Predictive Model of Psychological Distress in Patients With Lung Cancer: A Cross-sectional Study.

BACKGROUND: Patients with lung cancer suffer from significant psychological distress. The underlying theoretical model that may explain what predicts or mediates the degree of psychological distress has not been elucidated. OBJECTIVES: To describe the incidence of psychological distress in patients with lung cancer and to test a predictive theoretical model of psychological distress based on symptom burden, type D personality, social support, and intrusive thoughts. METHODS: Three hundred eighty-nine patients with stages I to IV lung cancer were recruited. Participants completed a battery of scales, including measures of psychological distress, symptom burden, type D personality, perceived social support, intrusive thoughts, and demographic and clinical characteristics. The predictive theoretical model was tested using structural equation modeling. RESULTS: Experiencing clinically significant psychological distress was reported by 63.75% of participants. Consistent with the social cognitive processing model, symptom burden, type D personality, social support, and intrusive thoughts all significantly and directly predicted the level of psychological distress in patients with lung cancer. Moreover, intrusive thoughts mediated the effects of type D personality and symptom burden on psychological distress; social support and symptom burden mediated the effects of type D personality on psychological distress. CONCLUSIONS: The majority of the participants experienced psychological distress at a clinically significant level. Intrusive thoughts and social support mediated the effects of type D personality and symptom burden on psychological distress. IMPLICATIONS FOR PRACTICE: Patients with type D personality and symptom burden should be identified. Interventions for targeting social support and intrusive thoughts might ultimately reduce their psychological distress.

Changes of geriatric syndromes in older adults survived from Intensive Care Unit.

Nearly 90% of the older adult patients discharged from hospital with a cluster of geriatric syndromes. The patterns of geriatric syndromes in older adult ICU survivors are to be further explored. The aim of this study was to examine the risk factors and patterns of geriatric syndromes among older adult patients before admitting to ICU and throughout their hospitalization. A total of 137 older adult patients (age 76.9 ± 6.6; 52.6% male) participated in the study. The results showed significant increase in the occurrence of geriatric syndromes from T0 (upon ICU admission) to T1 (transition to inpatient care unit), with improvement at T2 (hospital discharge), but did not return to the baseline. The three most prevalent geriatric syndromes were: functional decline, urination incontinence, and defecation incontinence. Polypharmacy was associated with functioning decline. Patients with delirium were six times more likely to be re-admitted to ICU.