Related Distress Research Articles

Lived experiences of lymphoma patients with sexual dysfunction and related sexual distress during cancer treatment

Lived experiences of lymphoma patients with sexual dysfunction and related sexual distress during cancer treatment

Diabetes distress and depression in type 2 diabetes. A cross-sectional study in 18,000 individuals in the Central Denmark region.

Type 2 diabetes is linked to psychological distress and a doubled risk of depression. This study aims to characterize individuals with type 2 diabetes experiencing diabetes distress and/or depression in relation to lifestyle and metabolic outcomes. A population-based survey in 2020 targeted individuals with type 2 diabetes (aged 18-75 years) in the Central Denmark Region. This cross-sectional study assessed diabetes distress (using Problem-Area-in-Diabetes-scale) and depression (via hospital diagnosis and prescribed medication) as exposures. Logistic regression, adjusting for potential confounders, compared exposed and non-exposed groups on lifestyle habits, metabolic factors and medication usage related to cardio-metabolic risks. Of 18,222 respondents with type 2 diabetes (46% response rate), 11% had depression, 14% had diabetes distress and 4% had both. Compared to those with neither condition, those with depression were more often smokers (OR: 2.0, 95% CI: 1.8; 2.3) and sedentary in leisure time (OR: 2.0, 95% CI: 1.8; 2.2). Diabetes distress was associated with elevated HbA1c (OR: 1.8, 95% CI: 1.5; 2.0) and treatment with insulin (OR: 1.8, 95% CI: 1.6; 2.0). Half with diabetes distress displayed stable blood glucose levels. Those with both conditions had a higher risk of sedentary behaviour (OR: 2.7, 95% CI: 2.3; 3.2), clinical insomnia (OR: 6.5, 95% CI: 5.5; 7.7) and low self-rated health (OR: 7.5, 95% CI: 6.3; 9.0) than those with either psychological condition in isolation. This study emphasizes the importance of recognizing distinct features and risk factors associated with diabetes distress and depression in individuals with type 2 diabetes. Tailored care strategies for comorbid mental health issues are crucial for comprehensive management.

Evolution of the oxyhemoglobin dissociation curve in COVID-19 related ARDS patients

IntroductionSevere hypoxemia is the leading cause of admission in intensive care (ICU) in patients with COVID-19 related acute respiratory distress syndrome (ARDS). In these patients, several studies reported a left shift of the oxyhemoglobin dissociation curve associated with a lower mortality. However, these results are conflicting, as these studies include few patients and often no control groups. Moreover, the calculation of P50, representing the PaO2 value at which 50% of hemoglobin is saturated, is not corrected for factors known to influence it (pH, PaCO2 or temperature). For all of these reasons, we compared the corrected P50 between ICU patients with severe COVID-19 related ARDS on mechanical ventilation or not, and ARDS from other causes. We investigated the evolution of the corrected P50 during the first 3 days of ICU and its relationship with ICU mortality.Methods and PatientsWe retrospectively calculated the corrected P50 in three groups of patients: intubated and mechanically ventilated COVID-19 related ARDS, non-intubated COVID-19 related ARDS and intubated patients with ARDS due to other infectious causes. The corrected P50 was calculated, on the worst blood gas analysis on days 1 and 3 of ICU admission, by the formula of Hill but modified by Dash et al., controlled for pH, PaCO2 and temperature. We collected ICU mortality.Results463 blood gas analysis at days 1 and 3 from 214 ICU COVID-19 related ARDS patients (114 with intubation and 100 without) and 35 ICU patients with ARDS from other causes were analyzed. All patients were severely hypoxemic: PaO2/FiO2 of 76 [58-108] mmHg for intubated COVID-19, 79 [60-108] mmHg for non-intubated COVID-19 and 142 [78-197] mmHg for the third group (p < 0.001). The mortality rate was higher in intubated COVID-19 related ARDS patients (44.7 versus 14 versus 37% in ARDS from other causes; p < 0.001). The corrected P50 was significantly lower in COVID-19 patients, especially in non- intubated patients (21.2 [18.8–25.2] mmHg vs. 25.5 [19.2–30.3] mmHg in intubated patients; compared to ARDS from other causes: 27.2 [23.3-35.4] mmHg; p < 0.001. The corrected P50 does not change over the first 3 days, except for the non intubated COVID-19 related ARDS and is not correlated with ICU mortality (odds ratio = 0.98 [0.95-1.03]; p = 0.51), in contrast of PaO2/FiO2 and ICU gravity scores.ConclusionThe oxyhemoglobin dissociation curve at ICU admission was left shifting in severe COVID-19 related ARDS patients regardless of the type of ventilation. This deviation increases the third day only in non-intubated COVID-19 related ARDS and was not related to the outcome.

