Psychological Well-being Of Patients Research Articles

Effect of Mindfulness Meditation on Personality and Psychological Well-being in Patients with Multiple Sclerosis.

Varied evidence shows that mindfulness-oriented meditation improves individuals' mental health, positively influencing practitioners' personality profiles as well. A limited number of studies are beginning to show that this type of meditation may also be a helpful therapeutic option for persons with multiple sclerosis (MS). We evaluated the effects of an 8-week mindfulness-oriented meditation training on the personality profiles, anxiety and depression symptoms, and mindfulness skills of a group of patients with MS. A control group of patients with MS not enrolled in any training was also tested. After mindfulness-oriented meditation training, participants in this group (n = 15) showed an increase in character traits reflecting the maturity of the self at the intrapersonal (self-directedness) and interpersonal (cooperativeness) levels. Moreover, increased mindfulness and conscientiousness and decreased trait anxiety were observed in participants after the training. These data support the utility for patients with MS of therapeutic interventions based on mindfulness meditation that may lead to enhanced character and self-maturity.

Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis.

Most studies on fatigue in patients with cancer aggregate its prevalence and severity on a group level, ignoring the possibility that subgroups of patients may differ widely in their development of fatigue. This study aimed to identify subgroups of patients with clinically distinct trajectories of fatigue from diagnosis to 18months post-diagnosis. As fatigue might trigger goal disturbance, the study also identified trajectories of concrete and abstract goal disturbance and longitudinally examined their co-occurrence with fatigue. Prospective design with quantitative and qualitative method of data collection. Patients with colorectal cancer (n=183) reported on their levels of fatigue and goal disturbance shortly after diagnosis (T1 ) and at 7months (T2 ) and 18months (T3 ) post-diagnosis. Growth mixture model analyses were performed to identify trajectories of fatigue and goal disturbance. Guidelines for the clinical relevance of fatigue were applied. Four clinically distinct trajectories of fatigue were identified as follows: (1) persistent severe fatigue (25.4%), (2) moderate fatigue (56.1%), (3) no fatigue (13.8%), and (4) rapidly improving fatigue (4.7%). The majority of patients with cancer reported high disturbance of their concrete goals, while high disturbance of abstract goals was less evident. Fatigue and concrete goal disturbance co-occurred longitudinally. The fatigue and goal disturbance experienced from diagnosis to 18months post-diagnosis differ considerably for subgroups of patients with cancer. Fatigue and concrete goal disturbance are persistent burdens in the majority of patients. Investigating symptom burden beyond average trends can guide clinicians to identify patients most in need for treatment. Targeting goal disturbance might benefit the psychological well-being in patients suffering from persistent symptoms. Statement of contribution What is already known on this subject? Fatigue is a common and distressing symptom at all stages of the cancer experience. Earlier studies suggest that many patients recover from fatigue after treatment completion. Patients with cancer experience disturbance in their personal goals, which is related to poor psychological well-being. What does this study add? Developments of fatigue and goal disturbance differ between subgroups of patients with cancer but co-occur within these subgroups. About 30% of the patients experience severe fatigue after diagnosis, of which only few patients recover within 18months post-diagnosis. Targeting goal disturbance might benefit patients with severe and ongoing symptoms.

Hypopituitarism is associated with lower oxytocin concentrations and reduced empathic ability

PurposeCentral diabetes insipidus is characterised by arginine vasopressin deficiency. Oxytocin is structurally related to vasopressin and is synthesised in the same hypothalamic nuclei, thus we hypothesised that patients with acquired central diabetes insipidus and anterior hypopituitarism would display an oxytocin deficiency. Moreover, psychological research has demonstrated that oxytocin influences social and emotional behaviours, particularly empathic behaviour. We therefore further hypothesised that central diabetes insipidus patients would perform worse on empathy-related tasks, compared to age-matched and gender-matched clinical control (clinical control-isolated anterior hypopituitarism) and healthy control groups.MethodFifty-six participants (age 46.54 ± 16.30 yrs; central diabetes insipidus: n = 20, 8 males; clinical control: n = 15, 6 males; healthy control: n = 20, 7 males) provided two saliva samples which were analysed for oxytocin and completed two empathy tasks.ResultsHypopituitary patients (both central diabetes insipidus and clinical control groups) had significantly lower oxytocin concentrations compared to healthy control participants. Hypopituitary patients also performed significantly worse on both the reading the mind in the eyes task and the facial expression recognition task compared to healthy control participants. Regression analyses further revealed that central diabetes insipidus patients’ oxytocin concentrations significantly predicted their performance on easy items of the reading the mind in the eyes task.ConclusionsHypopituitarism may therefore be associated with reduced oxytocin concentrations and impaired empathic ability. While further studies are needed to replicate these findings, our data suggest that oxytocin replacement may offer a therapeutic approach to improve psychological well-being in patients with hypopituitarism.

