Antidepressant-like activity of oroxylin A in mice models of depression: A behavioral and neurobiological characterization.

Depression is a mood disorder which causes a huge economic burden to both families and societies. However, those monoamine-based antidepressants used in clinical practice have been found to have various limitations. Therefore, currently it is very necessary to explore novel antidepressant targets and medications. As a main active component extracted from Scutellariae radix, oroxylin A possesses many pharmacological functions such as anti-cancer, anti-inflammation and neuroprotection. Here, the present study aims to investigate whether oroxylin A possess antidepressant-like actions using the chronic unpredictable mild stress (CUMS) and chronic restraint stress (CRS) models of depression, forced swim test, tail suspension test, open field test, sucrose preference test, western blotting, immunofluorescence and viral-mediated gene interference. Our results revealed that treatment of oroxylin A fully prevented both the CUMS-induced and CRS-induced depressive-like behaviors in mice. Moreover, the protecting effects of oroxylin A against CUMS and CRS on mice behaviors were accompanied with a significant enhancement on the levels of brain-derived neurotrophic factor (BDNF), phosphorylated tyrosine kinase B (pTrkB), phosphorylated cAMP-response element binding protein (pCREB) and neurogenesis in the hippocampus. Furthermore, genetic knockdown of BDNF and TrkB in the hippocampus remarkably abolished the antidepressant-like efficacy of oroxylin A in both the CUMS and CRS models of depression, proving that the hippocampal BDNF-TrkB system participates in the antidepressant mechanism of oroxylin A. In summary, our findings are the first evidence showing that oroxylin A possesses potential of being an antidepressant candidate.

Effectiveness and moderators of cancer patient-caregiver dyad interventions in improving psychological distress: A systematic review and meta-analysis.

Objective: As patients and family caregivers are increasingly viewed as a dyadic whole, growing studies have emerged that identify ways to improve the two parties' emotional distress. However, the specific effectiveness, quality, and optimal intervention details of these studies are unclear. Our objective is to synthesize the effectiveness of existing dyadic interventions for improving the psychological distress of cancer patient-caregiver dyads and identify potential moderators that influence intervention effectiveness. Methods: PubMed, Cochrane Library, Web of Science, CINHAL, Embase, and Clinical Trials were searched to identify all randomized controlled trials from inception until June 2021. Two reviewers performed the process independently. The Cochrane Risk of Bias tool was used for quality assessment. We calculated effect sizes (Hedges' adjusted g) by standard mean difference. Potential moderators influencing the intervention effects were explored. Results: We included 28 articles, of which 12 were available for meta-analysis. In total, 4784 participants were included, who were primarily middle-aged (M â€‹= â€‹58 years old), with the highest proportion reporting a diagnosis of "mixed cancer" (30%). Patients' anxiety (g â€‹= â€‹-0.31; 95% CI: â€‹-0.51 to -0.12; P â€‹= â€‹0.001; I 2 â€‹= â€‹17%) and cancer-related distress (g â€‹= â€‹-0.32; 95% CI: â€‹-0.46 to -0.18; P â€‹< â€‹0.0001; I 2 â€‹= â€‹0%) were statistically significantly improved from baseline to post-intervention. Interventionist, delivery type, duration, and frequency were potential moderators for psychosocial interventions on negative emotions. Conclusions: Face-to-face, relatively shorter interventions led by psychologists in moderator analysis seem to have better performance. Cancer dyad-based interventions were efficacious in improving the emotional distress of both parties in the dyad, but the effect was more apparent in patients than in family caregivers. However, the long-term effects were modest for both groups.

Effects of continuous care on health outcomes in patients with stoma: A systematic review and meta-analysis.