Developing guidelines on EFT for same-sex/gender relationships: Recommendations from a Delphi study.

Emotionally focused therapy (EFT) is one of few empirically supported treatments for relationship distress. While evidence-based approaches are critical for ensuring safe and effective treatment, EFT has not been adapted for use with same-sex/same-gender (SS/SG) relationships. This study used the Delphi method to generate consensus on treatment guidelines for using EFT with SS/SG relationships. Forty therapists with clinical expertise in EFT for SS/SG relationships were recruited. Data were collected in three phases. In phase one, participants responded to open-ended questions regarding how EFT should be adapted for SS/SG relationships. Phases two and three involved participants rating the importance of the recommended guidelines. Data were analyzed using thematic analysis and descriptive statistics. The final recommendations included 49 guidelines on EFT for SS/SG relationships. The data reflected modifications to therapists' foundational knowledge and development, practice set up and orientation, and the three stages and nine steps of EFT.

Reframing prolonged negative mental health effects of COVID-19: cognitive restructuring promotes posttraumatic growth

Objective The study aimed to investigate the level of peritraumatic distress in relation to possible traumatic outcomes in university personnel and students across three pandemic waves. Methods Three cross-sectional surveys were conducted to investigate university students and staff (n = 1426). An online survey including the COVID-19 Peritraumatic Distress Index (CPDI), Ways of Coping, Impact of Events Scale (IES), and Posttraumatic Growth Inventory (PTGI) were administered across three waves. Psychometric properties of the Hungarian version of CPDI were assessed and associations between peri/posttraumatic stress and coping were explored. Cluster analysis based on posttraumatic stress and growth was used to identify subgroups. Results An increasing trend of peritraumatic stress over the waves was found. Regression analyses revealed that two coping styles, cognitive restructuring and problem analysis were negatively and positively associated, respectively, with both peritraumatic and posttraumatic stress. Two-step cluster analysis conducted on PTGI and IES scores yielded three clusters of posttraumatic changes: IES-low/PTGI-low, IES-high/PTGI-low and IES moderate/PTGI-high. Multinomial regression showed that cognitive restructuring and peritraumatic stress were significant predictors of cluster membership. Conclusion Our findings point out that cognitive restructuring may be effective for dealing with longer-term psychological results of traumatic life events, such as the COVID-19 pandemic, even in highly exposed groups of the society.

Adaptative and maladaptive cognitive processing of trauma on relationship distress among community couples.

Adaptative and maladaptive cognitive processing of trauma on relationship distress among community couples.