The effect of a mindfulness-based intervention in cognitive functions and psychological well-being applied as an early intervention in schizophrenia and high-risk mental state in a Chilean sample: study protocol for a randomized controlled trial

BackgroundAccording to the projections of the World Health Organization, 15% of all disabilities will be associated with mental illnesses by 2020. One of the mental disorders with the largest social impacts due to high personal and family costs is psychosis. Among the most effective psychological approaches to treat schizophrenia and other psychotic disorders at the world level is cognitive behavioral therapy. Recently, cognitive behavioral therapy has introduced several tools and strategies that promote psychological processes based on acceptance and mindfulness. A large number of studies support the effectiveness of mindfulness in dealing with various mental health problems, including psychosis. This study is aimed at determining the efficiency of a mindfulness-based program in increasing cognitive function and psychological well-being in patients with a first episode of schizophrenia and a high risk mental state (those at risk of developing an episode of psychosis).Methods and designThis is an experimentally designed, multi-center randomized controlled trial, with a 3-month follow-up period. The study participants will be 48 patients diagnosed with schizophrenia (first episode) and 48 with a high-risk mental state, from Santiago, Chile, aged between 15 and 35 years. Participants will be submitted to a mindfulness-based intervention (MBI), which will involve taking part in eight mindfulness workshops adapted for people with psychosis. Workshops will last approximately 1.5 hours and take place once a week, over 8 weeks. The primary outcome will be the cognitive function through Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) and the secondary outcome will be psychological well-being measured by self-reporting questionnaires.DiscussionThe outcomes of this trial will add empirical evidence to the benefits and feasibility of MBIs for the psychotherapeutic treatment of patients with schizophrenia and high-risk mental states in reducing cognitive impairment in attention, working memory, and social cognition, as well as increasing the psychological well-being by empowering the patients’ personal resources in the management of their own symptoms and psychotic experiences.Trial registrationISRCTN registration number ISRCTN24327446. Registered on 12 September 2016.

Identifying Psychosocial Distress and Stressors Using Distress-screening Instruments in Patients With Localized and Advanced Penile Cancer.

We examined the effects of treatment on the psychological well-being of patients with localized or advanced penile cancer using screening questionnaires to determine the consecutive need for psychosocial care. Penile cancer is a rare, but highly aggressive, malignancy. The psychological stress of patients with penile cancer arises from the cancer diagnosis per se and the corresponding consequences of treatment. In addition, cancer-specific distress results (eg, fear of metastasis, progression, relapse, death). Studies of the psychosocial stress of penile cancer patients are rare. We undertook a prospective analysis of the data from patients with penile cancer who had undergone surgery or chemotherapy from August 2014 to October 2016 at our department. Patients were evaluated using standardized questionnaires for stress screening and the identification for the need for psychosocial care (National Comprehensive Cancer Network Distress Thermometer and Hornheider screening instrument) and by assessing the actual use of psychosocial support. The average stress level was 4.5. Of all the patients, 42.5% showed increased care needs at the time of the survey. Younger patients, patients undergoing chemotherapy, and patients with recurrence were significantly more integrated with the psychosocial care systems. Finally, 67% of all patients received inpatient psychosocial care. Owing to the potentially mutilating surgery, patients with penile cancer experience increased psychological stress and, consequently, have an increased need for psychosocial care. Therefore, the emotional stress of these patients should be recognized and support based on interdisciplinary collaboration offered.

Systematic and organizational issues implicated in post-hospitalization suicides of medically hospitalized patients: A study of root-cause analysis reports.