Objective: Continuing care, which is an extension of post-discharge care, is recognized as a crucial element of high-quality health services and is essential to patients. This systematic review aims to identify the effectiveness of continuing care for patients with stomas. Methods: PubMed, EMBASE, Cochrane Trial Register and Web of Science databases were searched. Study selection and quality appraisal were performed independently by two reviewers. We calculated the mean differences (MD) or the relative risk (RR) with 95% confidence intervals and assessed heterogeneity. Results: Nine studies (1134 participants) met the inclusion criteria. This meta-analysis revealed that, in the continuous care group, the stoma self-efficacy (MD â€‹= â€‹6.46; 95% CI â€‹= â€‹3.81-9.11; P â€‹< â€‹0.001; I 2 â€‹= â€‹0%), and the quality of life (MD â€‹= â€‹7.48; 95% CI â€‹= â€‹5.13-9.82; P â€‹< â€‹0.001; I 2 â€‹= â€‹0%) increased significantly 1 month after discharge; stoma adjustment and care satisfaction also showed a trend toward improvement while stoma complications (RR â€‹= â€‹0.71; 95% CI â€‹= â€‹0.58-0.87; P â€‹= â€‹0.001; I 2 â€‹= â€‹25%) decreased significantly. Continuing care did not decrease hospital readmission rates or medical costs. Conclusions: Continuing care showed beneficial effects in improving health outcomes and care satisfaction for patients with stomas compared with routine care. We proposed an integrated continuing care program with different elements and recommendations for its implementation.

Network meta-analysis of the optimal time of applying enteral immunonutrition in esophageal cancer patients receiving esophagectomy.

BACKGROUND: Enteral immunonutrition (EIN) has been extensively applied in cancer patients; however, its role in esophageal cancer (EC) patients receiving esophagectomy remains unclear. We performed this network meta-analysis to investigate the impact of EIN on patients undergoing surgery for EC and further determine the optimal time of applying EIN. METHODS: We searched PubMed, EMBASE, Cochrane library, and China National Knowledgement Infrastructure (CNKI) to identify eligible studies. Categorical data was expressed as the odds ratio with 95% confidence interval (CI), and continuous data was expressed as mean difference (MD) with 95% CI. Meta-analysis with head-to-head approach and network meta-analysis was performed to evaluate the impact of EIN on clinical outcomes using RevMan 5.3 and ADDIS V.1.16.8 software. The surface under the cumulative ranking curve (SUCRA) was calculated to rank all nutritional regimes. RESULTS: Total 14 studies involving 1071 patients were included. Meta-analysis with head-to-head approach indicated no difference between EIN regardless of the application time and standard EN (SEN); however, subgroup analyses found that postoperative EIN was associated with decreased incidence of total infectious complications (OR = 0.47; 95%CI = 0.26 to 0.84; p = 0.01) and pneumonia (OR = 0.47; 95%CI = 0.25 to 0.90; p = 0.02) and shortened the length of hospitalization (LOH) (MD = - 1.01; 95%CI = - 1.44 to - 0.57; p < 0.001) compared to SEN, which were all supported by network meta-analyses. Ranking probability analysis further indicated that postoperative EIN has the highest probability of being the optimal option in terms of these three outcomes. CONCLUSIONS: Postoperative EIN should be preferentially utilized in EC patients undergoing esophagectomy because it has optimal potential of decreasing the risk of total infectious complications and pneumonia and shortening LOH. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/KJ9UY.

The efficacy and mechanism of positive psychological intervention on well-being for colostomy patients: a randomized controlled trial.