Associations among psychological health problems, intimate-relationship problems, and suicidal ideation among United States Air Force active-duty personnel

ABSTRACT Linkages among psychological health problems, intimate relationship distress, and suicide risk have been widely studied, but less is known about how these factors interact, especially in military populations. With steady increases in suicide rates among active military and post-service members (SMs), it is critical to better understand the relation among known risk factors. The current study addresses this gap by testing a model hypothesizing that the association between intimate-relationship problems and suicidal ideation is mediated by individual mental health symptoms. We tested this model on a sample of 862 active-duty Air Force members in committed relationships. The sample consisted of 35.0% women and 64.8% men, with an average age of 21.9 years and a mean relationship length of 2.8 years. Findings supported the hypothesized statistical mediation model. Results indicated that relationship problems contribute to psychological health problems, which, in turn, are related to suicidal ideation. These findings may help direct suicide intervention and prevention protocols that consider intimate relationship distress as a significant risk factor. Limitations and further implications for policies regarding suicide prevention in the armed forces are discussed.

Existential aspects of breathlessness in serious disease.

Breathlessness may evoke existential threat but may also affect the person with serious illness or their caregiver/s in other important ways which can be considered 'existential'. This review explores existential aspects of breathlessness in people with serious illness and presents recent studies of assessment and management of associated distress and suffering. Both existential distress and breathlessness are multidimensional and include a range of constructs, many of which have behavioural consequences. Existential distress tracks closely with distressing breathing potentially due to shared underlying neurobiological processing. Paradoxically 'contagious' and isolating effects of breathlessness and related distress have been recently highlighted. Approaches to screening and assessment vary. Preliminary studies have investigated novel approaches to breathing-related anxiety and existential distress. Studies with existential constructs as outcome measures in people with breathlessness are scarce. Interventions for existential distress developed for those with malignant disease may be beneficial for those with non-malignant conditions, but adaptations may be required. Recently proposed taxonomies of existential distress/concerns may guide assessment and direct novel therapeutic interventions in people living with serious illness and breathlessness-related distress. Neglecting existential aspects of breathlessness represents a missed opportunity to support holistic well-being in people with serious illness.

Impact of Workplace Bullying on Psychological Distress: Role of Perceived Organisational Support and Religious Coping

Despite the fact that perceived organisational support (POS) and religious coping have been advocated as a crucial component of the stress model, the roles remain unclear among academics that often associate with heavy workloads. Therefore, this study aims to examine the moderating role of POS, and the mediating role of religious coping between the relationship of workplace bullying and psychological distress among academics in higher educational institutions (HEIs). Data were collected from academic staff from private and public universities in Malaysia, and a total of 219 data were used. The results revealed that workplace bullying has a positive impact on academics’ psychological distress, and the POS significantly moderated the relationship between workplace bullying and psychological distress. However, this study failed to support the mediating role of religious coping. This study adds to our knowledge of the stress model, by focusing more on perceived organisational support in minimising psychological distress and less on personal resources (religious coping).

Internalized Racism and Mental Health: The Moderating Role of Collective Racial Self-Esteem

Internalized racism is the internalization of beliefs about racism and colonization that contribute to the acceptance of negative messaging or stereotypical misrepresentations that inform perceptions about worth and ability. Internalized racism is associated with psychological distress in racially diverse people. Collective racial self-esteem is a potential protective factor that can serve as a moderator in reducing distress and facilitating psychological well-being. The sample for the present study consisted of 526 participants who self-identified as African American, Asian American/Pacific Islander, Latinx American, or American of Arab or Middle Eastern descent. The researchers used regression with the Process macro to investigate the potential moderating properties of collective racial self-esteem on the relationship between internalized racism and psychological distress in the sample. The findings indicated that specific domains of collective racial self-esteem moderated the internalized racism–psychological distress relationship.

Peer Support Workers in Mental Health Services: A Qualitative Exploration of Emotional Burden, Moral Distress and Strategies to Reduce the Risk of Mental Health Crisis.

This research aimed to explore the experience of emotional burden among peer support workers (PSWs) in mental health care in Poland. It also examined the issue of moral distress in relation to this professional group and identified institutional sources of support for the well-being of PSWs in the workplace. The data presented in the article are derived from fourteen qualitative in-depth individual interviews with PSWs employed in four mental health centres with different organisational structures. The narratives of PSWs revealed several experiences that could be considered to be moral distress. The inability to assist patients was found to be associated with both individual and institutional barriers. Furthermore, our findings suggest that organisations can implement a number of specific practices to ensure the wellbeing of PSWs, which dissemination would be beneficial to teams employing PSWs.

