Psychosocial adjustment changes and related factors in young and middle-aged patients with first-episode acute myocardial infarction: a longitudinal study.

AIMS: This study aimed to explore the change trend and group heterogeneity of psychosocial adjustment level and to determine its influencing factors among young and middle-aged patients with first-episode acute myocardial infarction (AMI). METHODS AND RESULTS: The Psychosocial Adjustment Scale of Illness was used to assess the psychosocial adjustment level of the patients at 1, 3, and 6 months after discharge, respectively. Data were analyzed using Pearson correlation analysis, generalized estimating equations, and growth mixed models. A total of 233 patients were included, and their psychosocial adjustment scores at the three-time points were 57.18 ± 15.50, 36.17 ± 15.02, and 24.22 ± 12.98, respectively. The trajectories of changes in patients' psychosocial adjustment levels were divided into three latent categories: moderate adjustment improvement group (72.5%), low adjustment improvement group (16.3%), and persistent maladjustment group (11.2%). Among them, predictors of the persistent maladjustment group included no spouse, low monthly family income per capita, normal body mass index, never smoking, never exercising, combined with hyperlipidemia, low social support, submission coping, and high perceived stress. CONCLUSIONS: The psychosocial adjustment level of young and middle-aged patients with first-episode AMI showed an upward trend within 6 months after discharge, and there was group heterogeneity in the change trajectory of psychosocial adjustment level. It is suggested that a multi-center, large-sample longitudinal study should be carried out in the future, and the time of follow-up investigation should be extended to further clarify the change trajectory and influencing factors of psychosocial adjustment of patients with different subtypes, to provide the theoretical basis for formulating targeted intervention programs.

Associations of illness perception and social support with fear of progression in young and middle-aged adults with digestive system cancer: A cross-sectional study.

PURPOSE: While Fear of progression (FoP) is a natural reaction in cancer, elevated FoP can impact life quality and social function. Our study aims to explore how illness perception, social support, and posttraumatic growth influence patients' FoP. METHODS: This study enrolled 243 young and middle-aged adults with digestive system cancer at a hospital in Guangzhou from November 2022 to November 2023. In this study, the measurement instruments utilized included The Fear of Progression Questionnaire-Short Form, The Brief Illness Perception Questionnaire, The 12-item Perceived Social Support Scale, and The 21-item Posttraumatic Growth Inventory. Data was analyzed employing polynomial regression and response surface analyses. RESULTS: The mean score of FoP was 35.45 ± 10.05, and 59.3% of the cancers (scores≥34) had clinically dysfunctional levels of FoP. Regarding congruence, patients' FoP was higher when the levels of illness perception and social support were both low or high than when the levels were both intermediate. Regarding incongruence, patients' FoP was lower when the level of illness perception was low and social support was high compared with when the level of illness perception was high and social support was low. Additionally, posttraumatic growth moderated the (in)congruence effect of illness perception-social support on the FoP of patients. CONCLUSIONS: Low or high illness perception-social support congruence was detrimental to the FoP of patients. Low illness perception-high social support incongruence was beneficial to patients' FoP. Posttraumatic growth can be a positive factor for enhancing the impact of low illness perception-high social support incongruence on patients' FoP.

Illness perception profile among cancer patients and its influencing factors: A cross-sectional study.

PURPOSE: The purpose of this study was to explore latent profiles of illness perception among cancer patients and its influencing factors. METHODS: This study was a cross-sectional study adopting convenience sampling to select cancer patients from two hospitals in China. A total of 286 patients completed Brief Illness Perception Questionnaire, Post-traumatic Growth Inventory, Fear of Disease Progression Questionnaire and Psychosocial Adjustment to Illness Scale. Latent profile analysis and multiple linear regression were performed to explore the subgroups and factors influencing classification. RESULTS: Three subgroups were identified, which were labelled as "Moderate Illness Perception Group" (16.8%; C1), "High Illness Perception with Heightened Concerns Group" (68.5%; C2) and "High Resilience and Low Symptomatic Impact Group" (14.7%; C3). Specifically, "Normal", "Mild symptom" and "Bed time during the day <50%" of "Functional Status" were more associated with C3. "Worker", "Farmer" and "Self-employed" were more associated with C1 and C2. Patients who had more "knowledge of the disease" were more associated with C2 and C3, who had less "post-traumatic growth" were more associated with C1, and who had less "fear of disease progression" and more "psychosocial adjustment" were more associated with C3 (all P < 0.05). CONCLUSIONS: There was significant variability of illness perception among three subgroups of cancer patients, which emphasized the complexity of psychological condition. The insights derived from these distinct profiles enables tailored interventions and patient-centered communication strategies. However, integrating objective measures or biomarkers is needed to complement self-reported data.