Analysis of sleep quality, disease uncertainty, and psychological tolerance in patients undergoing chemotherapy for digestive tract malignancies.

BACKGROUND: Colorectal cancer is the second leading cause of cancer-related deaths among digestive tract malignancies, following gastric cancer. Sleep is of great significance for maintaining human health. The incidence of sleep disorders in patients with cancer is approximately twice that observed in the general population. Lack of sleep can prolong hospital stays, increase the likelihood of infection, and increase mortality rates. Therefore, studying the factors related to sleep quality is significant for improving the quality of life of patients with malignant tumors of the digestive tract. AIM: To investigate the relationships among sleep quality, disease uncertainty, and psychological resilience in patients undergoing chemotherapy for digestive tract malignancies. METHODS: A total of 131 patients with malignant digestive tract tumors who were treated at Hefei BOE Hospital between April 2021 and September 2022 were selected as research participants. Based on their Pittsburgh Sleep Quality Index (PSQI) scores, participants were divided into either the sleep disorder group (PSQI score > 7) or the normal sleep group (PSQI score ≤ 7). The clinical data-together with the Mishel Uncertainty in Illness Scale for Adults (MUIS-A) and Connor-Davidson Resilience Scale (CD-RISC) scores-were compared. RESULTS: In this study, 78 (59.54%) patients with digestive tract malignancies developed sleep disorders after chemotherapy. Sleep disorder incidence was higher in patients with colorectal cancer than in those with gastric and esophageal cancers (P < 0.05). The total MUIS-A score and those for each item in the sleep disorder group were higher than those in the normal sleep group. The total CD-RISC score and those for each item in the sleep disorder group were lower than those in the normal sleep group (P < 0.05). The PSQI scores of patients with malignant digestive tract tumors were positively correlated with the scores for lack of disease information, disease uncertainty, and unpredictability in the MUIS-A and negatively correlated with the scores for tenacity, self-improvement, and optimism in the CD-RISC (P < 0.05). CONCLUSION: Patients undergoing chemotherapy for digestive tract malignancies are prone to sleep problems related to disease uncertainty and psychological resilience. Therefore, interventions can be implemented to improve their sleep quality.

Non-adaptive cognitive emotion regulation mediates the relationship between disease uncertainty and acute stress disorder in patients with ischaemic stroke.

Background: During epidemic outbreaks, hospitalized patients, especially those with cerebrovascular disease, were identified as a vulnerable group suffering from acute stress disorder (ASD) and consequent psychological distress. For stroke patients, not only will they suffer from physical illness, but the uncertainty of illness caused by sudden illness may also cause patients to experience different degrees of ASD. Relevant studies have shown that the impact of ASD on individuals may vary according to age, gender, disease characteristics, individual personality, treatment methods, income level, family support, cognitive psychology and other factors. However, non-adaptive cognitive emotion regulation plays a crucial role in influencing individual psychological states. At present, the risk factors of ASD after stroke and the mechanism between illness uncertainty and cognitive emotion regulation are not fully understood. Therefore, we focus on exploring the predictive effects of general demographic and disease-related characteristics, maladaptive cognitive emotion regulation, and illness uncertainty on ASD after stroke, and make hypotheses. When a disease acts on the body, the patient will have the corresponding cognition of the disease, and ASD will appear at the same time. Then the maladaptive cognitive emotion regulation as an important mediating variable can aggravate the level of acute stress disorder and be verified. Methods: We used a cross-sectional design, which can be used to investigate the distribution of a disease or health condition and its related factors in a specific population at a specific time, so as to describe the distribution of the disease or health condition and its relationship with related factors. A total of 256 hospitalized patients with ischemic stroke were enrolled, including 145 males and 111 females, aged from 26 to 90 years, with a mean age of (64.71 ± 12.20) years. All patients completed and returned a self-report questionnaire that included demographic information, illness uncertainty, cognitive emotion regulation, and ASD. We then compared the differences in general demographic data, illness uncertainty, and maladaptive cognitive emotion regulation in acute stress disorders. Results: The majority of hospitalized stroke patients (67.6%) developed ASD due to the COVID-19 pandemic and were therefore at risk for PTSD. More than one third (39.1%) of stroke survivors also suffered from severe psychological distress. More specifically, younger stroke patients are more likely to experience ASD than older patients. Although higher illness uncertainty scores indicate more severe ASD, adaptive cognitive emotion regulation was a protective factor. Conclusion: Given that individuals with ASD are susceptible to PTSD, it is critical to follow up hospitalized patients with ischemic stroke for screening for PTSD and referral to appropriate psychological services. Maladaptive cognitive emotion regulation can increase the impact of uncertainty on the traumatic experience of stroke patients. Therefore, health care institutions should increase their efforts to provide psychosocial support services to hospitalized patients and make continuous efforts to screen for symptoms of trauma and psychological distress in hospitalized stroke patients.

