The effects of psychological interventions on suicide for cancer patients: a systematic review and network meta-analysis.

Numerous psychological interventions are available for suicidal and death ideation (SDI) and suicidal behavior among cancer patients. To identify the optimal psychological interventions for reducing SDI and suicidal behavior in cancer patients. However, it remains unclear which psychological intervention is the most effective. We performed a pairwise and network meta-analysis by searching seven databases from the date of inception until 8 April 2022. An important focus of this network meta-analysis was the comparison of the effects of various psychological interventions on the reduction of SDI and suicidal behavior among cancer patients. For determining efficacy, we used standardized mean differences (SMDs) and 95% confidence intervals (CIs). Besides, a pairwise meta-analysis, inconsistency test, network meta-analysis, the surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, subgroup analysis, and sensitivity analysis were also carried out. A total of 8 studies involving 1,350 patients were searched in this study. It showed that empathy therapy (SUCRA = 95.3%) has the best effect among the six interventions. Comprehensive psychological intervention (SUCRA = 77.6%) was ranked in the top two positions, followed by meaning-centered therapy (SUCRA = 40.7%). Comparison-adjusted funnel plots revealed no significant publication bias. In addition, our conclusions have not changed significantly after the sensitivity analysis. In this network meta-analysis, empathy therapy was identified as the optimal choice for reducing SDI and suicidal behaviors in cancer patients. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous.

Childbirth as Fault Lines: Justifications in Physician-Patient Interactions About Postnatal Rehabilitation.

Research on justifications has shown their significance in advice-giving, decision-making and children disputes. However, the majority of studies gloss over practical functions of justifications in patient-physician interactions as they are often expected and pursued by patients and in turn, are adopted by physicians to support their stance and authority. This study, through conversation analysis (CA), aims to explore a) what are pragmatic functions of justifications in patient-physician interaction? b) how and when do physicians unfold their justifications for treatment recommendations? c) how do physicians deal with different responses based on their epistemic and deontic domains?. A total of 32 video-recordings between postpartum women and physicians are collected and studied. Four pragmatic functions of justifications drawn upon by physicians are explored: justifications as face-saving, reassurance, risk discussion and clarification-seeking. Despite physicians' attempts to justify their positions as less challenged by patients, this is not the entire picture as they demonstrate their desire to resolve patients' concerns and coordinate their viewpoints to achieve the best practice that facilitates patients' well-being.

Optical single-channel color image encryption based on chaotic fingerprint phase mask and diffractive imaging.

An optical single-channel color image encryption scheme based on chaotic fingerprint phase mask and diffractive imaging is proposed. In this proposed encryption scheme, the fingerprint used to generate the random phase masks is served as a secret key directly. Additionally, the random phase masks generated by the fingerprint, chaotic Lozi map, and secure hash algorithm (SHA-256) are used only as interim variables. With the help of the chaotic fingerprint phase masks placed at different diffraction distances, the color image that is encoded into a grayscale pattern by the phase-truncation technique is encrypted into a noise-like diffraction pattern. For decryption, the color image can be retrieved from the noise-like diffraction pattern by using an iterative phase retrieval algorithm, fingerprint, and phase keys generated from the encryption process. Since the fingerprint key shared by the sender and authorized receiver is strongly linked with the user and does not need to be transmitted over the open network, the security of this proposed encryption scheme can be greatly improved. Additionally, the parameters of the chaotic Lozi map and Fresnel diffraction distances can also provide additional security to the proposed encryption scheme. Furthermore, compared with the encryption schemes based on digital holography, the implementation of this proposed encryption scheme is relatively simple. The numerical simulations and analysis verify the feasibility, security, and robustness of this proposed encryption scheme.

Optical encoding and hiding scheme for a double image based on chaotic fingerprint phase masks and phase-shifting digital holography.

This paper proposes a novel, to the best of our knowledge, double-image hiding scheme based on the chaotic fingerprint phase masks (CFPMs) and three-step phase-shifting digital holography (PSDH). First, the two images to be hidden are encoded into a complex amplitude image, and then with the help of the CFPM located in the Fresnel transform (FrT) domain and the three-step PSDH, the complex amplitude image can be encoded into three noise-like interference holograms. Finally, the three noise-like interference holograms are hidden into the texture part of the host image by the discrete wavelet transform based fusion approach and variational image decomposition technique. This scheme can simultaneously hide two images into one host image, and the invisibility and robustness of the hiding scheme can be well balanced by embedding the secret image in the texture of the host image. Additionally, the introduction of a biometric feature increases the association of the key and the authorized user, and the parameters of the chaotic map and FrT can also provide additional security to the proposed scheme. We have verified the scheme's feasibility, security, and robustness through extensive experiments.

