptance and commitment therapy intervention can improve the post-traumatic growth level of patients with recovery period of craniocerebral injury, and provide a reliable basis for clinical medical staff to promote positive psychological adjustment of patients with recovery period of craniocerebral injury. Key words: Craniocerebral injury; Acceptance and commitment therapy; Group therapy; Post-traumatic growth

AB059. Psychological status investigation and psychological adjustment of patients with erectile dysfunction

BackgroundTo understand the present situation of psychological symptoms of erectile dysfunction (ED) patients and analyze their related factors to give appropriate psychological adjustment.MethodsOne hundred and five patients diagnosed with ED from March 2016 to March 2017 that visited our Outpatient Clinic of Andrology were recruited. Baseline date including age, educational level, marital status, weight, smoking and drinking status, etc. were gathered. Psychological status for included participants were evaluated using Symptom Checklist 90 (SCL-90), an elf-assessment symptom scoring symptom. The erectile status for the participants were assessed by International Index of Erectile Function 5 (IIEF-5). A multivariate linear regression model was applied to investigation the possible factors affecting the erectile status, with an adjusting R2 to interpret the variability.ResultsIn the assessment of SCL-90, the score was relatively higher in the enrolled patients than in the norm, except for the score in the “interpersonal relationship” item. Besides, the identified factors that could significantly affect the SCL-90 score were the duration of ED and patient’s marital satisfaction level. Furthermore, the nocturnal penile erection and the depression and anxiety psychological problems could statistically influence the IIEF-5 scores.ConclusionsObvious psychological problems existed in ED patients, in which depression and anxiety statistically influence the IIEF-5 scores. The optimal treatment strategy should be targeted in patient psychological status and combined with the treatment of the spouses.

Psychological evaluation and support in patients with left ventricular assist devices: preliminary data at 6-month follow-up

Heart disease has an impact on patient's identity and self-perception. Taking into account the wide literature about psychological aspects before and after heart transplant, it clearly emerges that there is a lack of data and results for patients up to implantation of ventricular assist devices (VAD). The aim of the present study was to explore quality of life and factors correlated with psychological adjustment in patients supported with VAD. From February 2013 to August 2014, 18 patients (17 male, mean age 57 years) under clinical evaluation before and after VAD implantation were enrolled. During interviews, patients were assessed with EuroQoL-5D questionnaire to monitor improvement of quality of life before implantation and at 3 and 6 months; critical issues, needs and point of views of patients have been described. A significant improvement in the quality of life score was observed at 3 (score 38 [interquartile range 30-40] vs 75 [60-80], p<0.05) and 6 months (38 [30-40] vs 70 [60-80], p<0.05). Overall, patients' psychological state investigated by the test showed a clear and positive trend. All patients need to empower through complete information about the device, related risks and life expectancy. Interdisciplinary approach improved compliance with therapy. Successful treatment and efficient psychological care are closely related to assessment and continuous clinical support. This approach ensures a better selection of patients and improves their compliance. Further data are needed to support our preliminary observations and to explore long-term quality of life.

An evaluation of the effectiveness of 'Time to Adjust' a group-based cognitive-behavioural-therapy (CBT) programme for patients recovering from cancer.

'Time to Adjust' (TTA) is a 6-week group-based cognitive-behavioural-therapy programme for patients recovering from cancer. The TTA intervention is designed to facilitate patient's adjustment to life after cancer by enhancing existing coping skills, developing new coping skills and drawing on peer support within the context of group delivery of the programme. The study aims to explore patient psychological adjustment and to identify features of the intervention that patients find most beneficial. This retrospective repeated measures design study represents a clinical evaluation of a group-based intervention routinely delivered by the Cancer Psychology Service at University Hospital Limerick. TTA was open to patients with a cancer diagnosis who had completed their surgery, radiotherapy and chemotherapy treatment by the programme start date. Patients self-referred and suitability for the programme was assessed by pre-programme clinical interview. Pre- and post-intervention data from 59 participants was collected using self-report measures of stress and coping. A brief end-of-programme questionnaire provided descriptive feedback on patients' experience of the programme. Findings revealed favourable trends in the psychological adjustment of patients. Self-reported depression, anxiety and negative adjustment was lower post-TTA. This study indicates that TTA supports patients' psychological recovery from cancer with multiple components of the programme facilitating psychological adjustment. Findings support the delivery of group-based therapeutic interventions for this patient group. Future research could use in-depth post-intervention interviews for a richer understanding of the programme benefits. Longer-term follow-up in could examine the degree to which benefits are maintained over time.