Analysison the level of disease uncertainty and its related influencing factors in patients with primary aldosteronism / 现代医院

Objective To explore the influencing factors of disease uncertainty levels in patients with primary aldosteron-ism(PA),in order to guide the formulation of clinical intervention measures and reduce the level of disease uncertainty in PA patients.Methods 83 patients with PA admitted to the hospital from January 2021 to January 2022 were selected to evaluate the level of disease uncertainty of all patients[MUIS score],design a baseline data questionnaire,and make detailed statistics on the baseline data of all patients,compare the MUIS score of PA patients with different data characteristics,and focus on the analysis of the factors affecting the level of disease uncertainty of PA patients.Results After evaluation,the MUIS score of 83 PA patients was(89.73±8.60)points;The MUIS scores of PA patients with different social support,education level,anxiety and family monthly per capita income were statistically different(P＜0.05),while the MUIS scores of PA patients with different ages,gen-ders,work conditions,religious beliefs,diabetes and living alone were not statistically different(P＞0.05);The influencing fac-tors of disease uncertainty level in PA patients are low monthly per capita income,low social support,anxiety,and low education level(P＜0.05).Conclusion The disease uncertainty of PA patients is at a medium-high level.Low education level,low social support,anxiety and low family monthly per capita income are all factors affecting the disease uncertainty level of PA patients.Clin-ical intervention measures can be designated according to the above factors to reduce the disease uncertainty of patients.

The mediating role of anxiety in disease uncertainty and acute stress in acute ischaemic stroke patients in the post-epidemic era.

Objective: To analyse the influencing factors of anxiety, disease uncertainty and acute stress response in patients with acute ischaemic stroke, and to verify the mediating role of anxiety in the post-epidemic era. Methods: 240 patients with acute ischaemic stroke were selected from a tertiary hospital in Wuhan City and investigated by questionnaire and convenience sampling methods. Results: The total anxiety score, disease uncertainty and acute stress reaction were at moderate levels. Anxiety was positively correlated with illness uncertainty, and anxiety and acute stress response were negatively correlated. Multiple linear regression analysis showed that Sickness uncertainty, acute stress response, age, and work status influenced anxiety. Anxiety mediated the prediction of Sickness uncertainty and acute stress response, with the mediating effect accounting for 35.6% of the total effect. Conclusion: Disease uncertainty in patients with acute ischaemic stroke in the post-epidemic era directly affects the acute stress response and indirectly through anxiety.

Current situation and influencing factors of disease uncertainty in parents of children with Sturge‒Weber syndrome: a retrospective study.

BACKGROUND: Sturge Weber syndrome (SWS), can cause extensive capillary malformations on the face, head, trunk, and other parts of the body, and the eyes can also suffer optic nerve injury. Secondary glaucoma can cause blindness, which has the characteristics of a relatively hidden onset and unclear pathogenesis. The treatment of SWS secondary glaucoma has always been difficult, and due to the characteristics of the disease, there is uncertainty about the long-term efficacy and safety of various treatment methods for such patients. METHODS: A total of 105 parents of children with SWS completed a self-designed general information questionnaire, a generalized anxiety questionnaire (GAD-7), a patient health questionnaire (PHQ-2), a stress perception scale (PSS-4), a simple coping scale (SCSQ) and a disease-uncertainty scale (PPUS). RESULTS: The total uncertainty score of parents of children with SWS was 79.07 ± 13.24, and the average item score was 2.82 ± 0.47. Multiple linear regression analysis revealed that anxiety and simple coping were the main influencing factors of disease uncertainty among parents of children with SWS (P < 0.05). CONCLUSIONS: Parents of children with SWS exhibit a high level of disease uncertainty. Medical staff should pay attention to the source of parents' disease uncertainty and provide targeted interventions, which are of great importance in reducing parents' disease uncertainty.

Mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke / 中国实用护理杂志

Objective:To explore the mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke, to provide a theoretical basis for improving patient health behavior.Methods:By cross-sectional survey methods, from June 2021 to June 2022, a total of 123 thrombolysis therapy in patients with acute ischemic stroke were investigated by general information, Mishel Uncertainty in Illness Scale, Health Behavior Scale for Stroke Patients and Revised Illness Perception Questionnaire by convenience sampling method. The mediating effect of disease perception between disease uncertainty and health behavior was verified by structural equation model.Results:The scores of disease uncertainty, health behaviors and disease perception were (52.21 ± 7.67), (63.77 ± 9.40), (127.70 ± 26.19) points in patients with acute ischemic stroke. Health behaviors and each dimension including exercise, medication, instruction, nutrition, responsibility, tobacco and alcohol were negatively correlation between disease uncertainty ( r values were -0.762 to -0.411, all P<0.01), and positively correlation between disease perception ( r values were 0.689 to 0.912, all P<0.01). Disease uncertainty was a significantly negative predictor for health behaviors ( β= -0.71, P<0.01); disease perception was also a significantly negative predictor for disease perception ( β = -0.85, P<0.01). Disease uncertainty had a significantly indirect effect on the health behaviors for thrombolysis therapy in patients with acute ischemic stroke through disease perception, which showed the mediating effect of health behaviors accounts for 15.2% of total effect. Conclusions:Disease perception play a mediating role in the relationship between disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke.

