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1.
BMC Womens Health ; 24(1): 228, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38589804

RESUMEN

BACKGROUND AND AIM: Although infertility as a significant cause of marital crises is prevalent almost equally in men and women, infertile women are under more pressure and distress than infertile men. Therefore, this study was conducted aiming to compare anxiety, depression, and stress between couples with male and female infertility. METHODS: In this descriptive-analytical cross-sectional study, 40 couples (n = 80) with male infertility and 40 couples (n = 80) with female infertility were referred to the infertility clinic of Al-Zahra Educational and Medical Center, Rasht, Iran. Eligible infertile couples were selected by convenience sampling method. The data collection tool was a two-part questionnaire consisting of a demographic information form and a short form of the standard Depression Anxiety Stress Scale-21 (DASS-21). Data analysis was carried out using descriptive and inferential statistical tests at a significant level of p < 0.05. RESULTS: The severity of depression, anxiety, and stress also had a statistically significant difference between men and women. The severity of depression was mild in 57.5% of infertile women and moderate in 40% of infertile men. The severity of anxiety was moderate in 42.5% of infertile women and mild in 57.5% of infertile men. The severity of stress was Severe in 37.5% of infertile women and mild in 40% of infertile men. There was a statistically significant difference between infertile women and men in terms of depression (t=-4.213, df = 1619, p < 0.001), anxiety (t=-7.261, df = 2274, p < 0.001), and stress (t=-9.046, df = 2308, p < 0.001) subscales, and the total scores (t=-7.709, df = 2315, p < 0.001). The depression, stress and anxiety levels were higher in infertile women than in healthy women with infertile spouses. This difference was statistically significant (p < 0.01). The depression, anxiety, and stress levels were significantly different between infertile men and healthy men with infertile wives (p < 0.001). CONCLUSION: The results of this study indicated that depression, anxiety, and stress were more prevalent in infertile women than in infertile men. The severity levels of depression, anxiety, and stress in the wives of infertile men were higher than those in the spouses of infertile women.


Asunto(s)
Infertilidad Femenina , Infertilidad , Masculino , Femenino , Humanos , Depresión/epidemiología , Depresión/etiología , Estudios Transversales , Estrés Psicológico/etiología , Ansiedad/epidemiología , Ansiedad/etiología , Encuestas y Cuestionarios
2.
Midwifery ; 131: 103951, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38402661

RESUMEN

BACKGROUND: Psychological distress during pregnancy is a well-documented risk factor for adverse maternal outcomes. Distress related to the COVID-19 pandemic may further increase the vulnerability of pregnant women to negative mental health outcomes. AIM: To explore the mental health experiences of pregnant women, focusing on mental health outcomes, challenges related to the pandemic, coping strategies, and factors buffering mental health factors during the restricted COVID-19 lockdown period. METHODS: A mixed-methods survey study was conducted, examining symptoms of anxiety, depression, and burnout among 21 pregnant women. Qualitative data were gathered through open-ended questions about participants' experiences of challenges, coping strategies and buffering factors amid the pandemic. Symptoms of anxiety, depression and burnout were calculated, and qualitative data was thematically analyzed. RESULTS: Approximately one-third (24 %) of the respondents reported clinically significant levels of depression, 19 % reported clinically significant levels of anxiety, and 43 % reported experiencing burnout. All participants reported distress and emotional burden, including fear, worry, stress and anxiety related to the pandemic. Specific concerns such as fear of giving birth alone, fear of the consequences due to lockdown restrictions, insufficient information, disruption of prenatal healthcare services, and fear of miscarriage were prevalent among the participants. Social support, financial stability, stable relationships, adherence to daily routines, reduced stress and social demands, a calmer daily life, physical activity, and less work-related stress including working from home, emerges as buffering factors that aided women in coping with pandemic-related distress. CONCLUSION: Healthcare providers should prioritize stability, predictability, and minimizing disruptions to prenatal care. Broad-based screening is crucial to identify women at risk of depression, anxiety, and burnout. Recommendations for clinical pathways aimed at pregnant women are discussed.


Asunto(s)
Agotamiento Profesional , COVID-19 , Distrés Psicológico , Femenino , Embarazo , Humanos , COVID-19/epidemiología , COVID-19/psicología , Depresión/etiología , Depresión/psicología , Pandemias , Estrés Psicológico/etiología , Control de Enfermedades Transmisibles , Ansiedad/etiología , Miedo , 60670 , Agotamiento Profesional/etiología
3.
Sci Rep ; 14(1): 3727, 2024 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-38355646