AIMS: The positive psychology intervention (PPI) is an effective therapy designed to motivate individuals' positive quality and power, to help them survive in an adverse situation, and to establish a high-quality personal and social life. This study aims to evaluate the efficacy and mechanism of PPI on the psychological capital, psychological distress, and life satisfaction among colostomy patients. METHODS: Patients (n = 120) with permanent stomas were recruited and randomly assigned into two groups. Patients in the experimental group (n = 60) received standard care and PPI, whereas patients in the control group (n = 60) only received standard care. The psychological capital, psychological distress, and life satisfaction were measured and compared between two groups before the intervention, the immediate post-intervention, and follow-up. RESULTS: All 120 patients completed the study. The hope, optimism, resilience, psychological distress, and life satisfaction score of the experimental group were significantly higher than those of the control group at T1 and T2 (P < 0.05). Self-efficacy score of the experimental group had no significant difference at the two time points after the intervention than the control group (P > 0.05). Changes in hope and resilience which belong to psychological capital mediated the intervention's efficacy on changes in PPI on life satisfaction (ß = 0.265, P = 0.005; ß = 0.686, P = 0.002). CONCLUSIONS: PPI could effectively improve psychological capital, psychological distress, and life satisfaction among patients with stomas. Besides, our findings add novel support that increased hope and resilience are the active ingredients that promote intervention change.

PDE4D targeting enhances anti-tumor effects of sorafenib in clear cell renal cell carcinoma and attenuates MAPK/ERK signaling in a CRAF-dependent manner.

Clear cell renal cell carcinoma (ccRCC) is the most lethal form of kidney cancer and effective treatment regimens are yet to be established. Tyrosine kinase inhibitors (TKI) have widely been used as ccRCC therapeutics, but their efficacy is limited due to accompanying resistance mechanisms. Previous studies have provided substantial evidence for crosstalk between cAMP and the MAPK/ERK signaling pathway. Low levels of intracellular cAMP have been found in several human malignancies and some data suggest that elevation of cAMP expression can be achieved by phosphodiesterase 4 (PDE4) inhibition, resulting in cell growth arrest and/or cell death. The effects of crosstalk between cAMP and the MAPK/ERK pathway on the development progression in ccRCR, however, remain to be fully understood. In this study, we sought to explore the involvement of PDE4 in ccRCC and to assess its potential as a target for therapeutic intervention. We demonstrated that PDE4D is the predominant subtype of PDE4 expressed in healthy and cancerous renal cell lines, particularly in metastatic Caki-1 cells. We generated a CRISPR/Cas9-mediated PDE4D-KO Caki-1 cell model and showed that PDE4D depletion reduced cell proliferation and recovered cAMP expression in these cells. PDE4D-KO and/or PDE4 inhibition with the FDA approved PDE4 inhibitor, roflumilast, also attenuated MAPK/ERK signaling in a CRAF-dependent manner. Most interestingly, we showed that PDE4D-KO enhanced the effectiveness of the TKI, sorafenib, to stunt cell survival. In conclusion, we provide preliminary evidence of PDE4 involvement in ccRCC and suggest a rationale for dual tyrosine kinase/PDE4D targeting in patients with CRAF-dependent MAPK activation.

Circ-CREBBP promotes cell tumorigenesis and glutamine catabolism in glioma by regulating miR-375/glutaminase axis.

Circular RNA CREB-binding protein (circ-CREBBP) has been reported to involve in the tumorigenesis of glioma. However, the role and underlying molecular mechanism of circ-CREBBP in glioma glutamine catabolism remain unclear. The expression of circ-CREBBP, microRNA (miR)-375 and glutaminase (GLS) was detected using quantitative real-time polymerase chain reaction and western blot. The 3­(4, 5­dimethylthiazol­2­y1)­2, 5­diphenyl tetrazolium bromide (MTT), colony formation, flow cytometry and transwell assays were used to determine the effects of them on glioma cell malignant biological behaviors in vitro. Glutamine metabolism was analyzed using assay kits. Murine xenograft model was established to investigate the role of circ-CREBBP in vivo. The binding interactions between miR-375 and circ-CREBBP or GLS were confirmed by the dual-luciferase reporter assay. Circ-CREBBP was highly expressed in glioma tissues and cells, and high expression of circ-CREBBP predicted poor prognosis. Circ-CREBBP knockdown suppressed cell proliferation, migration, invasion and glutamine metabolism while expedited cell apoptosis in glioma in vitro, as well as impeded tumor growth in vivo. Circ-CREBBP directly targeted miR-375, which was demonstrated to restrain glioma cell growth, motility and glutamine metabolism. Moreover, miR-375 inhibition reverted the anticancer effects of circ-CREBBP knockdown on glioma cells. GLS was a target of miR-375, GLS silencing or the treatment of GLS inhibitor bis-2-(5-phenylacetamido-1,3,4-thiadiazol-2-yl)ethyl sulfide (BPTES) impaired glioma cell malignant phenotypes and glutamine metabolism. Importantly, GLS up-regulation weakened the tumor-suppressive functions of miR-375 on glioma cells. Mechanistically, circ-CREBBP indirectly regulated GLS expression through sponging miR-375. In all, circ-CREBBP expedited glioma tumorigenesis and glutamine metabolism through miR-375/GLS axis, suggesting a promising target for combined glioma therapy.

