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Ma CY, Shang J, Zhang L, Chen J, Qian KY, Zhou JY. Anxiety, depression, and coping styles among cervical cancer patients during radiotherapy and their correlations with uncertainty in illness. World J Psychiatry 2025; 15:103510. [PMID: 40309582 PMCID: PMC12038664 DOI: 10.5498/wjp.v15.i4.103510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Revised: 02/20/2025] [Accepted: 03/03/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND Currently, there is limited research examining the relationship between anxiety, depression, coping styles, and illness uncertainty in patients with cervical cancer (CC) undergoing radiotherapy. Addressing this gap could provide valuable insights and more reliable evidence for clinical practice targeting this patient population. AIM To analyze the anxiety, depression, and coping styles of patients with CC undergoing radiotherapy and explore their correlations with illness uncertainty. METHODS A total of 200 patients with CC undergoing radiotherapy at The First Affiliated Hospital of Soochow University between June 2018 and June 2022 were enrolled. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), comprising subscales for anxiety (HADS-A) and depression (HADS-D). Coping styles were evaluated using the Jalowiec Coping Scale (JCS-60), comprising dimensions such as confrontive, evasive, optimistic, fatalistic, emotive, palliative, supportive, and self-reliant. Illness uncertainty was measured using the Mishel Uncertainty in Illness Scale (MUIS), encompassing ambiguity, complexity, information deficit, and unpredictability. Correlations among anxiety, depression, coping styles, and illness uncertainty were analyzed. RESULTS During radiotherapy, the mean scores were 7.12 ± 3.39 for HADS-A, 6.68 ± 3.49 for HADS-D, 1.52 ± 0.23 for JCS-60, and 93.40 ± 7.44 for MUIS. Anxiety (HADS-A ≥ 8) was present in 39.5% of patients, depression (HADS-D ≥ 8) in 41.0%, and both in 14.0%. Anxiety was significantly positively correlated with ambiguity, unpredictability, and total MUIS score (P < 0.05). Depression was significantly positively correlated with ambiguity, information deficit, unpredictability, and total MUIS score (P < 0.05). Most patients adopted an optimistic coping style, whereas the emotive style was least utilized. Evasive, fatalistic, and emotive coping styles were significantly positively correlated with illness uncertainty, whereas the self-reliant style was significantly negatively correlated with unpredictability (P < 0.05). CONCLUSION Anxiety, depression, and coping styles in patients with CC undergoing radiotherapy correlate significantly with their level of illness uncertainty. Medical staff should address patients' psychological status and coping strategies by providing targeted information to reduce negative emotions, foster adaptive coping styles, and decrease illness uncertainty.
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Affiliation(s)
- Chen-Ying Ma
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Jing Shang
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Lu Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Jie Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Ke-Yan Qian
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
| | - Ju-Ying Zhou
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215123, Jiangsu Province, China
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Qian X, Wu L, Xu S. Impact of simulated animated video education on patients' disease uncertainty, anxiety, and sleep quality in digestive endoscopy examination. BMC Gastroenterol 2025; 25:124. [PMID: 40021954 PMCID: PMC11871668 DOI: 10.1186/s12876-025-03718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 02/19/2025] [Indexed: 03/03/2025] Open
Abstract
BACKGROUND Gastrointestinal endoscopy examinations were commonly associated with patient uncertainty, anxiety, and sleep disturbances. Simulated animated video education has emerged as a potential intervention to address these psychosocial aspects in the healthcare setting. This study explores the impact of simulated animated video education on patients' disease uncertainty, anxiety, and sleep quality in the context of digestive endoscopy examinations. METHODS A total 166 patients who underwent digestive endoscopy examinations were conducted and divided into the conventional education group (n = 77) and the simulated animated video education group (n = 89). Disease uncertainty was assessed using the Mishel's Uncertainty in Illness Scale (MUIS), anxiety was evaluated using the Hamilton Anxiety Rating Scale (HAMA), and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). RESULTS Both conventional and simulated animated video education interventions led to a reduction in disease uncertainty, anxiety levels, and improvement in sleep quality post-education and at the one-month follow-up. However, the simulated animated video education group exhibited greater reductions in disease uncertainty (post-education: 86.69 ± 2.65 vs. 85.65 ± 3.46, P = 0.031; follow-up: 82.57 ± 4.57 vs. 81.21 ± 3.69, P = 0.038), anxiety (post-education: 19.88 ± 3.78 vs.18.75 ± 3.42, P = 0.046; follow-up: 18.59 ± 3.4 vs. 17.54 ± 3.25, P = 0.046), and improvement in sleep quality (post-education: 5.57 ± 1.25 vs. 5.15 ± 1.1, P = 0.023; follow-up: 5.22 ± 1.13 vs. 4.89 ± 0.86, P = 0.038) compared to the conventional education group. CONCLUSION The study findings suggest that simulated animated video education was associated with reduced disease uncertainty, alleviated anxiety, and improved sleep quality among patients undergoing gastrointestinal endoscopy.