Too much or not enough? Self-reported experiences of relational distress based on level of sexual desire

ABSTRACT The diagnostic of sexual desire disorders is based on not only physiological and psychological symptoms but also on the extent of distress about these symptoms. Using data from a 2022 national survey of 3,000 respondents in Austria, this paper explores the range of relational distress individuals experience about their level of sexual desire. Participants were asked, ‘Have you ever been ostracised or ridiculed in your life for feeling too much (not enough) sexual desire? If yes, in what way?’ Gender and sexual minorities were more likely than cisgender and heterosexual participants to report negative reactions to their level of desire. The paper presents the results of a thematic analysis of the 341 written answers to the latter question. The analysis identified three themes: a) harassment, such as mocking, bullying, or public humiliation; b) the pathologization of desire as a sexual disorder; and c) negative social classification with respect to gender, age, or sexual orientation. By investigating different types of negative social reactions that individuals experience with respect to their level of sexual desire, the paper critically questions an individualised notion of sexual distress that has often been the basis for biomedical and psychological interventions by highlighting social factors that produce distress in the first place.

The transition to Teletherapy: Experiences of emotionally focused therapists.

Emotionally focused therapy (EFT) is an evidence-based treatment for relational distress based on experiential, humanistic, and attachment theories. Despite the empirical support for EFT, there are no studies on EFT delivered via teletherapy. In this study, we aimed to understand therapists' experiences delivering EFT through teletherapy using open-ended questions on a web-based survey of certified EFT therapists (n = 69). Reflexive thematic analysis identified five themes: (1) Delivering EFT via teletherapy is similar to in-person therapy, (2) Delivering EFT via teletherapy is more challenging than in-person therapy, (3) Delivering EFT via teletherapy is more challenging with certain clients, (4) therapists adapted EFT for teletherapy, and (5) teletherapy and the COVID-19 pandemic changed therapy practice. The themes illustrated the mixed experiences of EFT therapists using teletherapy. Whereas some found it straightforward to use EFT via teletherapy with couples, others experienced exhaustion and barriers. Practice recommendations for delivering EFT via teletherapy are outlined, including modifying assessment strategies, implementing new safety protocols, and providing additional psychoeducation.

Adolescent close friendships, self-perceived social acceptance, and peer-rated likeability as predictors of wellbeing in young adulthood

IntroductionLinks between interpersonal relationships and physical and psychological functioning have been well-established in the literature. During adolescence, success or distress in peer relationships may have distinct effects on different aspects of wellbeing. The present study aims to examine the ways in which different adolescent peer relationship contexts (i.e., close friendship quality, social acceptance, and likability from peers) can predict outcomes relevant to adult wellbeing (i.e., social anxiety, depression, aggression, social integration, romantic insecurity, job satisfaction, and physical health). Further, the study considers how different developmental stages of adolescence may impact links between peer relationships and wellbeing outcomes.MethodPeer relationship contexts were assessed in early (ages 13–14) and late (ages 17–18) adolescence. Markers of wellbeing were measured in young adulthood (ages 28–30). A path analysis was used to examine whether the developmental timing of adolescent peer relationship contexts could predict wellbeing in young adulthood.ResultsResults suggest that, across adolescence, broader perceived social acceptance may be a more robust predictor of adult wellbeing compared to close friendship quality and peer likability. When examined at early and late adolescence separately, early adolescent social acceptance and late adolescent close friendship quality best predicted outcomes of adult wellbeing.DiscussionImplications and considerations for future research are discussed.

Predicting change in relationship distress and depressive symptoms among couples in Taiwan: The role of attachment, emotional expressivity, and gender roles in Emotionally Focused Therapy.