Weaving rapport: doctors' strategies towards patients' noncompliance.

BACKGROUND: A successful therapeutic rapport between doctors and patients is built on effective doctor-patient communication. Noncompliance of patients which challenges their communication has been described in the research, yet the rapport strategies are not well discussed. METHODS: This qualitative study investigates the rapport strategies when doctors face noncompliance in consultations and its pragmatic effects achieved through the doctors' speeches. The 10-hour recordings come from the doctor-patient communication in the hospital setting. Thereafter, we analyze their conversation following the Spencer Oatey's rapport management model. RESULTS: Compliments and joking in the illocutionary domain, storytelling in the discourse domain, the doctors' participation in the participation domain and the choice of appropriate titles in the stylistic domain are identified and analyzed as the rapport-building strategies. CONCLUSION: The present study has offered insights into physicians' rapport-building strategies in the face of rapport-threatening behavior from patients. These strategies will help the doctors to deal with rapport-challenging behavior and boost overall patient wellness.

Physical disability, low self-esteem, and suicidal ideation among Chinese nursing home residents: the moderating role of resilience.

OBJECTIVES: This study aimed to investigate the mediating role of self-esteem in the relationship between physical disability and suicidal ideation, and whether the mediation effect was moderated by resilience among nursing home residents. METHODS: Participants were 538 nursing home residents recruited from 37 nursing homes in Jinan, China (mean age = 78.13 years, SD = 8.72). The Lawton and Brody Activities of Daily Living Scale, Rosenberg Self-Esteem Scale, 10-item version of the Connor-Davidson Resilience Scale, and Beck Suicidal Ideation Inventory-Chinese Version were used. Mediation and moderated mediation analyses were performed using Models 4 and 15 of the PROCESS macro for SPSS. RESULTS: The prevalence of suicidal ideation among the nursing home residents was 14.90%. The mediation analysis showed that self-esteem partially mediated the association between physical disability and suicidal ideation. Resilience was a protective factor for suicidal ideation and moderated the relationship between physical disability and suicidal ideation, and between self-esteem and suicidal ideation. CONCLUSION: Both physical disability and lower self-esteem are important in understanding the development of suicidal ideation among nursing home residents. Improving resilience may be crucial for suicide prevention.

How dignity-related distress interacts with quality of life in young adult patients with cancer during the active treatment stage: A network analysis.

OBJECTIVE: Young adult patients with cancer are a growing concern. By means of network analysis, this study aimed to explore the interplay between dignity-related distress and quality of life (QoL) in young adult patients with cancer when they undergo active treatments. METHODS: In this cross-sectional study, 309 young adults aged 18-39 and diagnosed with malignant tumors were recruited from an oncology center in China between September 2020 and August 2021. Participants completed the Patient Dignity Inventory and SF-36 questionnaires. Network analysis was applied to examine the network structure. RESULTS: Overall, the core facets of dignity-related distress were negatively related to QoL and its corresponding domains, either directly or indirectly. Developmental distress played a central role among estimated networks and strongly interplayed with most QoL domains, especially the mental domains. Symptom distress was the only facet consistently interplayed with the physical domains of QoL (i.e., physical function and bodily pain). The social aspects were also revealed in the association between limited social support and vitality. CONCLUSIONS: Early attention must be paid to guarantee the need of preserving dignity and enhancing QoL for young adult patients.

Asymmetric double-image encryption based on chaotic random phase encoding.

An asymmetric double-image encryption scheme based on chaotic random phase encoding (CRPE) is proposed. In this proposed encryption scheme, two grayscale images to be encrypted are first Fresnel transformed and combined into a complex image. Then, the amplitude and phase components are obtained by conducting phase-amplitude truncation on the complex image. Finally, the amplitude component is again Fresnel transformed and encrypted into a noise-like pattern by the CRPE in the Fresnel domain. Since the initial values and control parameters of the chaotic map can replace the random phase masks to serve as secret keys, the management and transmission of secret keys will become more convenient in the proposed encryption scheme. Furthermore, the Fresnel transform parameters and phase keys derived from the complex image's phase component can also act as secret keys during the decryption process. Numerical simulations have demonstrated the feasibility, security, and robustness of the proposed encryption scheme.