Factors affecting the disease uncertainty among caregivers of colorectal cancer patients undergoing chemotherapy / 预防医学

Objective@#To investigate the status and influencing factors of disease uncertainty among caregivers of colorectal cancer patients receiving chemotherapy, so as to provide insights into psychological interventions among caregivers. @*Methods@#Caregivers of colorectal cancer patients hospitalized in Hunan Cancer Hospital, the Third Xiangya Hospital and the Second Xiangya Hospital for chemotherapy from March 2020 to December 2021 were recruited. Caregivers' demographics, health status, medical and nursing support and social support, as well as patients' demographics, frequency of chemotherapy and disease stage were collected using questionnaire surveys. Caregivers' disease uncertainty was evaluated using Chinese version of the Uncertainty in Illness Scale for Family Members, and factors affecting caregivers' disease uncertainty were identified using a multivariable linear regression model.@*Results@#A total of 318 caregivers were enrolled, including 115 men (36.16%) and 203 women (63.84%), with a mean age of (45.89±6.57) years, and there were 186 caregivers as patients' spouses (58.49%). The mean score of disease uncertainty was (86.65±10.82) points, and the scores of the unpredictability dimension, uncertainty dimension, complexity, and lack of information dimension were (3.21±0.35), (2.98±0.48), (2.84±0.49) and (2.36±0.59) points, respectively. There were 285 participants with a high level of disease uncertainty (89.62%), and multivariable linear regression analysis identified social support (β′=-0.199), medical and nursing support (β′=-0.118), patient's age (β′=-0.155) and stage Ⅲ and Ⅳ of colorectal cancer (β′=0.151) as factors affecting caregiver's disease uncertainty.@*Conclusion@#Caregivers of colorectal cancer patients with chemotherapy have a high level of disease uncertainty, which is affected by social support, medical and nursing support, patient's age and duration of disease.

Establishment and validation of risk nomogram of post-traumatic stress disorder in fathers with hospitalized premature infants / 中国实用护理杂志

Objective:To understand the incidence of post-traumatic stress disorder(PTSD) in fathers with premature infants and analyze the risk factors.Methods:Conveniently, the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire, Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition (PPQ-C), Parents, Perception of Uncertainty Scale, Social Support Rating Scale, Simplified Coping Style Questionnaire. Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model. ROC curve was used to verify the discrimination ofthe model. Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results:PPQ-C total score of 203 fathers was 17.17 ± 8.77, 81 fathers, symptoms were positive and the incidence of PTSD was 39.90%(81/203). Logistic regression analysis showed college degree ( OR = 0.297, 95% CI 0.116 - 0.763, P<0.05), very low birth weight ( OR = 2.491, 95% CI 1.027 - 6.044, P<0.05), sense of disease uncertainty ( OR = 1.038, 95% CI 1.012 - 1.066, P<0.05), negative coping style ( OR = 1.871, 95% CI 1.127 - 3.108, P<0.05) were risk factors of PTSD in fathers with premature infants. The nomogram model was established basing on the results of the Logistic regression analysis, and the ROC curve proved (AUC = 0.751) the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test ( P = 0.974) and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values. Conclusions:A higher incidence of PTSD was observed in fathers with hospitalized premature infant. It was related to education level, the infants′s birth weight, disease uncertainty and coping style. Therefore, the nurses should give information support and psychological guidance according to the individual situation of the infants′ father to reduce the incidence of PTSD.

Influence of disease uncertainty to emotion among advanced lung cancer chemotherapy patients / 中国实用护理杂志

Objective In order to understand the influence of disease uncertainty to emotion among advanced lung cancer chemotherapy patients, in order to guide the clinical nursing work. Methods A total of 146 advanced lung cancer chemotherapy patients were selected as the research object, using the general information, Disease Uncertainty Scale and Brief Profile of Mood States Scale for investigation. Results The disease uncertainty scores of advanced lung cancer chemotherapy patients were 77.91 ± 16.87; scores of emotion was 39.37 ± 18.72; they were positively correlated (r=0.363,P<0.01). Patients′family per capita income, cultural degree, two dimensions of disease uncertainty (uncertainty, poor information) were the main influencing factors of emotion (t=-4.947-4.603, P<0.05). Conclusions Advanced lung cancer chemotherapy patients with the higher level of disease uncertainty have more bad emotion. The patient's family per capita income level, cultural level and disease uncertainty will affect the mood of patients. Targeted intervention measures should be taken to reduce the patient′s disease uncertainty, and improve the patient′s emotion, improve the quality of life.