The use of mindfulness-based stress reduction (MBSR) for lung cancer patients: protocol for a systematic review and meta-analysis.

BACKGROUND: Mindfulness-based stress reduction (MBSR) intervention has been extensively applied in cancer patients for relieving symptom burden and its effectiveness has also been demonstrated. However, the effectiveness of MBSR on psychological and physical functions in lung cancer patients has not yet been determined. The aim of the present systematic review and meta-analysis seeks to determine the role of MBSR in lung cancer patients. METHODS: A systematic search of PubMed, EMBASE, Cochrane Library, and China National Knowledgement Infrastructure (CNKI) will be carried out from their inception until to December 30, 2020. Studies investigating the comparative effects between MBSR and control groups on psychological and physical outcomes will be documented. Data concerning studies, patient characteristics, and outcomes will be extracted. Methodological quality of each eligible randomized controlled trial (RCT) will be assessed individually by two investigators independently using criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Meanwhile, Newcastle-Ottawa Quality Assessment Scale (NOS) will be used to assess methodological quality of non-randomized studies. All statistical analyses will be performed with RevMan and STATA softwares. DISCUSSION: The role of MBSR in lung cancer patients has not yet been demonstrated. This systematic review and meta-analysis will further determine the effectiveness of MBSR on psychological and physical outcomes and QoL among lung cancer patients, which will provide golden references for developing psychological interventions in order to improve patient care and designing future studies to bridge the gap between research findings and clinical practice. TRIAL REGISTRATION: We registered the protocol of this systematic review and meta-analysis in Open Science Framework (OSF) platform with a registration DOI of 10.17605/OSF.IO/MWVBQ (available from: https://osf.io/mwvbq).

Predicting the Risk of Psychological Distress among Lung Cancer Patients: Development and Validation of a Predictive Algorithm Based on Sociodemographic and Clinical Factors.

OBJECTIVE: Lung cancer patients reported the highest incidence of psychological distress. It is extremely important to identify which patients at high risk for psychological distress. The study aims to develop and validate a predictive algorithm to identify lung cancer patients at high risk for psychological distress. METHODS: This cross-sectional study identified the risk factors of psychological distress in lung cancer patients. Data on sociodemographic and clinical variables were collected from September 2018 to August 2019. Structural equation model (SEM) was conducted to determine the associations between all factors and psychological distress, and then construct a predictive algorithm. Coincidence rate was also calculated to validate this predictive algorithm. RESULTS: Total 441 participants sent back validated questionnaires. After performing SEM analysis, educational level (ß = 0.151, P = 0.004), residence (ß = 0.146, P = 0.016), metastasis (ß = 0.136, P = 0.023), pain degree (ß = 0.133, P = 0.005), family history (ß = -0.107, P = 0.021), and tumor, node, and metastasis stage (ß = -0.236, P < 0.001) were independent predictors for psychological distress. The model built with these predictors showed an area under the curve of 0.693. A cutoff of 66 predicted clinically significant psychological distress with a sensitivity, specificity, positive predictive value, and negative predictive value of 65.41%, 66.90%, 28.33%, and 89.67%, respectively. The coincidence rate between predictive algorithm and distress thermometer was 64.63%. CONCLUSIONS: A validated, easy-to-use predictive algorithm was developed in this study, which can be used to identify patients at high risk of psychological distress with moderate accuracy.