RESUMEN

Remote work (REMOTE) causes an overlap between working and domestic demands. The study of the cardiac autonomic profile (CAP) by means of heart rate variability (HRV) provides information about the impact of REMOTE on workers' health. The primary aim was to determine whether CAP, self-perceived stress, environmental and workstation comfort are modified during REMOTE. The secondary aim was to explore how these indices are influenced by individual and environmental work-related factors. Fifty healthy office employees alternating REMOTE and in-office (OFFICE) working were enrolled, rated self-perceived stress, environmental and workstation comfort using a visual analogue scale and performed a 24-h electrocardiogram during REMOTE and OFFICE. Stress was lower (5.6 ± 2.2 vs. 6.4 ± 1.8), environmental comfort higher (7.7 ± 1.9 vs. 7.0 ± 1.5), and the workstation comfort poorer (6.2 ± 1.8 vs. 7.5 ± 1.2) during REMOTE. CAP was similar during REMOTE and OFFICE. CAP was influenced by some work-related factors, including the presence of offspring, absence of a dedicated workspace during REMOTE and number of working hours. All these variables determined a decreased vagal modulation. The working setting seems to impact the levels of perceived stress and comfort, but not the CAP. However, individual and environmental work-related factors reduce cardiac vagal modulation during REMOTE, potentially increasing the risk of developing cardiovascular diseases.


Asunto(s)
Sistema Nervioso Autónomo , Salud Laboral , Humanos , Corazón , Nervio Vago , Frecuencia Cardíaca/fisiología , Estrés Psicológico/etiología
4.
Support Care Cancer ; 32(2): 142, 2024 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-38308080

RESUMEN

PURPOSE: This study aims to understand the association between emotional intelligence, perceived social support, and psychological distress (i.e., anxiety, depression, stress) in women with cancer at different stages. Specifically, the aims of this study were to investigate: i) the links between emotional intelligence and psychological distress (i.e., symptoms of anxiety, stress and depression); ii) the mediating role of perceived social support provided by family members, friends, and significant others in the relationship between emotional intelligence and psychological distress; iii) the impact of cancer type and cancer stage (I-II vs III-IV) in moderating these relationships, among Italian women. METHODS: The research sample consisted of 206 Italian women (mean age = 49.30 ± 10.98 years; 55% breast cancer patients) who were administered a questionnaire to assess emotional intelligence, perceived social support, and psychological distress. Structural equation model (SEM) analysis was carried out to confirm the hypothetical-theoretical model. RESULTS: Emotional intelligence had a positive association with perceived social support, which in turn prevented psychological distress only in women with early-stages cancers. The type of cancer has no effect on these relationships. CONCLUSIONS: The findings of this study indicate a pressing need to screen and recognize women with lower emotional intelligence and perceived social support, as they may be more prone to experiencing psychological distress. For such individuals, our results recommend the implementation of psychological interventions aimed at enhancing emotional intelligence and fortifying their social support networks, with consideration for the stage of cancer they are facing.


Asunto(s)
Neoplasias de la Mama , Distrés Psicológico , Humanos , Femenino , Adulto , Persona de Mediana Edad , Apoyo Social , Neoplasias de la Mama/psicología , Inteligencia Emocional , Ansiedad/etiología , Ansiedad/psicología , Depresión/etiología , Depresión/psicología , Italia , Estrés Psicológico/etiología , Estrés Psicológico/psicología
5.
J Natl Compr Canc Netw ; 22(2): 91-97, 2024 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-38364368

RESUMEN

BACKGROUND: Distress among gynecologic oncology patients correlates with poor clinical outcomes and decreased quality of life. The purpose of this study was to determine risk factors for elevated NCCN Distress Thermometer (DT) results among postoperative gynecologic oncology patients. PATIENTS AND METHODS: We performed a retrospective chart review of all postoperative visits over a 5-year period. NCCN DT results were analyzed as both discretized values (DT ≤3 = low distress; DT 4-8 = moderate distress; DT ≥9 = high distress) and continuous variables. Patients with a DT score ≥4 were referred to social work. Univariate and multivariate regression analyses were performed to compare NCCN DT results with clinical and sociodemographic variables. Statistical significance was P<.05. RESULTS: In total, 1,795 NCCN DT results were included, with uterine (37.72%) being the most common disease site. Benign pathology was known prior to completion of the NCCN DT in 13.15% of patients. Most patients (71.75%) endorsed low levels of distress. Moderate/High levels of distress were reported by 28.25% of patients. Increasing levels of distress were significantly associated with younger age (P=.006), history of depression (P≤.001), status as a current smoker (P=.028), and history of asthma (P=.041). Knowledge of benign pathology was associated with low levels of distress (P=.002). Procedure type and disease site were not associated with distress. CONCLUSIONS: More than one-fourth of postoperative patients in a gynecologic oncology practice reported moderate or high distress. Distress was highest among those with malignancy regardless of disease site or surgical intervention. Benign pathology correlated with decreased distress. Identified associations with distress provide opportunities for prevention, early intervention, and tailored counseling.