Medical hospitalization is a high risk period for suicide. It is important to understand system-level factors that may be associated with suicide after a medical hospitalization. Retrospective study of root-cause analysis (RCA) reports of suicide occurring within three months of Veterans Administration (VA) medical hospitalization, 2002-2015. We collected patient and system-level factors to characterize events. There were 96 RCA reports pertaining to suicide within three months of medical hospitalization. A total of 168 root causes for suicide were identified and fell into three major themes including: management of known suicide risk (N=73, 43%), decision making to monitor suicide risk (N=48, 29%), and patient engagement in treatment (N=47, 28%). RCA reports raised concerns that medical teams did not provide mental health treatment when indicated and lacked a standardized process for assessing psychological well-being in patients with a serious medical illness. In 25 cases, patients declined recommended treatment and in 15 cases, patients left against medical advice (AMA). Challenges with patient engagement in treatment and lack of standardized processes for assessing and managing suicide risk may play an important role in suicide risk after medical hospitalization. Additional high quality studies are needed to confirm our findings.

Eye-tracking-based assessment suggests preserved well-being in locked-in patients.

We assessed quality of life (QoL) and psychological well-being in patients with amyotrophic lateral sclerosis-induced locked-in state and their next of kin in a fully unbiased manner using eye-tracking computer systems. Eleven of 30 screened patients and 9 next of kin completed study procedures. Patients reported good QoL, which appeared to be at the cost of the QoL of their next of kin. Next of kin rated their own or patients' QoL similarly, but they identified different areas as important as compared with patients. Our results are of importance for the discussion of end-of-life decisions and the evaluation of patients' presumed wishes as well as for psychosocial interventions. Ann Neurol 2017;81:310-315.

Remote Monitoring of Patients With Heart Failure: An Overview of Systematic Reviews.

BackgroundMany systematic reviews exist on the use of remote patient monitoring (RPM) interventions to improve clinical outcomes and psychological well-being of patients with heart failure. However, research is broadly distributed from simple telephone-based to complex technology-based interventions. The scope and focus of such evidence also vary widely, creating challenges for clinicians who seek information on the effect of RPM interventions.ObjectiveThe aim of this study was to investigate the effects of RPM interventions on the health outcomes of patients with heart failure by synthesizing review-level evidence.MethodsWe searched PubMed, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Library from 2005 to 2015. We screened reviews based on relevance to RPM interventions using criteria developed for this overview. Independent authors screened, selected, and extracted information from systematic reviews. AMSTAR (Assessment of Multiple Systematic Reviews) was used to assess the methodological quality of individual reviews. We used standardized language to summarize results across reviews and to provide final statements about intervention effectiveness.ResultsA total of 19 systematic reviews met our inclusion criteria. Reviews consisted of RPM with diverse interventions such as telemonitoring, home telehealth, mobile phone–based monitoring, and videoconferencing. All-cause mortality and heart failure mortality were the most frequently reported outcomes, but others such as quality of life, rehospitalization, emergency department visits, and length of stay were also reported. Self-care and knowledge were less commonly identified.ConclusionsTelemonitoring and home telehealth appear generally effective in reducing heart failure rehospitalization and mortality. Other interventions, including the use of mobile phone–based monitoring and videoconferencing, require further investigation.

"Hemophilia Vertical": Effects of Therapeutic Rock Climbing on Joint Health in Hemophilia Patients with Severe Arthropathies