This pilot study examined predictors of change in relationship distress and depressive symptoms over the course of Emotionally Focused Therapy (EFT) in a one-arm, pragmatic clinical trial of 17 couples in Taiwan. Results revealed that masculine ideology, feminine ideology, traditionalism, and emotional expressivity at intake predicted change in relationship distress. Specifically, women's high traditional gender roles and traditionalism and both partners' high emotional expressivity at intake were associated with decreases in relationship distress over time. In addition, attachment and emotional expressivity predicted change in depressive symptoms. Specifically, high attachment avoidance, high attachment anxiety, and high emotional expressivity at intake were associated with decreases in depressive symptoms over time. While more research is needed, these findings offer preliminary support for the types of partners who may experience more improvement after receiving EFT in Taiwan.

Pengaruh Profitabilitas, Solvabilitas Dan Financial Distress Terhadap Audit Delay Dengan Ukuran Perusahaan Sebagai Variabel Moderasi Pada Perusahaan Manufaktur Yang Terdaftar Di BEI Tahun 2017-2021

This study aims to determine the effect of Profitability, Solvency, Financial Distress, on Audit Delay with Company Size as a moderation variable in Manufacturing Companies listed on the IDX in 2017-2021. The Moderated Regression Analysis (MRA) design is used to examine the causal relationship between the independent variable and the dependent variable which is strengthened or weakened in the presence of a moderating variable. This type of research is quantitative. The samples used 44 companies. The results showed that Profitability, Solvency and Financial Distress had a significant effect on Audit Delay. Using Company Size as a moderating variable, shows that Company Size is able to moderate the relationship of Profitability variables to Audit Delay but is unable to moderate the relationship of Solvency and Financial Distress to Audit Delay.

Assessing the impact of mobile-based interventions provided by pharmacists on glycemic control and diabetes related distress in adolescent patients with type 1 diabetes mellitus in Pakistan

Assessing the impact of mobile-based interventions provided by pharmacists on glycemic control and diabetes related distress in adolescent patients with type 1 diabetes mellitus in Pakistan

Core outcome set for studies evaluating interventions to prevent or treat delirium in long-term care older residents: international key stakeholder informed consensus study.

Trials of interventions to prevent or treat delirium in older adults resident in long-term care settings (LTC) report heterogenous outcomes, hampering the identification of effective management strategies for this important condition. Our objective was to develop international consensus among key stakeholders for a core outcome set (COS) for future trials of interventions to prevent and/or treat delirium in this population. We used a rigorous COS development process including qualitative interviews with family members and staff with experience of delirium in LTC; a modified two-round Delphi survey; and virtual consensus meetings using nominal group technique. The study was registered with the Core Outcome Measures in Effectiveness Trials (COMET) initiative (https://www.comet-initiative.org/studies/details/796). Item generation identified 22 delirium-specific outcomes and 32 other outcomes from 18 qualitative interviews. When combined with outcomes identified in our earlier systematic review, and following an item reduction step, this gave 43 outcomes that advanced to the formal consensus processes. These involved 169 participants from 12 countries, and included healthcare professionals (121, 72%), researchers (24, 14%), and family members/people with experience of delirium (24, 14%). Six outcomes were identified as essential to include in all trials of interventions for delirium in LTC, and were therefore included in the COS. These are: 'delirium occurrence'; 'delirium related distress'; 'delirium severity'; 'cognition including memory', 'admission to hospital' and 'mortality'. This COS, endorsed by the American Delirium Society and the European and Australasian Delirium Associations, is recommended for use in future clinical trials evaluating delirium prevention or treatment interventions for older adults residing in LTC.

Longitudinal assessment of cancer-related distress during cancer treatment using an electronic health record–based tool and impact of social work intervention.