The chain mediating role of social support and stigma in the relationship between mindfulness and psychological distress among Chinese lung cancer patients.

PURPOSE: Psychological distress greatly impaired the psychological and physical well-being of lung cancer patients. Identification of protective and risk factors is a prerequisite of developing effective psychological treatment protocol. The study aims to determine the relationship of mindfulness and psychological distress and further clarify the mechanism of mindfulness against psychological distress through perceived stigma and social support among Chinese lung cancer patients. METHOD: A cross-sectional survey study involving 441 valid Chinese lung cancer patients was conducted from September 2018 to August 2019. After all validated questionnaires that measured psychological distress, level of mindfulness, social support, and perceived stigma were returned by patients, we firstly performed correlation analysis to assess the associations between mindfulness, social support, perceived stigma, and psychological distress. Then structural equation modelling analysis was conducted to further clarify the mediating effects of perceived stigma and social support on the relationship between mindfulness and psychological distress. RESULTS: According to our hypothesis and further modification, our revised model adequately fits to data. Mindfulness (ß = - 0.107, p = 0.008) and social support (ß = - 0.513, p < 0.001) had a direct effect on psychological distress. Meanwhile, mindfulness had a direct effect on perceived stigma (ß = - 0.185, p < 0.001), and perceived stigma had a direct effect on social support (ß = - 0.373, p < 0.001). Furthermore, mindfulness had also the indirect effect on psychological distress through the chain mediating role of stigma and social support among lung cancer patients. CONCLUSIONS: Mindfulness has direct negative effect on psychological distress and has also indirectly negative psychological distress through impacting social support and perceived stigma.

Relationships among Social Support, Coping Style, Perceived Stress, and Psychological Distress in Chinese Lung Cancer Patients.

OBJECTIVE: Social support is associated with improved psychological distress in cancer patients. This study investigates the impact of social support on Chinese lung cancer patients' psychological distress and further clarifies the mediating role of perceived stress and coping style. METHODS: A cross-sectional survey study examined social support and psychological distress in 441 patients diagnosed with lung cancer from seven hospitals in Chongqing, China, between September 2018 and August 2019. Coping style and perceived stress were considered to be potential mediators of adjustment outcomes. RESULTS: We found a detection rate of 17.7% for psychological distress among Chinese lung cancer patients. Social support was in significantly negative association with psychological distress, which was partially mediated by confrontation coping and perceived stress. CONCLUSIONS: Social support appears to contribute to ameliorate psychological distress by enhancing confrontation coping with cancer and enhancing perceived stress. There is a need for the development and evaluation of psychological intervention program to enhance the buffering effects of social support in lung cancer patients.

The positive effect of social support on psychological distress among Chinese lung cancer patients: The mediating role of self-esteem.

AIM: To investigate the effect of social support on psychological distress among Chinese lung cancer patients and clarify the mediating role of self-esteem. DESIGN: A cross-sectional descriptive correlational survey of 441 Chinese lung cancer patients was designed. METHODS: Self-esteem was supposed to play a mediating role in the association between social support and psychological distress. We collected demographic information, the Distress Thermometer, Multidimensional Scale of Perceived Social Support and Rosenberg Self-Esteem Scale. RESULTS: Our revised model demonstrated an acceptable fit to the data (χ2  = 37.489, comparative fit index (CFI) = 0.965, Tucker-Lewis index (TLI) = 0.926, root mean square error of approximation [RMSEA] = 0.099). Social support had a direct effect on self-esteem and psychological distress, and self-esteem had also a direct effect on psychological distress. Meanwhile, self-esteem also partially mediated the relationship between social support and psychological distress among Chinese lung cancer patients.

Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis.

BACKGROUND: Yoga receive more attention from breast cancer patients, however its feasibility and efficacy during chemotherapy remains conflicting. We performed this systematic review to assess the effects of yoga on health-related quality, physical health and psychological health in breast cancer patients undergoing chemotherapy. METHODS: A systematic search was conducted to retrieve randomized controlled trials (RCTs) which investigated the comparative efficacy of yoga versus comparators such as usual care among breast cancer patients for health-related quality, physical health and psychological health in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CNETRAL), Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature (CBM) Database, China Science and Technology Journal (CSTJ) Database, China National Knowledge Infrastructure (CNKI), and Wangfang Database from inception to December 2018. The latest search was updated on September 2020. All analyses were completed using RevMan version 5.3. RESULTS: Seven trials involving 693 breast cancer patients met inclusion criteria. Meta-analysis indicated a short-term improvement in fatigue [standard mean difference (SMD), -0.62; 95% confidence interval (CI), -1.17 to -0.07], sleep disturbance (SMD, -0.34; 95% CI, -0.55 to -0.12), depression (SMD, -0.50; 95% CI, -0.70 to -0.31) anxiety (SMD, -0.50; 95% CI, -0.70 to -0.31), and health-related quality of life (QoL) (SMD, 0.72; 95% CI, -0.12 to 1.56) in the yoga group; however beneficial medium- and long-term effects in fatigue, sleep disturbance were not identified. Moreover, qualitative analyses suggested that yoga was not associated with decreased adverse events (AEs) compared with control groups. CONCLUSIONS: Yoga may benefit to reduce fatigue, depression and anxiety, improve sleep disturbance, and improve QoL in breast cancer patients receiving chemotherapy in the short-term; however, medium- and long-term effects should be further established owing to limitations.

CircRNA hsa_circ_0030018 regulates the development of glioma via regulating the miR-1297/RAB21 axis.

Circular RNAs (circRNAs) play a crucial role in tumor occurrence and progression. And the dysregulated circRNAs are reported to be relevant to glioma development. Nevertheless, the function and regulatory mechanism of hsa_circ_0030018 in glioma progression are largely indistinct. The abundances of hsa_circ_0030018, miR-1297, and RAB21 were detected using quantitative real-time polymerase chain reaction or western blot. Cell proliferation was assessed via colony formation assay and 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Cell apoptosis and cell cycle progression were evaluated by flow cytometry. Cell migration and invasion were examined using transwell assay and wound healing assay. The protein levels were measured by western blot. The interaction between miR-1297 and hsa_circ_0030018 or RAB21 was validated via dual-luciferase reporter analysis, RNA immunoprecipitation (RIP), and RNA pull-down assays. A xenograft model experiment was performed to analyze the function of hsa_circ_0030018 on tumor growth in vivo. hsa_circ_0030018 and RAB21 levels were enhanced, and the miR-1297 level was reduced in glioma tissues and cells. The silence of hsa_circ_0030018 or overexpression of miR-1297 impeded cell proliferation, metastasis, and expedited cell apoptosis and cycle arrest in glioma cells. Furthermore, hsa_circ_0030018 modulated glioma malignant behaviors via sponging miR-1297, and miR-1297 suppressed glioma development via targeting RAB21. Moreover, hsa_circ_0030018 knockdown inhibited tumor growth in vivo. The hsa_circ_0030018 knockdown repressed glioma progression by mediating the miR-1297/RAB21 pathway, providing potential therapeutic targets for glioma treatment.

Development and psychometric evaluation of the colostomy disgust scale in patients with colostomy.