Background: Hemophilia is a bleeding disorder associated with frequent hemarthroses and ensuing debilitating arthropathies. Patients with hemophilia (PWH) are encouraged to participate in low impact physical activities to improve joint health, mobility, and quality of life (QoL). However, activities such as walking, swimming or physical therapy are often perceived as "boring", which results in participation in high risk activities that may cause injury or bleeding. Indoor therapeutic rock climbing is practiced successfully to improve physical and psychological well-being in patients with neuromuscular disorders, and may be a "fun" alternative for PWH. The aim of this study was to investigate the safety of therapeutic rock climbing and its effects on joint health for PWH with arthropathies.Methods: Twelve adult male patients (median age 31 years, IQR=24,41) with moderate to severe hemophilia A and arthropathies (defined by decreased normative range of motion (ROM)) were recruited from the Hemophilia Treatment Centers at University of California, San Diego, USA (UCSD) and Ludwig Maximilians University, Munich, Germany (LMU)). All participants completed 12 sessions of individually tailored indoor top rope rock climbing, instructed by a climbing coach and physical therapist. Functional and clinical joint status including ROM, Hemophilia Joint Health Score (HJHS) for elbows, knees, and ankles (n=12), climbing skills (UCSD: Yosemite Decimal Scale; LMU: Union Internationale des Associations d’Alpinisme scale), QoL measures (UCSD: Haem-A-Qol, Hep-Test-Q; LMU: Hemo-Qol-A), annual bleed rate (ABR), and clotting factor consumption were assessed in both cohorts (UCSD n=6; LMU n=6) pre and post climbing. Additionally, effects on cartilage health, joint inflammation and soft tissue hypertrophy were assessed by musculoskeletal ultrasound and power doppler (MSKUS/PD) in the UCSD cohort. Descriptive statistics and Wilcoxon matched-pairs signed-rank tests were used for data analysis. Data are expressed as median and inter-quartile range; p-values ≤ 0.05 were considered significant.Results: Compared to baseline, HJHS improved significantly after completion of the program (16.5 [IQR=6.0, 28.5] post vs 17.5 [6.0, 35.0] pre; n=12; p = 0.03). A significant increase in dorsiflexion was evident in arthropathic ankles (0 degrees [IQR= -4, 4] post vs -4 [IQR-10, -3] pre; n = 9; p<0.01), with trends towards increased ROM in arthropathic elbows and knees. All subjects advanced their climbing skills significantly (UCSD: 4 levels; LMU: 3 levels; both p-values =0.03). ABRs and clotting factor consumption were comparable before and during the climbing program for the UCSD cohort, whereas ABRs improved slightly in the LMU cohort in conjunction with pharmacokinetic tailored clotting factor therapy. Pre and post ABRs were 1 [IQR=0,4] and 0 [IQR=0,4] for the UCSD cohort (p = 1.00), and 5.5[IQR=1,8] and 1.7[IQR=0,2.3] for the LMU cohort (p=0.09), respectively. Clotting factor usage during climbing was similar between the 2 cohorts (UCSD 499 [IQR=298,593] U/kg/month; LMU 355 [IQR=250,490] U/kg/month, p = 0.39). Climbing resulted in significantly improved QoL in the LMU cohort (25.9 [IQR=21.4,30.0] points post vs 25.2 [IQR=21.0, 28.6] pre; n=6; p=0.05), but remained unchanged for the UCSD participants (p=0.31), possibly because of high QoL at outset. However, all UCSD participants voiced a meaningful increase of well-being and new confidence to overcome challenges. MSKUS/PD examinations of arthropathic joints revealed no negative effects on cartilage or soft tissue health, and demonstrated decreased inflammation.Conclusions:Therapeutic rock climbing is not only safe but improves joint health and well-being in PWH with advanced arthropathies without triggering excessive clotting factor consumption. "Hemophilia Vertical" is an innovative athletic concept without the "boring" stigma of other low impact sports, and should be promoted to advance athletic hemophilia care concepts. Disclosuresvon Drygalski:Pfizer: Consultancy, Honoraria, Speakers Bureau; Biogen: Consultancy, Honoraria, Speakers Bureau; CSL-Behring: Consultancy, Honoraria, Speakers Bureau; Novo Nordisk: Consultancy, Honoraria, Speakers Bureau; Bayer: Consultancy, Honoraria, Speakers Bureau; Baxalta/Shire: Consultancy, Honoraria, Speakers Bureau; Hematherix LLC: Membership on an entity's Board of Directors or advisory committees.

Can botox and hyaluronic acid fillers really improve a patient's psychological well-being?

Can botox and hyaluronic acid fillers really improve a patient's psychological well-being?