207 Background: Cancer-related distress affects 35-45% of patients. 2020 ASCO-QOPI standards require baseline and ongoing psychosocial assessments, with interventions as needed. We examined the feasibility and outcomes of integrating the NCCN Distress Thermometer (DT) into the oncology electronic health record (EHR) for distress monitoring. Methods: A flowsheet containing NCCN DT questions was created in Epic EHR (Epic Systems, Verona, WI). Oncology nursing staff administered the electronic DT as part of normal patient ‘rooming’ protocol and alerted providers when distress level was ≥ 4 (DT4). This in turn generated a social work (SW) referral. SW interventions were documented in a SW dashboard. Results: Between May 1 st 2023, and April 30 th 2024, our Epic EHR DT was used to screen 6,270 distinct oncology patients, 1,852 scored >=4. 19.7%, 14.2%, 20.4% and 5.4% of the responses were in the emotional, practical, physical, and familial domains respectively. 447 (24.1%) of these patients were referred to SW. When contacted by SW, worry/anxiety in 37.5%, finance in 34.9% and transportation in 29.4% were the top three concerns. Access to grants, free-care, lodging and gas cards was made available to 37.4%, 14.5%, 20.5% and 13.1% of patients respectively. Additionally, in accordance with QOPI certification requirements, 947 patients with active oncology treatment plans were serially screened during successive cycles of chemotherapy generating 6,330 responses. 398 (42%) of these responses indicated DT4. SW referral was placed in 163 (41%) of patients with DT4. Serial distress monitoring revealed a trend towards improved distress in later cycles of chemotherapy, with DT4 percentage decreasing from 27.7% in cycle 1 to 7.9% in cycle 6. Process improvement efforts informed by this data increased DT use from 42.7% to 50% between May-October 2023 and November 2023-April 2024. Conclusions: Electronic capture of cancer related distress as part of routine care is feasible in a community-based oncology program and resulted in a variety of meaningful SW interventions. Cumulatively, distress caused by emotional, social, and practical problems are more frequent than distress caused by physical problems, underscoring the need for comprehensive cancer care. Distress tends to diminish during successive cycles of chemotherapy, possibly due to lower cancer related morbidity due to therapy, or increased patient familiarity with chemotherapy and improved use of supportive care.

Understanding Therapeutic Lying In The Care Of A Person with Dementia: An Evolutionary Concept Analysis

Abstract Background Therapeutic lying, described as any verbal or non-verbal behaviour or communication that involves the manipulation of information has been shown to be pervasive in dementia care. However, its theoretical foundation is difficult to underpin and appears to have evolved through practice without a clear definition. The aim of this study is to establish conceptual clarity around the concept of therapeutic lying in the care of a person with dementia. Methods Rodgers’ evolutionary concept analysis was used to focus on the contextual qualities of therapeutic lying. This dispositional view recognises that concepts are fluid in nature. The analysis involves deconstructing the concept into surrogate terms, attributes, antecedents, consequences and related terms to generate a greater understanding of its innate features. A systematic search relating to “therapeutic lying” and “dementia” was undertaken. The final study sample consisted of 37 papers. Results This analysis revealed therapeutic lying’s surrogate terms, attributes, antecedents, consequences and related terms in the care of a person with dementia. This study highlighted this concept is intended to be used in the person's best interests, for the purpose of doing good. However, its subjective nature makes it an extremely difficult concept to grasp collectively. Conclusion Therapeutic lying is highly dependent on individual interpretation and the caregiver’s moral compass. It can potentially damage trust in a caring relationship and may contribute to the “othering” of a person with dementia. The negative consequences surrounding this concept must be studied comprehensively before it is considered in practice. Therapeutic lying should be used only as a last resort when a person with dementia is exhibiting truth related distress. As the therapeutic effect of a therapeutic lie cannot be guaranteed, the term “well intentioned lying” is proposed as a potential alternative for the concept as this term highlights the caregiver’s good intention behind incorporating a lie during care.