Beliefs About Willpower Are Related to Therapy Adherence and Psychological Adjustment in Patients With Type 2 Diabetes

Research suggests that self-control, the ability to forego immediate needs for the sake of future rewards, promotes health behavior. The present study examined the role of beliefs about willpower as predictor of self-control in the context of diabetes. Seventy-nine type 2 diabetes patients reported their beliefs about willpower, therapy adherence (i.e., self-care activities, diet, exercise), and psychological adjustment (i.e., emotional distress, well-being, life quality). Endorsing the belief that willpower is a limited versus nonlimited resource was associated with lower therapy adherence and lower psychological adjustment. How people think about their willpower might be crucial for therapy success in diabetes patients.

The Beneficial Effects of Postrhinoplasty Taping

Initial patient perceptions of rhinoplasty results are complicated by early postoperative edema, ecchymosis, and distortion. Anecdotal evidence suggests that taping the nose immediately upon splint removal aids with the patient's psychological adjustment to his or her new appearance. The authors attempt to assess the overall impact of taping after splint removal on patient well-being while providing statistical validation regarding the utility of this intervention. The authors evaluated the reaction of 24 postoperative rhinoplasty patients on the day of splint removal by photographing them and noting their verbal responses. Those patients who were obviously happy received no taping and were dismissed from the study. The remainder of the patients received flesh-colored tape (3M, St Paul, Minnesota) and their subsequent reactions were noted and photographed. Of 24 consecutive patients, 16 received tape. Fifteen of those taped initially displayed a flat affect (group A), while 1 was clearly unhappy (group B). The remaining 8 patients were obviously happy (group C) and were excluded from taping. Thirteen (86%) of those in group A displayed immediate subjective improvement after taping (χ(2) = 12.8; P < .001). The lone patient in group B continued to be unhappy and required ongoing reassurance. Application of tape immediately upon splint removal after rhinoplasty improves initial patient perceptions. Taping can provide a simple and risk-free intervention for patients who do not express immediate satisfaction.

Psychosocial Interventions With Cognitive-Behavioral Components for the Treatment of Cancer-Related Traumatic Stress Symptoms: A Review of Randomized Controlled Trials.

Cancer-related traumatic stress symptoms, including posttraumatic stress disorder (PTSD), can significantly impact the quality of life and psychological adjustment of patients and survivors with cancer. Cognitive behavioral therapy (CBT) is an effective intervention previously shown to ameliorate non-cancer-related PTSD. Because of some of the unique aspects of cancer-related traumatic stress, such as the internal and ongoing nature of the traumatic stressor, it is important to review the overall efficacy of CBT interventions in populations with cancer. To review the findings of randomized clinical trials (RCTs) testing the efficacy of interventions with CBT components for cancer-related traumatic stress symptoms, including intrusion and avoidance, in adults with cancer. Eligible RCTs were identified via search of OVID, PubMed, EMBASE, and Scopus. Bayesian random effects analysis of treatment effect sizes (ES) was conducted in a portion of the studies for which data were available. Nineteen RCTs met search criteria. Six trials reported reductions in traumatic stress symptoms as a result of the intervention and 13 studies reported null findings. Bayesian modeling based on 13 studies showed no overall discernible effect of interventions with CBT components on intrusion and avoidance symptoms. Most of the studies were not designed to target traumatic stress symptoms in highly distressed patients with cancer and did not include previously validated CBT components, such as cognitive restructuring and exposure. Thus, there was insufficient evidence from which to draw definitive conclusions about the efficacy of CBT interventions for the treatment of cancer-related traumatic stress symptoms, including PTSD. However, interventions with CBT components may have potential for the reduction of PTSD symptoms in highly distressed patients. Future research should focus on testing trauma-focused interventions in demographically and clinically diverse samples.