Asunto(s)
Neoplasias de los Genitales Femeninos , Neoplasias , Humanos , Femenino , Neoplasias de los Genitales Femeninos/cirugía , Neoplasias de los Genitales Femeninos/complicaciones , Estudios Retrospectivos , Calidad de Vida , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/psicología , Neoplasias/complicaciones , Factores de Riesgo , Encuestas y Cuestionarios
6.
Rev Esc Enferm USP ; 57: e20230273, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38315806

RESUMEN

OBJECTIVES: The study aimed to investigate the relationship between perceived stress level and death anxiety in individuals with COPD. METHOD: It was planned with a descriptive and relational screening design. It was carried out with the participation of 132 patients diagnosed with COPD. The study data were collected through Patient Information Form, Perceived Stress Scale, and Death Anxiety Scale. Descriptive statistics and multiple regression analysis were used in data analysis. RESULTS: The COPD patients' total perceived stress scale and perceived insufficient self-efficacy and perceived stress/distress subscale mean scores were found as 32.75 ± 5.32, 15.81 ± 3.60, and 16.93 ± 2.97, respectively. The patients' Anxiety total scale mean score was determined to be 6.96 ± 3.40. A positive and statistically significant relationship was found between COPD patients' Perceived Stress total scale mean score and their Death Anxiety Scale mean score (F = 4.332, p < 0.05). CONCLUSION: Perceived stress level of COPD patients was found to be at a high level, while their death anxiety level was determined as moderate. It was also determined that as perceived stress levels of the patients increased, their death anxiety levels also increased.


Asunto(s)
Ansiedad , Pruebas Psicológicas , Enfermedad Pulmonar Obstructiva Crónica , Autoinforme , Humanos , Ansiedad/epidemiología , Ansiedad/etiología , Ansiedad/diagnóstico , Depresión/diagnóstico , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología
7.
J Affect Disord ; 351: 172-178, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38296055

RESUMEN

BACKGROUND: Little is known about the mechanism between interpersonal stressors and social anxiety in college students. This study was to investigate the mediating effect of interpersonal sensitivity between interpersonal stressors and social anxiety. METHODS: The data was taken from a large-scale health-related cohort among Chinese college students. This study used data from the first four waves, including 4191 participants. The latent growth curve mediation model was used to examine the potential mediating role of interpersonal sensitivity in the relationship between interpersonal stressors and social anxiety over time. RESULTS: Both levels and changes in interpersonal stressors were positively associated with subsequent levels and changes in social anxiety. Mediation analysis showed that interpersonal sensitivity mediated the relationship between interpersonal stressors and social anxiety. LIMITATION: All variables were collected based on self-report. CONCLUSIONS: Interpersonal stressor is a significant risk factor for social anxiety, and this association appears to be mediated by interpersonal sensitivity. It is necessary to evaluate and intervene against interpersonal sensitivity related to interpersonal stressors for the prevention of social anxiety.


Asunto(s)
Ansiedad , Análisis de Mediación , Humanos , Ansiedad/etiología , Estrés Psicológico/etiología , Miedo , Factores de Riesgo
8.
J Fam Psychol ; 38(2): 296-308, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38236275

RESUMEN

Parenting stress reflects a discrepancy between a parent's perception of their resources, the demands of their child's needs, and the caregiving relationship and contexts (Abidin, 1992). Parenting stress can increase the risk of issues in the parent-child relationship, as well as child behavioral and emotional outcomes (Neece et al., 2012; Spinelli et al., 2021). Chronic stressors, such as living through the COVID-19 pandemic, have the potential to increase the demands of parenting and thus parenting stress. Using latent growth curve modeling, we examined parenting stress trajectories of 298 American parents with young children (Mage = 15.02 months, range = 1-34 months) over the first year of the COVID-19 pandemic. We also examined the effects of parental mental health on parenting stress, and the effects of parental mental health and parenting stress on child problem behaviors using data gathered through the Prolific survey platform. Parental mental health, measured by depressive symptoms Centre for Epidemiological Studies Depression Scale-10, anxiety symptoms Generalized Anxiety Disorder Scale (GAD-7), and overall stress levels 10-item Perceived Stress Scale, was related to higher initial parenting stress index-short form. Changes in parenting stress over time were linked with higher levels of children's problem behaviors (CBCL). Child temperament was also related to initial parenting stress. Lower levels of household income were linked with higher levels of parental mental health symptoms and higher rates of parenting stress increases over time. These results highlight the importance of considering the well-being of all family members in child outcomes, and the ways in which different experiences and resources during the COVID-19 pandemic affect parental and child well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
COVID-19 , Problema de Conducta , Pruebas Psicológicas , Autoinforme , Humanos , Preescolar , Lactante , Responsabilidad Parental/psicología , Salud Mental , Pandemias , Estrés Psicológico/etiología , Padres/psicología , Relaciones Padres-Hijo
9.
Appl Psychophysiol Biofeedback ; 49(1): 85-102, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38244109