Psychological Well Being In Type 2 Diabetes Mellitus Patients In Mulyorejo Public Health Center Surabaya

Introduction: Living with chronic diseases such as Diabetes mellitus type 2 will make patients experience change or imbalance include biological, psychological, social and spiritual. One of psychology aspects in patients with Diabetes mellitus type 2 is psychological well being (PWB). Emotional response of type 2 DM patients since the early diagnosis to begin undergoing the treatment will be different for each person. Type 2 DM patients need a good transition process to achieve well being state. The transition from a healthy to a diseased condition is needed for the successful self care management of type 2 DM patients. The purpose of this research was to explore the description of PWB in patients of type 2 Diabetes mellitus in six aspects of PWB and PWB facilitate and inhibitor factors in type 2 DM patients. Methods: This research used qualitative design research with case studies approach. The subject of research was seven participants who met the inclusion criteria. Data collection was done by structured interview and observation. Data analysis was done by thematic analysis. Result and Analysis: This study generated 14 themes. The result showed that the process of type 2 DM patients subjected to the process of transition from a healthy condition into ill condition. The transition process started with cyclic lose response which influence type 2 DM patient to self control and make a right decision-making to self care. Self-control would make type 2 DM patients able to adapt and engage with new experiences that become a new habit for type 2 DM patients and will facilitate type 2 DM patients in adapting to the internal and external environment and make type 2 DM patients have a positive hope in their life. Discuss and conclusion: finding in this study would hopefully be beneficial for professional health staff to make assessment about PWB in type 2 DM patients, nurse hopefully can assist patients in transition with the condition of type 2 DM. Need further research about the relation between self acceptance and self control, activation process till engagement to new habit in type 2 DM patients, perceived support to PWB in type 2 DM patient DM.Keywords: psychological well being, type 2 Diabetes mellitus, qualitative

Kesejahteraan Psikologis pada Pasien Diabetes Mellitus Tipe 2 di Puskesmas Mulyorejo Surabaya

Introduction: Living with chronic diseases such as Diabetes mellitus type 2 will make patients experience change or imbalance include biological, psychological, social and spiritual. One of psychology aspects in patients with Diabetes mellitus type 2 is psychological well being (PWB). Emotional response of type 2 DM patients since the early diagnosis to begin undergoing the treatment will be different for each person. Type 2 DM patients need a good transition process to achieve well being state. The transition from a healthy to a diseased condition is needed for the successful self care management of type 2 DM patients. The purpose of this research was to explore the description of PWB in patients of type 2 Diabetes mellitus in six aspects of PWB and PWB facilitate and inhibitor factors in type 2 DM patients.Methods: This research used qualitative design research with case studies approach. The subject of research was seven participants who met the inclusion criteria. Data collection was done by structured interview and observation. Data analysis was done by thematic analysis.Result and Analysis: This study generated 14 themes. The result showed that the process of type 2 DM patients subjected to the process of transition from a healthy condition into ill condition. The transition process started with cyclic lose response which influence type 2 DM patient to self control and make a right decision-making to self care. Self-control would make type 2 DM patients able to adapt and engage with new experiences that become a new habit for type 2 DM patients and will facilitate type 2 DM patients in adapting to the internal and external environment and make type 2 DM patients have a positive hope in their life.Conclusion: finding in this study would hopefully be beneficial for professional health staff to make assessment about PWB in type 2 DM patients, nurse hopefully can assist patients in transition with the condition of type 2 DM. Need further research about the relation between self acceptance and self control, activation process till engagement to new habit in type 2 DM patients, perceived support to PWB in type 2 DM patient DM.

The role of psychological skills within physiotherapy: a narrative review of the profession and training

The importance of treating the psychological well-being of patients is increasingly recognised as an integral part of physiotherapy provision and specified in the World Health Organisation (WHO) and National Institute for Health and Care Excellence (NICE) guidelines. However, the term psychology encompasses a huge variety of aspects including; communication skills, goal setting, imagery, personality theories and effective inter-disciplinary practices which need be trained. The purpose of this review is to explore the historical development of physiotherapy as a profession in the context of present standards requiring physiotherapists to manage psychological issues that impact rehabilitation. The review will focus specifically on how the role of psychology in practice has evolved and whether this is reflected in current physiotherapy training programmes. Electronic papers were identified through a rigorous search of CINAL, AMED, MEDLINE, PsychINFO and EMBASE. Due to the historical exploration of this review, no time limits were applied to the searches and articles were retrieved as far back as 1894. The history of the profession demonstrates a very ‘hands on’ approach to treatment with minimal psychology related practices. Whilst numerous studies exploring psychology training in physiotherapy have reported significant inconsistencies across UK undergraduate physiotherapy programmes. Due to shifts in the dynamics of healthcare, it is apparent that physiotherapy programmes would benefit from including psychology skills training, as a core module, to meet these ever changing demands. Future research should explore what psychological interventions physiotherapists currently utilise in daily practice, as well as practitioner feelings on the standard and relevance of the psychology content provided in their formal training.