Uncertainty and psychological adjustment in patients with lung cancer

For many patients with lung cancer, disease progression occurs without notice or with vague symptoms, and unfortunately, most treatments are not curative. Given this unpredictability, we hypothesized the following: (1) poorer psychological adjustment (specifically, more depressive symptoms, higher perceptions of stress, and poorer emotional well-being) would be associated with higher intolerance for uncertainty, higher perceived illness-related ambiguity, and their interaction; and (2) greater avoidance would mediate associations between higher intolerance of uncertainty and poorer psychological adjustment. Participants (N = 49) diagnosed with lung cancer at least 6 months prior to enrollment completed the Center for Epidemiologic Studies - Depression Scale, the Functional Assessment of Cancer Therapy - Lung Emotional Well-being subscale, the Perceived Stress scale, the Intolerance of Uncertainty scale, the Mishel Uncertainty in Illness Scale Ambiguity subscale, the Impact of Event - Revised Avoidance subscale, and the Short-scale Eysenck Personality Questionnaire - Revised Neuroticism subscale. Mean age was 64.2 years (standard deviation [SD] = 11.0), mean years of education was 15.6 (SD = 3.1), and 71.4% were female. Hypotheses were tested with regression analyses, adjusted for neuroticism. Higher perceptions of stress and poorer emotional well-being were associated with higher levels of intolerance of uncertainty and higher perceived illness-related ambiguity. Non-somatic depressive symptoms were associated with higher levels of intolerance of uncertainty. Avoidance was found to mediate relations of intolerance of uncertainty with non-somatic depressive symptoms and emotional well-being only. Findings suggest that interventions to address avoidance and intolerance of uncertainty in individuals with lung cancer may help improve psychological adjustment.

Negative support of significant others affects psychological adjustment in breast cancer patients

Significant others play an important role in providing support in patients’ lives, but some types of support negatively affect the patients. This study was conducted in early-stage breast cancer patients to examine the structure of support, which was provided by their significant others and assessed negatively by the patients, and to identify negative support relating to the psychological adjustment of these patients. Thus, we first conducted interviews among 28 breast cancer patients to identify these support items assessed as negative; next, we conducted a questionnaire survey using the resulting items in 109 postoperative patients who had early-stage breast cancer. We performed exploratory and confirmatory factor analyses and obtained a valid second-order factor structure, including superordinate factors (excessive engagement, avoidance of problems and underestimation) and subordinate factors (overprotection, encouragement and management). Among these factors, the avoidance of problems was the only factor to be negatively associated with psychological adjustment of the patients, suggesting that these patients receive problem-avoiding support. The results of our study suggest that such problem-avoiding support from significant others can be counter-productive and potentially worsen the psychological adjustment of breast cancer patients.

Expressed emotion in wives of myocardial infarction patients: an exploratory feasibility study

We assessed the emotional components expressed by the spouses of patients at the first episode of acute myocardial infarction (AMI) and considered potential underlying links among these components and the course of the cardiac symptoms over time. This was an exploratory prospective cohort study. A sample of 50 consecutive male inpatients with a diagnosis of AMI and their wives was studied. At baseline spouses were assessed with the Camberwell Family Interview and ratings of Expressed Emotion were made. Patients completed the State-Trait Anxiety Inventory (STAI XI-X2) and the Beck's Depression Inventory (BDI). After 12 months (T1), during appropriate treatment by a cardiologist blinded to the Expressed Emotion ratings, the existence or absence of serious adverse events (death or hospitalizations because of cardiac causes) were determined as an all-or-none phenomenon. Stepwise logistic regression analysis was performed to estimate associations among illness course and Expressed Emotion subscales, STAI X1-X2, BDI scores and clinical variables. High family Emotional Overinvolvement (EOI) scores were associated with higher study entry levels of depression (P = 0.003) among the patients and high Warmth was related to higher score on state anxiety scale (P = 0.000). Poor illness course at T1 was associated with high EOI [P = 0.005, exp(B) = 0.502, 95% confidence interval 0.308-0.818]. The association among wives' emotional profile, patients' psychological variables and illness course suggested the importance of a family assessment and of interventions directed towards changing emotional behaviours which could threaten the patient's psychological adjustment and the clinical course following a heart attack.