RESUMEN

Police officers demonstrate increased risk of physical and mental health conditions due to repeated and prolonged exposure to stressful occupational conditions. Occupational stress is broken into two types: operational stress, related to the content of field duties (e.g., physical demands); and organizational stress, related to cultural and structural contexts (e.g., interpersonal relationships). Applied police research focuses on physiological activation in operational tasks as a mechanism explaining health risk and non-optimal performance outcomes. However, recent survey-based studies indicate numerous organizational stressors associated with self-reported mental health symptoms. The question of whether organizational stressors elicit significant physiological activity remains unknown. The current proof-of-concept field study tests the hypothesis that police managers will display significant physiological reactivity before, during, and after engaging in reality-based scenarios representative of stressful police management tasks developed from evidence-based pedagogical approaches. A sample of 25 training police managers (7 female, M = 16 +/- 5.3 years of experience) completed 5 reality-based scenarios, including resolving a heated conflict between colleagues, delivering negative feedback to a subordinate, and critical incident command. Significant increases in heart rate relative to rest were observed during all tasks, and in anticipation of several tasks. Greater increases in reactive heart rate were associated with longer recovery times. Sex differences and relationships between objective biological and subjective psychological measures of stress are discussed. The current findings demonstrate significant physiological responses to organizational stressors similar to levels observed during operational tasks, despite the absence of physical or aerobic exertion. Implications for police health and training are discussed.


Asunto(s)
Enfermedades Profesionales , Estrés Laboral , Humanos , Masculino , Femenino , Estrés Psicológico/etiología , Policia/psicología , Enfermedades Profesionales/etiología , Enfermedades Profesionales/psicología , Encuestas y Cuestionarios
10.
Top Stroke Rehabil ; 31(1): 1-10, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37004716

RESUMEN

BACKGROUND: Stroke is a leading cause of disability for persons with stroke (PWS). Difficulty coping with long-term stress for PWS and their caregivers (CG) contributes to their poor health. Variations of chronic-disease self-management programs (CDSMPs) have reduced long-term stress in PWS and CGs. CDSMPs include training for decision-making, problem-solving, resource utilization, peer support, developing a patient-provider relationship, and environmental support. OBJECTIVE: This study examined whether a user-designed stroke camp addressed CDSMP domains, used consistent activities, and decreased stress in PWS and CG. METHODS: This open cohort survey study followed STROBE guidelines and assessed stress at four timepoints: 1 week before camp, immediately before camp, immediately after camp, and 1 month after camp. Mixed-model analysis examined changes in stress from the two baseline time points to the two post-camp time points. The research team reviewed documents and survey responses to assess activities described in camp documents and CDSMP domains across camps. POPULATION: PWS and CG who attended a camp in 2019. The PWS sample (n = 40) included50% males, aged 1-41-years post stroke, 60% with ischemic, one-third with aphasia, and 37.5% with moderate-severe impairment. CG sample (n = 24) was 60.8% female, aged 65.5 years, and had 7.4 years CG experience. RESULTS: Stress decreased significantly in PWS (Cohen's d = -0.61) and CGs (Cohen's d = -0.87) from pre- to post-camp. Activities addressing all but one CDSMP domains were evident across camps. CONCLUSIONS: Stroke camp is a novel model that addresses CDSMP domains, which may reduce stress in PWS and CG. Larger, controlled studies are warranted.


Asunto(s)
Automanejo , Accidente Cerebrovascular , Masculino , Humanos , Femenino , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia , Cuidadores , Sobrevivientes , Enfermedad Crónica , Estrés Psicológico/etiología , Estrés Psicológico/terapia
11.
Stress Health ; 40(1): e3263, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37243509

