Resilience and coping styles as predictors of health outcomes in breast cancer patients: A structural equation modelling analysis.

INTRODUCTION: Resilience has been associated with psychological adaptation to many threatening life events, but previous studies have rarely analysed the integrated relationships among demographic and disease characteristics and various health outcomes in Taiwan. This study examined the associations among demographic factors, disease characteristics, resilience, coping styles and adverse health outcomes, including anxiety and depressive symptoms and sleep disorders. METHODS: A descriptive, cross-sectional study design was used. Data from a convenience sample of 175 patients with breast cancer aged 20 years or older were collected using a self-reported questionnaire. A structural equation modelling approach was applied to examine the relationships among the variables. RESULTS: The results showed that greater resilience was related to fewer depressive symptoms, lower anxiety levels and better sleep quality. All three coping styles, including active coping, minimising the situation and avoidance coping, were negatively correlated with depressive symptoms, but only active coping was significantly correlated with sleep quality. Resilience had a direct effect on depressive symptoms, anxiety and sleep disorders. Furthermore, a mediating effect of resilience was observed on the relationship between marital satisfaction and depressive symptoms. CONCLUSION: Resilience can strengthen breast cancer-related adaptation. Additionally, breast cancer survivors who used mainly the active and minimising coping styles tended to experience fewer depressive symptoms.

Establishment of a Comprehensive Inpatient Suicide Prevention Network by Using Health Care Failure Mode and Effect Analysis.

Inpatient suicide is a common sentinel event. However, evidence supporting effective inpatient suicide prevention measures is currently lacking. In this project, health care failure mode and effect analysis was used in a general hospital quality improvement process to identify suicide risk and reduce inpatient suicide behavior. Interventions were designed to improve steps in the process with the highest risk of failure, resulting in significantly higher consultation rates and reduction of attempted suicide.

Social support as a mediator between sleep disturbances, depressive symptoms, and health-related quality of life in patients undergoing hemodialysis.

BACKGROUND: The hemodialysis regimen is an inevitable and mandatory treatment for patients with end-stage renal disease (ESRD). During the dialysis journey, patients may experience maladaptation in terms of sleep disturbances, depressive symptoms, and reduced health-related quality of life (HRQOL). Psychosocial resources such as social support may have beneficial influences on health outcomes, but studies have rarely analyzed the integrated relationships among risk factors which include pain, sleep disturbances, duration since diagnosis and various health outcomes in Taiwan. This study aimed to bridge this gap by investigating the relationships among related risk factors, social support, sleep disturbances, depressive symptoms, and HRQOL, which is composed of physical quality of life (PQOL) and mental quality of life (MQOL), in ESRD patients. METHOD: A correlational design was used, and 178 patients aged 20 years or older were recruited via convenience sample. The relationships among the risk factors, the mediators, depressive symptoms, PQOL, and MQOL were analyzed using structural equation modeling. RESULTS: The findings showed that more than 70% of the participants reported poor sleep quality, and 32% reported depressive symptoms. When participants had greater pain and more sleep disorders, they were more likely to be depressed. When participants had more appraisal support; they had better PQOL and fewer depressive symptoms. Overall, the structural equation model explained 31.8% of the variance in self-reported depressive symptoms, 29.4% of the variance in PQOL, and 5.7% of the variance in MQOL. Moreover, appraisal support enhanced PQOL and reduced depressive symptoms by exerting its two mediating effects on sleep disturbances. CONCLUSION: Our findings indicate that patients with ESRD who have more social support have better PQOL and MQOL and fewer depressive symptoms than those with less social support.

Synthesis of N2-(substituted benzyl)-3-(4-methylphenyl)indazoles as novel anti-angiogenic agents.

To search for novel compounds with potent anti-angiogenic activity, a series of N(1)-(substituted benzyl)-3-(4-methylphenyl)-1H-indazoles (16, 18, 20, 22, 24, 26, 28, 30, 32) and N(2)-(substituted benzyl)-3-(4-methylphenyl)-2H-indazoles (17, 19, 21, 23, 25, 27, 29, 31, and 33) were synthesized. The structures of these regioisomers were established by IR, UV, and NMR spectral data. 3-(4-Methylphenyl)-1H-indazole (6) and the N(2)-substituted derivatives (17, 19, 21, 23, 25, 29, 31, 33) were evaluated for their anti-angiogenic activity. Most of them showed more prominent activity than ethyl 4-(1-benzyl-1H-indazol-3-yl)benzoate (YD-3). Among these tested compounds, 2-(4-chlorobenzyl)-3-(4-methylphenyl)-2H-indazole (19), 2-(4-methylbenzyl)-3-(4-methylphenyl)-2H-indazole (25), and 2-(4-methoxybenzyl)-3-(4-methylphenyl)-2H-indazole (31) showed significant anti-angiogenic activity and are worthy of further investigation.