Relationship between depressive symptoms and subjective occupational well-being among nursing home staff: the mediating role of resilience.

OBJECTIVE: To assess the prevalence of depressive symptoms and subjective occupational well-being, and examine the mediating role of resilience between depressive symptoms and subjective occupational well-being among nursing home staff as well. MATERIALS AND METHODS: The cross-sectional study involving 236 convenient nursing home staff with an average age of 25.73 years was conducted from November 2020 till January 2021 in Jinan and Heze city, Shandong Province. Participants filled out the questionnaires of demographic information, depressive symptoms, resilience and subjective occupational well-being. Descriptive analysis, Pearson correlations and mediation analysis based on PROCESS macro were conducted. RESULTS: The study revealed that the prevalence of depressive symptoms among nursing home staff was 30.1%. Depressive symptoms were negatively related to subjective occupational well-being (r = -0.336, P < 0.001) and resilience (r = -0.373, P < 0.001), and resilience was positively correlated with subjective occupational well-being (r = 0.390, P < 0.001). Moreover, resilience mediated the relationship between depressive symptoms and subjective occupational well-being with the mediating effect accounting for 35.47% of the total effect. CONCLUSION: Depressive symptoms were highly prevalent among nursing home staff. Resilience could mediate the association between depressive symptoms and subjective occupational well-being. It is advisable to pay more attention to mental health among nursing home staff and contribute to the development of effective resilience improvement interventions to enhance subjective occupational well-being.

Exploring life and help-seeking experiences regarding suicidal ideations among nursing home residents.

Globally, older adults, especially nursing home residents, are at a higher risk of suicide. This study examined the life of nursing home residents with suicidal ideations and their help-seeking experiences. A qualitative analysis of 19 semi-structured interviews was conducted. Results indicate that suicidal ideations among nursing home residents correlates with their negative life experiences, both personally and institutionally. In terms of their life experiences, themes included the desire for death, emotional loneliness, a state of discomfort arising from incapacity, feeling like a burden on children, and dealing with the low-quality service. Older adults' negative attitudes toward seeking assistance as well as limited resort resources and ineffective help-seeking hinder them from finding more support or treatment. This study adds to a growing body of research on late-life suicide in institutional settings, and relevant findings can serve as references in improving nursing home residents' life quality and developing suicide-prevention strategies.

Death anxiety, self-esteem, and health-related quality of life among geriatric caregivers during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has influenced all social spaces and older adults are susceptible to COVID-19. Geriatric caregivers in nursing homes might experience death anxiety when faced with infected older adults and a closed working environment. Death anxiety is a negative and formidable affective state. Yet, little is currently known about the relationships among death anxiety, self-esteem, and health-related quality of life among geriatric caregivers during the COVID-19 pandemic. This study aimed to examine whether self-esteem could moderate the association between death anxiety and health-related quality of life during the pandemic. METHODS: A cross-sectional study was conducted in Jinan and Heze cities, Shandong Province, from November 2020 to January 2021. Participants comprised a convenience sample of 236 geriatric caregivers in nursing homes. Data on sociodemographic variables, death anxiety, self-esteem, and health-related quality of life were collected. Descriptive analysis, Pearson correlation, and moderated analysis were used for statistical analysis. RESULTS: Self-esteem moderated the association between death anxiety and health-related quality of life (death anxiety × self-esteem: B = -0.113, 95% CI: -0.143, -0.018). CONCLUSION: This study revealed that self-esteem played a moderating role between death anxiety and health-related quality of life during the pandemic, which implies that mental health should be given more attention, and that interventions for improving self-esteem need to be carried out.

Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents.

OBJECTIVES: Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support. METHODS: Residents (N = 538; Aged ≥60years; 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects. RESULTS: Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011-0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005-0.167]). Support from family and nursing home staff moderated the direct (path c') and indirect path (path b) of the mediation model, respectively. CONCLUSIONS: Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.HighlightsWe evaluated suicidal ideation in mainland Chinese nursing home residentsLoneliness and suicidal ideation were partially mediated by resilienceSocial support moderated the effect of loneliness and resilience on suicidal ideationThe results were self-reported and are not generalizable to all of ChinaResilience and social support can buffer against suicidal ideation among residents.

Social support moderates suicidal ideation among Chinese nursing home residents with limited activities of daily living and loneliness.