RESUMEN

Psoriasis is a chronic-inflammatory, immune-mediated disease leading to a state of increased systemic inflammation. Mental comorbidities often occur in the patients and may additionally affect the therapy outcome. Currently, it is unknown whether the disease severity, psychosocial stress or health-related quality of life determines the manifestation of anxiety/depression, or vice versa, in psoriasis. The interplay between these variables during the dermatological treatment of psoriasis remains to be elucidated in order to initiate appropriate psychological interventions and to identify patients at risk for comorbid anxiety/depression. In a prospective cohort study, the impact of disease severity, health-related quality of life and psychosocial stress on anxiety/depression were examined during the dermatological treatment in patients with moderate to severe psoriasis (patients with psoriasis = PSO). Patients were examined before (T1) and about 3 months after (T2) the beginning of a new treatment episode, in most cases by means of systemic therapy. Data were analysed, exploratory, using Bivariate Latent Change Score Models and mediator analyses. Assessments included patient-reported outcomes (Hospital Anxiety and Depression Scale/HADS, Perceived Stress Scale/PSS, Childhood Trauma Questionnaire/CTQ, Dermatology Life Quality Index-DLQI, Body Surface Area-BSA), at both T1 and T2. 83 PSO patients (37.3% women, median age 53.7, IQR 37.8-62.5, median BSA 18.0, IQR 9.0-40.0) with complete data of HADS and DLQI were included. In the total group, a higher anxiety/depression at T1 was associated with a lower improvement in psoriasis severity in the course of the dermatological treatment (γBSA  = 0.50, p < 0.001). In subgroups of PSO with low/high CTQ scores, anxiety/depression at T1 had no impact on the change in psoriasis severity. Only by tendency, in CTQ subgroups, a higher psoriasis severity at T1 was linked with a higher improvement in anxiety/depression at T2 (low/high CTQ, γHADS  = -0.16/-0.15, p = 0.08). An improvement in the health-related quality of life was positively associated with an improvement in anxiety/depression (Pearson's r = 0.49, p = 0.02). Here, the reduction of acute psychosocial stress seems to be a decisive factor, mediating this association (ß = 0.20, t [2,60] = 1.87; p = 0.07, 95% CI -0.01, 0.41). The results allude, that the initial severity of anxiety/depression may presumably have an impact on the treatment outcome in the total group. In contrast, analysing subgroups of patients with high/low childhood trauma, the impact of the initial disease severity on the course of anxiety/depression after a switch to a new dermatological treatment could not be conclusively ruled out. The latter results from the latent change score modelling should be treated cautiously because of the small sample size. A common aetiopathological mechanism for psoriasis and anxiety/depression might be assumed with impact of dermatological treatment on both. The change in perceived stress seems to play an important role in the manifestation of anxiety/depression, substantiating the need for adequate stress management in patients with increased psychosocial stress during their dermatological treatment.


Asunto(s)
Psoriasis , Pruebas Psicológicas , Calidad de Vida , Autoinforme , Humanos , Femenino , Persona de Mediana Edad , Masculino , Estudios Prospectivos , Psoriasis/complicaciones , Psoriasis/psicología , Psoriasis/terapia , Depresión/etiología , Estrés Psicológico/etiología , Índice de Severidad de la Enfermedad , Ansiedad/etiología
12.
Child Care Health Dev ; 50(1): e13193, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37908180

RESUMEN

BACKGROUND: Parents of children with developmental disorders (DD) or disabilities report greater parenting stress than parents of typically developing children. To minimise this stress, stressful factors need to be known and stress needs to be recognised early. The present cross-sectional study aims to systematically assess and compare parenting stress in families of children with various types of disabilities. In addition, the assessment of parenting stress by attending paediatricians will be evaluated. METHODS: We surveyed 611 parents about their parenting stress at the Children's Development Center (CDC). Three questionnaires, including the German versions of the Parenting Stress Index (PSI) and Impact on Family Scale (IOFS), were used to evaluate parenting stress. Furthermore, attending paediatricians assessed of the child's type of disability and their perception of parenting stress in a separate questionnaire. RESULTS: Fifty-five percent of all parents reported stress at a clinically relevant level, 65% in the child domain and 39% in the parent domain of the PSI. Parenting stress differed significantly across diagnostic categories (p < 0.01) and was associated with childhood disability related issues of behaviour, sleep or feeding issues. Parenting stress was often underestimated by the paediatricians, especially when the children had disabilities perceived as less severe. In one-third of parents with clinically relevant total stress, paediatricians reported low stress levels. Parent-reported financial problems, social isolation, and partnership conflicts were not suspected by paediatricians in ≥85% of cases. CONCLUSIONS: Clinically relevant parenting stress was found more often than in comparable studies. An assessment of parenting stress by paediatricians may be complicated by time constraints in medical appointments, the mainly child-centred consultation, or restricted expression of parents' stress. Paediatricians should move from a purely child-centred to a holistic, family-centred approach to treatment. Routine screening of parenting stress using standardised questionnaires could be helpful to identify affected families.


Asunto(s)
Niños con Discapacidad , Responsabilidad Parental , Humanos , Niño , Estrés Psicológico/etiología , Estudios Transversales , Padres , Pediatras
13.
Palliat Support Care ; 22(2): 258-264, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37885276