Effect of therapeutic communication system on the uncertainty and coping styleof patients with lung cancer receiving chemotherapy / 中国实用护理杂志

Objective To explore the influence of therapeutic communication system on uncertainty and coping style of patients with lung cancer chemotherapy. Methods The Cancer Hospital Affiliated to Harbin Medical University, 236 cases of lung cancer patients as the research object, which, from April 2015 to April 2016 were 120 cases as the control group, from May 2016 to April 2017 of 116 patients admitted to the intervention group 116 cases divided into intervention group and control group of 120 cases, compared two groups of patients with general information, the difference was not statistically significant. , control group patients received routine nursing care, patients in the intervention group received nursing intervention in the treatment of communication on the basis of routine nursing, the amount of uncertainty in illness coping scale and Jalowiec scale at the end of the course of chemotherapy, to evaluate the two groups of patients. Results Accept the treatment communication intervention, intervention group of patients with lung cancer disease uncertainty score and each dimension score was (63.27±12.69),(12.97±3.16),(12.71±2.81),(12.96±3.44),(24.63±6.11)points and those were(71.26± 14.58),(14.43±3.27),(14.15±3.02),(14.83±3.17),(27.85±6.03)points respectively in the control group, the differences were significant , t=-4.495--3.488, P<0.01. The scores of lung cancer patients by face, optimistic, emotional support, 4 coping style was(1.83 ± 0.79),(2.01 ± 0.91),(2.13 ± 1.08),(1.80 ± 0.78) points in intervention group and(1.52 ± 0.69),(1.60 ± 0.68),(1.77 ± 0.85),(1.54 ± 0.66)points respectively in the control group, the differences were significant, t=2.760-3.911, P<0.01, the escape, conservative and resigned;and 4 self reliant coping style scores were(1.19 ± 0.63),(1.31 ± 0.67),(1.35 ± 0.68),(1.22 ± 0.55)points in intervention group, and(1.55 ± 0.61),(1.59 ± 0.73),(1.63 ± 0.74),(1.51 ± 0.64)points in control group (t =-4.458--3.028, P< 0.01).Conclusions Therapeutic communication system can effectively improve the degree of uncertainty in patients with lung cancer chemotherapy, and adopt a positive coping style to improve the quality of life of patients.

Effects of nurse-led case management intervention on arm function and uncertainty for women with breast cancer / 中国实用护理杂志

Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.

Study on application of informational support to reduce disease uncertainty in liver cancer patients undergoing interventional therapy / 中国实用护理杂志

Objective To investigate the effect of informational support on disease uncertainty in liver cancer patients undergoing interventional therapy. Methods Sixty patients of liver cancer patients undergoing interventional therapy were randomly divided into the intervention group and the control group with 30 in each.The control group was treated with general treatment and care. The patients in the intervention group were given general treatment and care with a series of informational support interventions. Patients in the two groups were measured by uncertainty in illness scale (MUIS) at the day of admission,before operations and discharged from hospital. The measurement results were statistically analyzed. Results There was significant decrease about disease uncertainty scores both on the day before operation and the day before discharge in the intervention group compared to the day of admission. The decreasing score of uncertainty in illness in the intervention group was significantly greater than the control group on the day before operation and the day before discharge. Conclusions A series of informational support interventions could significantly reduce the diseases uncertainty in liver cancer patients undergoing interventional therapy.

The influence of disease uncertainty on dependency of remedy, shoulder joint movement and ability in daily life in post-operative breast cancer patients / 中华物理医学与康复杂志

Objective To observe the influence of disease uncertainty ( DU) to patients' compliance with rehabilitation training ( CWRT) , shoulder joint movement (SJM) , and abilities in activities of daily living ( ADL) in post-operative breast cancer (BCPO) patients. Methods Sixty-seven BCPO patients uncertain about their health was assessed using Missals' DU protocol. They were then treated according to the breast cancer rehabilitation training plan recommended by the Japanese Cancer Association. CWRT, SJM and ADL were evaluated before and after treatment. Results The scores on dependency of recovery training, systematic remedy and the ability to change their life style were distinctly higher among patients with low DU scores than among those with high DU scores. The shoulder joint mobility in two groups was similar before the remedy, but became better after treatment. ADL category grades and ADL total scores in the two groups were similar before treatment, and had increased significantly after treatment. The item scores for defecating, diet, dressing and bathing, as well as ADL total scores, were significantly lower in the high uncertainty group. Conclusion DU is one of most important factors for BCPO patients. It can influence CWRT and therapeutic effects in rehabilitation.