Rare studies are available exploring the impact of limited activities of daily living (ADL), loneliness on suicidal ideation, and protective effect of social support on their relationships in nursing home residents. This study aims to examine these links in a sample of older adults from nursing homes. A stratified random sampling was adopted to recruit 538 respondents from 37 nursing homes in Jinan. Suicidal ideation, limited ADL, social support and loneliness were assessed through instruments of Beck Suicidal Ideation Scale, ADL scale, Perceived Social Support Scale and UCLA Loneliness Scale. Relationships of latent variables were tested using Path Analysis in this cross-sectional study. The mediating effect of loneliness was significant on the association between limited ADL and suicidal ideation, and the mediation model was multiply moderated by social support with significant coefficients and acceptable model fitness. This study demonstrated the multiple moderating role of social support in the effect of limited ADL and loneliness on suicidal ideation among nursing home residents. More efforts are suggested in providing more available external resources to seniors' mental health for reducing risk of influencing factors of suicidal ideation.

Optical color image encryption based on chaotic fingerprint phase mask in various domains and comparative analysis.

Random phase masks serve as secret keys and play a vital role in double random phase encoding architecture. In this paper, we propose a new, to the best of our knowledge, method to generate the random phase masks using the chaotic Henon map and fingerprint. We then extend the generated chaotic fingerprint phase masks to the Fourier transform domain, fractional Fourier transform domain, Fresnel transform domain, and Gyrator transform domain to encrypt color images. In these four color image encryption schemes, the fingerprint and chaotic parameters serve as secret keys directly, and the chaotic fingerprint phase masks are just used as interim variables and functions. If the sender and receiver share the fingerprint, only the chaotic parameters are needed to transmit over the network. Thus, the management and transmission of the secret keys in these four encryption schemes are convenient. In addition, the fingerprint keys which are strongly linked with the sender or receiver can enhance the security of these four encryption schemes greatly. Extensive numerical simulations have been carried out to verify the feasibility, security, and robustness of these four color image encryption schemes.

Limitation on activities of daily living, depressive symptoms and suicidal ideation among nursing home residents: The moderating role of resilience.

Nursing home residents are at a higher risk of suicidal ideation, and depressive symptoms and limitations on activities of daily living (ADL) are presumed to be contributory factors, whereas resilience may buffer the negative effects of risk factors. This study aimed to investigate the prevalence of suicidal ideation and the moderating effect of resilience on suicidal ideation to dilute the adverse contribution of ADL limitation and depressive symptoms. A stratified random sampling was used to recruit 538 residents from 37 nursing homes in China. Participants' suicidal ideation, resilience, depressive symptoms, and ADL limitation were measured and tested by structural equation modeling. Statistics show that 14.9% of participants had suicidal ideation and the model where resilience moderated the effects of ADL limitation and depressive symptoms on suicidal ideation had the best model fit index. This suggests that positive psychological interventions for resilience building might be effective in reducing suicidal ideation.

Depressive symptoms mediate the association between insomnia symptoms and health-related quality of life and synergistically interact with insomnia symptoms in older adults in nursing homes.

AIMS: The aim of this study was to elucidate whether depressive symptoms mediate the association between insomnia symptoms and health-related quality of life (HRQOL) and to explore whether insomnia symptoms and depressive symptoms synergistically interact to affect HRQOL among older adults in nursing homes. METHODS: Older adults living in nursing homes (n = 323) completed Athens Insomnia Scale, the 15-item Geriatric Depression Scale, and the 36-item Short Form Health Survey. PROCESS for SPSS was used in the mediation model. Logistic regression analysis was conducted to obtain odds ratios (OR) for insomnia symptoms, depressive symptoms, and HRQOL. The relative excess risk due to interaction, the attributable proportion due to interaction, and the synergy index were assessed. RESULTS: Insomnia symptoms and depressive symptoms were negatively related to HRQOL. Depressive symptoms mediated the relationship between insomnia symptoms and HRQOL. Compared with the older adults without insomnia symptoms or depressive symptoms, those with only depressive symptoms (OR = 8.36, 95% confidence interval (CI): 3.46-20.18) or insomnia symptoms (OR = 2.24, 95%CI: 1.04-4.83) had a lower HRQOL. Also, the co-presence of insomnia symptoms and depressive symptoms significantly increased the risk of lowering HRQOL (OR = 25.79; 95%CI: 12.72-52.28). The relative excess risk due to interaction, attributable proportion due to interaction, and synergy index were 16.19, 0.63, and 2.88, respectively. CONCLUSIONS: Depressive symptoms may play a mediating role between insomnia symptoms and HRQOL. Comorbid insomnia symptoms and depressive symptoms synergistically interact to affect HRQOL. It is vital to focus on elderly nursing home residents with insomnia symptoms and/or depressive symptoms and to adopt interventions.

Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience.

PURPOSE: This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. METHODS: A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. RESULTS: Social support was positively related to HRQOL (ß = 0.303, p < 0.001) among Chinese rural elders in nursing homes. The mediating role of resilience in the relationship between social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. CONCLUSIONS: Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.

Image decomposition model Shearlet-Hilbert-L2 with better performance for denoising in ESPI fringe patterns.

In this paper, we propose an image decomposition model Shearlet-Hilbert-L2 with better performance for denoising in electronic speckle pattern interferometry (ESPI) fringe patterns. In our model, the low-density fringes, high-density fringes, and noise are, respectively, described by shearlet smoothness spaces, adaptive Hilbert space, and L2 space and processed individually. Because the shearlet transform has superior directional sensitivity, our proposed Shearlet-Hilbert-L2 model achieves commendable filtering results for various types of ESPI fringe patterns, including uniform density fringe patterns, moderately variable density fringe patterns, and greatly variable density fringe patterns. We evaluate the performance of our proposed Shearlet-Hilbert-L2 model via application to two computer-simulated and nine experimentally obtained ESPI fringe patterns with various densities and poor quality. Furthermore, we compare our proposed model with windowed Fourier filtering and coherence-enhancing diffusion, both of which are the state-of-the-art methods for ESPI fringe patterns denoising in transform domain and spatial domain, respectively. We also compare our proposed model with the previous image decomposition model BL-Hilbert-L2.

The relationship of interpersonal sensitivity and depression among patients with chronic atrophic gastritis: The mediating role of coping styles.

AIMS AND OBJECTIVES: To investigate the prevalence of depression and the relationship among interpersonal sensitivity, coping styles and depression in patients with chronic atrophic gastritis and explore the mediating role of coping styles between interpersonal sensitivity and depression. METHODS: A cross-sectional survey of 101 patients diagnosed with chronic atrophic gastritis aged 33-83 years. All the participants were surveyed face to face and given the informed consent. Sociodemographic and clinical characteristics, the interpersonal sensitivity dimension of the Symptoms Checklist-90-Revised, the Trait Coping Style Questionnaire and Hospital Depression Scale were measured. A descriptive analysis and a correlation matrix were used to illuminate the characteristics of subjects and bivariate correlations, respectively. Hierarchical regression analysis and bootstrapping method were used to test the mediating effect of coping styles between interpersonal sensitivity and depression. RESULTS: The prevalence of depression among patients with chronic atrophic gastritis was 54.50%. The regression analysis revealed that interpersonal sensitivity was positively related to depression. The effect of interpersonal sensitivity on depression was partially mediated by coping styles, including positive coping and negative coping. CONCLUSIONS: Depression was highly prevalent in patients with chronic atrophic gastritis. Coping styles played a mediating role between interpersonal sensitivity and depression, which had important clinical implications for physicians and nurses. RELEVANCE TO CLINICAL PRACTICE: Patients who are at high risk of depression should be identified and applicable targets should be made for prevention and intervention, in consideration of mental health of patients with chronic atrophic gastritis.

Psychological distress in patients with chronic atrophic gastritis: the risk factors, protection factors, and cumulative effect.

This study aimed to examine the psychological status among Chronic Atrophic Gastritis (CAG) patients and to find the cumulative effects of risk and protective factors. A sample of 101 CAG patients completed the investigation. Hierarchical linear regression was used to find risk and protective factors, and examine the cumulative effects in risk factor index (RFI) and protective factor index (PFI). Results showed that nine symptoms from SCL-90-R were severer among CAG patients than those in adult norm. Risk factors including positive family history of cancer and higher negative life events could predict higher GSI (ß = 0.206, p = 0.023; ß = 0.398, p < 0.001; R² = 0.203); more household resistant, positive coping and stronger resilience were protective factors and could predict GSI negatively (ß = -0.188, p = 0.020; ß = -0.350, p = 0.012; ß = -0.066, p = 0.621; R² = 0.190). The GSI was positively correlated with RFI (ß = 0.338, p < 0.001; R² = 0.113) and negatively related to PFI (ß = -0.378, p < 0.001; R² = 0.133). In conclusion, CAG patients suffered from various psychological distress, and the protective factors should be enhanced cumulatively to protect against psychological distress.