OBJECTIVE: To establish and validate the Colostomy Disgust Scale (CDS) for assessing disgust in colostomy patients. DESIGN: Triphasic, cross-sectional psychometric study. SETTING: A total of 423 patients with colostomy (222 first samples and 201 s samples) were recruited from a tertiary hospital between January 2015 and April 2016. METHODS: Three phases were undertaken: (a) item generation, (b) item selection and (c) evaluation and validation. The evaluation and validation of the CDS were performed through feasibility and initial item analysis, exploratory factor analysis, confirmatory factor analysis and internal consistency. RESULTS: Following item generation and item selection, a 22-item CDS was generated. Principal axis factoring indicated a two-factor solution for the proposed CDS model, which was also verified by confirmatory factor analysis. Moreover, the proposed CDS had a high internal consistency. CONCLUSION: The CDS is a self-report instrument with initial evidence for its validity and reliability. It is a promising tool to identify the triggers of disgust in colostomy contexts, which can be of great importance for promoting the mental health of colostomy patients.

Self-disgust and stigma both mediate the relationship between stoma acceptance and stoma care self-efficacy.

AIM: This paper is a report of a study exploring the relationship between stoma acceptance and stoma care self-efficacy in patients with colostomy and whether self-disgust and stigma play mediating roles in this relationship. DESIGN: A cross-sectional survey design. METHOD: In all, 476 participants were recruited from a tertiary hospital and completed structured, anonymous, self-report measures of stoma acceptance, self-disgust, stigma, and stoma care self-efficacy between January 2016-March 2017. RESULTS: Stoma acceptance was significantly negatively associated with personal disgust (r = -.640, p<.001), behavioural disgust (r = -.384, p<.001), and stigma (r = -.309, p<.001) and significantly positively associated with stoma care self-efficacy (r = .689, p<.001). Furthermore, regression-based mediation modelling showed that personal disgust and stigma had significant mediating effects on stoma acceptance and stoma care self-efficacy. CONCLUSION: We demonstrated, for the first time, that emotional responses (self-disgust and stigma) play important roles in the association between stoma acceptance and stoma care self-efficacy. Addressing concerns about emotional disorder should become part of the routine care for patients with stoma. IMPACT: Patients with colostomy must cope with many challenges and undergo profound changes in daily life. Acceptance of the existence of the stoma and effective management of the stoma can aid patients in the return to a full and active life. Illness acceptance and psychological states have been widely reported to be correlates of the ability to successfully reconstitute a meaning of life, but these have not been specifically explored in patients with colostomy. This study examined the effect of stoma acceptance on stoma care self-efficacy with the mediation role of self-disgust and stigma. Evidence of the relationship between illness acceptance and self-efficacy could offer practitioners to consider emotional factors like self-disgust and stigma when aiming to improve stoma care and management.

Questionnaire for the Assessment of Self-Disgust: The psychometric testing among mental disorders in China.

Research on self-disgust is relevant to psychopathologic tendencies because it has been shown to play a critical role in several mental disorders. Examining self-disgust and exploring its role in mental health are significant goals. The purpose of this study was to translate the Questionnaire for the Assessment of Self-Disgust (QASD) into Chinese and evaluate its validity and reliability. The translation and validation of the QASD were guided by the World Health Organization's Process of Translation and Adaptation of Instruments. Three phases were undertaken: (a) professional translation and expert panel review, (b) pretesting, and (c) psychometric evaluation. The psychometric evaluation was tested among 1,068 patients who were recruited from two psychiatric hospitals and three psychological clinics of tertiary hospitals. In this study, multigroup confirmatory factor analysis (CFA) supported the two-factor structure of the original QASD construct. Measurement invariance showed that the QASD is invariant across the patients with heterogeneous mental health diagnoses. The correlation of QASD with the Self-Esteem Scale (SES) and the Trait Anger Scale (TAS) showed that it has good convergent validity and discriminative validity. Internal consistency and test-retest yielded acceptable results. Thus, the findings suggest that the Chinese version of the QASD is a reliable and valid instrument with adequate psychometric properties for assessment of self-disgust among patients with mental disorders in China.