RESUMEN

OBJECTIVES: To evaluate the sensitivity and specificity of the Distress Thermometer (DT) as a screening tool for emotional distress in oncological palliative care patients and to compare the DT with the Edmonton Symptom Assessment System-revised (ESAS-r) and the gold standard to determine the most appropriate assessment method in palliative psychological care. METHODS: Data were collected from psychological screening tests (ESAS-r and DT), and clinical interviews (gold standard) were conducted by a clinical psychologist specialist in palliative oncology from January 2021 to January 2022 in an oncology palliative care service. RESULTS: The sample consisted of 356 first-time patients with a diagnosis of advanced cancer in palliative care. The most frequently reported oncological diagnoses were gastrointestinal tract (49.3%) and breast (18.3%). Most patients were female (n = 206; 57.9%), 60.4% were married/with a partner, 55.4% had between 6 and 9 years of schooling, and a median age of 57 (range, 46-65) years. The cutoff of the DT was 5, with a sensitivity of 75.88% and specificity of 54.3%. Emotional problems (sadness and nervousness) had a greater area under the curve (AUC) when measured using the DT than the ESAS-r; however, only in the case of the comparative sadness and discouragement was the difference between the AUC marginally significant. SIGNIFICANCE OF RESULTS: The use of the DT as a screening tool in oncological palliative care is more effective in the evaluation of psychological needs than the ESAS-r. The DT, in addition to evaluation by an expert psychologist, allows for a more comprehensive identification of signs and symptoms to yield an accurate mental health diagnosis based on the International Classification of Diseases-11th Revision and/or Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.


Asunto(s)
Neoplasias , Distrés Psicológico , Humanos , Femenino , Persona de Mediana Edad , Anciano , Masculino , Cuidados Paliativos/psicología , Evaluación de Síntomas/métodos , Termómetros , Estrés Psicológico/diagnóstico , Estrés Psicológico/etiología , Neoplasias/complicaciones , Neoplasias/psicología
14.
Chirurgie (Heidelb) ; 95(2): 135-147, 2024 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-37987763

RESUMEN

BACKGROUND: Surgery represents a challenging medical discipline. AIM: This article focuses on psychological stress in surgery and explains resilience as a protective factor against the consequences of psychological stress, based on selected literature references and own relevant clinical experiences. In this context, the sense of coherence, social support and self-efficacy expectation are discussed in more detail as resilience factors. METHOD: Narrative review. RESULTS (CORNER POINTS): Surgery is classified as a challenging medical subspecialty with a high reputation but associated with diverse and varied physical and psychological stress factors. Stress factors differ individually in terms of requirements (can be overdemanding or underdemanding but also stimulating, relevant to learning and meaningful, thus positively or negatively stressful) and resources (potentially beneficial working conditions, experience, or behavior, e.g., social support, scope for action). Fluctuations within surgical specialties and a high dropout rate during residency training are well known and the causes include high psychological stress. In the case of persistent and at the same time insufficient compensation of work stress caused by a lack of or insufficient resources, these can be associated with mental illnesses. Nonetheless, many physicians spend their entire lives working in hospital or private surgical settings and remain healthy, a strong sense of resilience to mental illness may be fundamental to this. Resilience can be present as a personal characteristic or it can be learnt through a process or adapted through positive or negative influences, thus strengthening the personal characteristics. Overall, data on surgeon resilience or interventional studies in resilience research in the surgical setting are limited and provide another research gap. Resilience training (directed at a sense of coherence, social support, strengthening knowledge of coping skills, positive emotions, optimism, hope, self-efficacy expectations, control beliefs or robustness), also clearly indicated in the "robust" medical specialty of surgery, is always individual and should not be generalized. If the surgeon cannot retrieve sufficient resources due to the stressful situation, stress management with its methods is helpful to reduce the psychological stress and to be able to maintain the performance and health of this person. CONCLUSION: The consolidation of resilience as a notable aspect of employee management. In collegial interactions, resilience must be based on workplace-based approaches to strengthen coping mechanisms in the face of work stress. Workplace-related stress should also be perceived, addressed and counteracted within the organization, certainly also as an elementary management task.


Asunto(s)
Estrés Laboral , Médicos , Resiliencia Psicológica , Humanos , Estrés Psicológico/etiología , Apoyo Social
15.
J Public Health (Oxf) ; 46(1): 194-201, 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38031278

RESUMEN

BACKGROUND: The study aimed to identify the causes of moral distress in public health professionals associated with the COVID-19 pandemic, and the potential ways of avoiding or mitigating the distress. METHODS: The survey was distributed to all members of the UK Faculty of Public Health between 14 December 2021 and 23 February 2022. Conventional qualitative content analysis was conducted to explore the situations in which moral distress arises, the moral judgments that led to distress and the proposed ways to address moral distress. RESULTS: A total of 629 responses were received from respondents broadly representative of the public health professional workforce. The main situations causing moral distress were national policy, guidance and law; public health advice; and workplace environments. Moral distress was precipitated by judgments about having caused injury, being unable to do good, dishonest communications and unjust prioritization. The need to improve guidance, communication and preparedness was recognized, though there was disagreement over how to achieve this. There were consistent calls for more subsidiarity, moral development and support and freedom to voice concerns. CONCLUSIONS: The causes of moral distress in public health are distinct from other healthcare professions. Important proposals for addressing moral distress associated with the COVID-19 pandemic have been voiced by public health professionals themselves.