Promoting Patient and Caregiver Engagement to Care in Cancer.

The positive outcomes associated with Patient Engagement (PE) have been strongly supported by the recent literature. However, this concept has been marginally addressed in the context of cancer. Limited attention has also received the role of informal caregivers in promoting physical and psychological well-being of patients, as well as the interdependence of dyads. The Cancer Dyads Group Intervention (CDGI) is a couple-based psychosocial intervention developed to promote engagement in management behaviors, positive health outcomes, and the quality of the relationship between cancer patients and their informal caregivers. The article examines the ability of the CDGI to promote adaptive coping behaviors and the perceived level of closeness by comparing cancer patients participating in the intervention and patients receiving psychosocial care at usual. Results indicate that individuals diagnosed with cancer attending the CDGI present significant increases in Fighting Spirit and Avoidance, while reporting also reduced levels of Fatalism and Anxious Preoccupation. Initial indications suggest that the intervention may contribute to strengthening the relationship with the primary support person.

Applied investigation of person-specific and context-specific factors on postoperative recovery and clinical outcomes of patients undergoing gastrointestinal cancer surgery: multicentre European study

IntroductionCancer treatments have greatly advanced over the past two decades causing survival improvements and reduced complications from cancer surgery. However, the cancer diagnosis and the effects of treatment modalities pose...

Diabetes Health Profile-18 is Reliable, Valid and Sensitive in Singapore

The Diabetes Health Profile-18 (DHP-18) measures diabetes-related psychological well-being in patients with type 2 diabetes mellitus (T2DM). It includes 3 subscales: psychological distress (PD), barriers to activity and disinhibited eating. The psychometric properties of the DHP have not been evaluated in Asia. The aim of this study was to determine the psychometric properties of the DHP in multiethnic Singapore. Patients between the ages of 18 to 65 diagnosed with diabetes (either type 1 or type 2) for at least 1 year were recruited from a diabetes outpatient clinic in a tertiary hospital. They completed a set of self-administered questionnaires including sociodemographic information and the DHP. Validity of the DHP was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Reliability was assessed with internal consistency and sensitivity was determined by effect size, associated with detecting a statistically significant and clinically important difference between various patient subgroups. A total of 204 patients with mean age 45.4 (11.9) years, comprising 64% males and 50% Chinese, 27% Indian and 12% Malay were studied. In CFA, model fit was poor. Forced 3-factor EFA supported the original 3-factor structure of the DHP. Convergent and discriminant validity was demonstrated (100% scaling success). DHP was sensitive across majority of social demographic, clinical and social-functioning determinants (i.e., effect size >0.3). Cronbach's alpha exceeded 0.70 for all subscales. Ceiling effects were negligible but large floor effects were seen for the PD subscale (23%). The DHP is valid, reliable and sensitive for measuring well-being in Asian patients with T2DM.

Social skills, social networks and psychological well-being of patiens with spinal cord injury

The paper presents information concerning the relations between the subjective evaluation of social skills, parameters of the social network and the factors determining psychological well-being ofpatients with spinal cord injury sequellae (SCIS). Thus, one of the focuses of the diagnostic and therapeutic work of a clinical psychologist and psychotherapist in the rehabilitation hospital environment becomes as well a subjective assessment by SCIS patients of their own social skills, as the development of these skills, contributing to the expansion of the social network, which is a resource for the provision ofpsychological wellbeing ofpatients. This testifies not only to the need for correction of the emotional state ofpatients, but also the necessity of specific psychotherapeutic interventions. Such interventions should be aimed at the increasing in the level of communication skills which are useful for the formation of new social relationships and the development of the social network of patients (group forms of training, support groups, chat forums, etc.).