Asunto(s)
COVID-19 , Pandemias , Humanos , Salud Pública , Estrés Psicológico/etiología , Principios Morales , COVID-19/epidemiología , Reino Unido/epidemiología
16.
Int Arch Occup Environ Health ; 97(1): 65-74, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38032508

RESUMEN

OBJECTIVE: Ageing populations and poor care workforce availability are causing increasing job demands for home care nurses across Europe. While recovery from work helps sustain work ability and wellbeing, past research has relied mainly on self-reported measures of health, stressors, and recovery. This study aims to examine how objective and subjective job demands are associated with measured day-time recovery among home care nurses. METHODS: Heart rate variability recording was conducted for 95 Finnish home care nurses. The study participants documented their work tasks throughout the workday and filled a wellbeing questionnaire. The amount of care time, breaktime, number of different weekly clients, and their care needs were obtained from the survey. The associations between job demands and measured day-time recovery were analysed using multivariate linear regression. RESULTS: The amount of day-time recovery was on average 75 min. The number of different clients during the workday (e.g., care continuity) and higher care needs of the clients were associated with lower day-time recovery. Additionally, something slightly disrupting the course of the workday was associated with increased recovery. CONCLUSIONS: Our findings indicate that reducing especially the objective job demands (workday characteristics) can contribute to better day-time recovery among home care nurses. To help sustain work ability and improve wellbeing, day-time recovery can be promoted with better work scheduling that supports care continuity and ensures sufficient care resources and support for nurses with many clients or clients with high care needs.


Asunto(s)
Servicios de Atención de Salud a Domicilio , Enfermeras y Enfermeros , Estrés Laboral , Humanos , Estudios Transversales , Finlandia , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Satisfacción en el Trabajo
17.
J Fam Psychol ; 38(1): 59-70, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38032655

RESUMEN

Adolescence is a unique developmental period marked with significant changes and challenges. As such, maintaining optimal psychological adjustment is crucial for young people, especially during the COVID-19 pandemic when their adjustment became more challenging. Self-control is a vital ability assisting individuals to navigate difficulties and stay well-adjusted during turbulent times. While the associations between adolescent self-control and adjustment have been well-documented, parental self-control has been considered to play a more fundamental role in adolescent adjustment. However, this consideration has received scant research. Drawing on the intergenerational transmission model of self-regulation, we examined an understudied yet plausible idea that parental self-control facilitates adolescent adjustment through parents' lower levels of perceived stress/better mindful parenting and adolescents' improved self-control. A two-wave survey study, spanning 1 year apart, was conducted among 426 Chinese adolescents (Mage = 11.6 years, 53.5% boys) and their parents. Parents rated their self-control, perceived stress, and mindful parenting at T1, while adolescents rated their self-control and adjustment (i.e., psychological difficulties and life satisfaction) at T1 and T2. The results of chain mediation model showed that after controlling for demographic covariates and baseline levels of adolescent self-control and adjustment, T1 paternal self-control facilitated T2 adolescent adjustment through fathers' lower levels of perceived stress and adolescents' improved self-control. By contrast, T1 maternal self-control facilitated T2 adolescent adjustment through mothers' better mindful parenting and adolescents' improved self-control. These findings advance our understanding of how self-control is transmitted from parents to offspring and clarify the processes of how parental self-control facilitates adolescent adjustment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Conducta del Adolescente , Autocontrol , Masculino , Femenino , Humanos , Adolescente , Niño , Responsabilidad Parental/psicología , Ajuste Emocional , Pandemias , Conducta del Adolescente/psicología , Padres/psicología , Relaciones Padres-Hijo , Madres/psicología , Estrés Psicológico/etiología
18.
Work ; 77(1): 197-209, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37638461

RESUMEN

BACKGROUND: Financial distress is a primary concern for young adults with cancer. OBJECTIVE: The aim of this study was to identify material resources, physical and psychological health, and workplace variables that are associated with financial distress in young adult cancer survivors. METHODS: A cross-sectional study was conducted using the Cancer Survivor Employment Needs Survey. Participants were young adults (18-39 years of age) who lived in the United States and had a cancer diagnosis. Multivariable linear regression was used to model relations between financial distress and material resources, physical and psychological health, and workplace variables. RESULTS: Participants (N = 214) were mostly non-Hispanic White (78%), female (79%), and had a mean age of 31 years and 4.6 years post-diagnosis. Material resources, physical and psychological health, and workplace variables were all identified as contributing to study participants' financial distress. Among the young adults surveyed, financial distress was prevalent, and an array of problems were associated with financial distress. CONCLUSION: Oncology and rehabilitation providers should openly discuss finances with YAs with cancer and guide them to resources that can address their financial, benefits, and vocational needs to ultimately improve quality of life.


Asunto(s)
Neoplasias , Calidad de Vida , Humanos , Adulto Joven , Femenino , Estados Unidos , Adulto , Calidad de Vida/psicología , Estudios Transversales , Estrés Psicológico/etiología , Estrés Psicológico/psicología , Lugar de Trabajo , Neoplasias/complicaciones , Neoplasias/psicología , Recursos en Salud
19.
Acta Diabetol ; 61(2): 151-159, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37747554

RESUMEN

AIMS: To analyze if midterm improvement in diabetes distress can be explained by resilience, diabetes acceptance, and patient characteristics. METHODS: N = 179 adults with type 1 diabetes were enrolled during their stay at a tertiary diabetes center (monocentric enrolment) and followed up over three months in a prospective, observational study ('DIA-LINK1'). Improvement in diabetes distress was assessed as reduction in the Problem Areas in Diabetes Scale score from baseline to follow-up. Resilience (Resilience Scale-13), acceptance (Diabetes Acceptance Scale), and patient characteristics were analyzed as predictors of improvement in diabetes distress using hierarchical multiple regression. RESULTS: Greater reductions in diabetes distress were significantly explained by lower diabetes acceptance at baseline (ß = -0.34, p < 0.01), while resilience, diabetes complications, and other person-related variables were not significantly related to changes in diabetes distress (all p > 0.05). When change in diabetes acceptance from baseline to follow-up was added to the model, improved diabetes distress was explained by increasing diabetes acceptance (ß = 0.41, p < 0.01) and a shorter duration of diabetes (ß = -0.18, p = 0.03), while baseline diabetes acceptance was no longer significantly associated (ß = -0.14, p > 0.05). CONCLUSIONS: Diabetes acceptance is inversely related to diabetes distress, and increasing acceptance explained greater improvement in diabetes distress. These findings suggest that increasing diabetes acceptance may facilitate the reduction of diabetes distress. Treatment approaches targeting acceptance might be useful for the mental healthcare of people with type 1 diabetes and clinically elevated diabetes distress.


Asunto(s)
Complicaciones de la Diabetes , Diabetes Mellitus Tipo 1 , Resiliencia Psicológica , Adulto , Humanos , Diabetes Mellitus Tipo 1/complicaciones , Estudios Prospectivos , Estrés Psicológico/etiología
20.
Ann Surg ; 279(3): 450-455, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-37477019

RESUMEN

OBJECTIVE: To describe the incidence and natural progression of psychological distress after major surgery. BACKGROUND: The recovery process after surgery imposes physical and mental burdens that put patients at risk of psychological distress. Understanding the natural course of psychological distress after surgery is critical to supporting the timely and tailored management of high-risk individuals. METHODS: We conducted a secondary analysis of the "Measurement of Exercise Tolerance before Surgery" multicentre cohort study (Canada, Australia, New Zealand, and the UK). Measurement of Exercise Tolerance before Surgery recruited adult participants (≥40 years) undergoing elective inpatient noncardiac surgery and followed them for 1 year. The primary outcome was the severity of psychological distress measured using the anxiety-depression item of EQ-5D-3L. We used cumulative link mixed models to characterize the time trajectory of psychological distress among relevant patient subgroups. We also explored potential predictors of severe and/or worsened psychological distress at 1 year using multivariable logistic regression models. RESULTS: Of 1546 participants, moderate-to-severe psychological distress was reported by 32.6% of participants before surgery, 27.3% at 30 days after surgery, and 26.2% at 1 year after surgery. Psychological distress appeared to improve over time among females [odds ratio (OR): 0.80, 95% CI: 0.65-0.95] and patients undergoing orthopedic procedures (OR: 0.73, 95% CI: 0.55-0.91), but not among males (OR: 0.87, 95% CI: 0.87-1.07) or patients undergoing nonorthopedic procedures (OR: 0.95, 95% CI: 0.87-1.04). Among the average middle-aged adult, there were no time-related changes (OR: 0.94, 97% CI: 0.75-1.13), whereas the young-old (OR: 0.89, 95% CI: 0.79-0.99) and middle-old (OR: 0.87, 95% CI: 0.73-1.01) had small improvements. Predictors of severe and/or worsened psychological distress at 1 year were younger age, poor self-reported functional capacity, smoking history, and undergoing open surgery. CONCLUSIONS: One-third of adults experience moderate to severe psychological distress before major elective noncardiac surgery. This distress tends to persist or worsen over time among select patient subgroups.


Asunto(s)
Pacientes Internos , Distrés Psicológico , Adulto , Masculino , Persona de Mediana Edad , Femenino , Humanos , Estudios de Cohortes , Estudios Prospectivos , Tolerancia al Ejercicio , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/psicología
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