Diabetes distress in males and females with type 1 diabetes in adolescence and emerging adulthood

BackgroundAge and gender are important factors in the adjustment and psychological well-being of patients with chronic physical illness. AimTo explore the gender and age differences in diabetes distress between adolescents and emerging adults with type 1 diabetes (T1D). Subjects and methodsDiabetes distress was compared in 255 adolescents and 283 emerging adults with T1D using Problem Areas in Diabetes scale. ResultsHigh diabetes distress level was found in 22.8% of participants.Lack of confidence in self-care (6.0 vs 3.0, p=0.002), negative emotional consequences (10.0 vs 6.0, p=0.004), and overall score (18.75 vs 11.25, p=0.002) were higher in adult than in adolescent males, when adjusted for age at T1D onset. Negative emotional consequences (13.0 vs 10.0, p=0.005) and overall score (25.0 vs 20.0, p=0.016) were higher in adult compared to adolescent females, when adjusted for age at T1D onset.Lack of confidence in self-care (6.0 vs 3.0, p=0.002), negative emotional consequences (10.0 vs 6.0, p=0.015), and overall score (20.0 vs 11.2, p=0.005) were higher in adolescent females compared to males, when adjusted for age at T1D onset. Negative emotional consequences score was higher in adult females compared to males (13.0 vs 10.0, p=0.029), when adjusted for age at T1D onset.In conclusion, our findings show that patients with T1D have greater burden of diabetes distress in emerging adulthood than in adolescence and add to evidence suggesting the importance of addressing diabetes distress in clinical care and the necessity of wider picture beyond the physical manifestation of diabetes to be taken into consideration.

Anxiety, depression and psychological well-being in a cohort of South African adults with Type 2 diabetes mellitus.

BackgroundThe prevalence of diabetes mellitus (DM) has increased at alarming rates globally. South Africa has the second highest number of people in Africa living with DM, with prevalence rates being among the top five countries in Africa. Accordingly, psychological issues associated with DM have been a growing focus of attention. Studies have found that patients with DM have elevated levels of anxiety and depression, and decreased levels of well-being. In South Africa, there is a paucity of studies on the psychological issues associated with DM.ObjectivesThe aim of this paper was to explore the prevalence and association of anxiety, depressive features and psychological well-being in patients with Type 2 DM.MethodIn a cross-sectional survey, patients with Type 2 DM were recruited from public and private facilities. The Hospital Anxiety and Depression Scale (HADS), the General Health Questionnaire (GHQ-28) and WHO-5 Well-being Index (WHO-5) were administered.ResultsFour hundred and one participants completed the questionnaires. On the WHO-5, 277 (69%) reported good well-being, while 124 (31%) indicated poor well-being and were considered at risk for depressive features. On the HADS, 186 (46%) had mild-to-severe depressive features and 128 (32%) had mild-to-severe anxiety. There was a strong negative correlation between the WHO-5, HADS and General Health Questionnaire (GHQ) scales, which indicated that an increase in anxiety and depressive features decreased psychological well-being.ConclusionHealth-care providers should identify and treat anxiety and depression as a standard part of diabetes care. Patients should also be referred to the appropriate mental health professional as part of the management of diabetes.

Psychological Well-Being in Patients After Preemptive Kidney Transplantation

BackgroundPreemptive kidney transplantation (PKT) is associated with improved patient and graft survival as compared with transplantation in previously dialyzed patients. Complications related to dialysis are avoided in preemptively transplanted patients. Psychological functioning of those patients is still under investigation. The aim of the study was to evaluate the acceptance of illness, satisfaction of life, and anxiety in patients preemptively transplanted (PET) and transplanted after dialysis (PTD). MethodsThe present study compares 23 pairs of PET and PTD patients after kidney transplantation from the same donor. Each patient completed a set of psychological questionnaires: Acceptance of Illness Scale, Satisfaction With Life Scale, and State-Trait Anxiety Inventory. Pairs were examined in the same moment, from 7 days to 5 years after transplantation. The PET and PTD groups did not differ significantly in respect to sex, underlying renal diseases, incidence of acute rejection, surgical complications, and graft function. More PTD patients had delayed graft function (P < .05). ResultsThe statistical analysis revealed a significant lower acceptance of illness as well as satisfaction with life in PET recipients (P < .05). The groups differed significantly in the trait of anxiety but not in the state of anxiety. ConclusionsAlthough the medical benefits of PKT are widely known, numerous psychological problems may occur in patients who do not have difficulties of dialysis and who after transplantation are faced with unexpected discomfort, which influences psychological well-being. Further effort should focus on providing psychological support during qualification to the transplantation and in follow-up after surgery.