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Affiliation(s)
- Xiaoqing Qian
- Department of Surgery Anesthesia, Endoscopy Center, Zhongshan People's Hospital, No. 2 Sunwen East Road, Zhongshan City, 528400, Guangdong Province, China.
| | - Lixin Wu
- Department of Surgery Anesthesia, Zhongshan People's Hospital, No. 2 Sunwen East Road, Zhongshan City, 528400, Guangdong Province, China
| | - Shuguang Xu
- Department of Surgery Anesthesia, Zhongshan People's Hospital, No. 2 Sunwen East Road, Zhongshan City, 528400, Guangdong Province, China
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Yi M, Zhao B, Zhang X, Wang Z. Exploration of subgroups and associated factors of the uncertainty in illness among older adults with chronic heart failure: A latent profile analysis. Geriatr Nurs 2025; 61:470-478. [PMID: 39733628 DOI: 10.1016/j.gerinurse.2024.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 11/05/2024] [Accepted: 12/18/2024] [Indexed: 12/31/2024]
Abstract
BACKGROUND Uncertainty in illness is regarded as a source of stress, and tends to have adverse consequences on quality of life among older adults with chronic heart failure (CHF). OBJECTIVE The purpose of this study was to identify distinct subgroups in uncertainty in illness, and to explore associated factors within the population of older adults with CHF. METHODS We conducted a cross-sectional study using convenience sampling to survey 311 hospitalized older adults with CHF. The Mishel Uncertainty in Illness Scale, the 14-item Fatigue Scale, and the Perceived Social Support Scale were administered through self-reported questionnaires. Statistical analyses were conducted using latent profile analysis to precisely categorize participants based on the variable of uncertainty in illness, and multinomial logistic regression was applied to identify factors associated with subgroup heterogeneity. RESULTS Participants were classified as four subgroups: overall low uncertainty group (27.3%), moderate uncertainty-inconsistency fluctuations group (43.7%), moderate uncertainty-strong inconsistency group (21.2%) and overall high uncertainty group (7.8%). In comparison to the first subgroup (the overall low uncertainty group), the marital status, educational background, monthly household income, number of comorbidities, fatigue level, and social support were associated with heterogeneity of uncertainty in illness among participants in other three subgroups. CONCLUSION The findings identified four distinct subgroups characterized by uncertainty in illness among older adults with CHF and revealed the demographic and clinical factors associated with each subgroup. Healthcare professionals should prioritize precise assessments and consider developing tailored interventions to reduce chronic uncertainty in illness among older patients.
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Affiliation(s)
- Mo Yi
- School of Nursing, Peking University, Beijing, China
| | - Baosheng Zhao
- Emergency Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xu Zhang
- School of Nursing, Peking University, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China.
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Wang S, Du Z, Lai C, Seth I, Wang Y, Huang Y, Fang Y, Liao H, Hu Y, Yu H, Zhang X. The association between cataract surgery and mental health in older adults: a review. Int J Surg 2024; 110:2300-2312. [PMID: 38668662 PMCID: PMC11020056 DOI: 10.1097/js9.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Although cataract surgery has been proposed as a potentially modifiable protective factor for enhancing emotional well-being in cataract patients, studies examining the relationship between anxiety or depression and cataract surgery have yielded inconsistent findings. This review summarizes existing evidence to establish whether cataract surgery is associated with depression and anxiety in older adults. METHODS A literature search was conducted across PubMed, Medline, Web of Science, and Embase databases. An initial screening by abstracts and titles was performed, followed by a review and assessment of the methodological quality of the relevant full papers, and final inclusion of 44 studies were deemed eligible for inclusion in this review. RESULTS Among 44 included studies, 36 studies (81.8%) were observational studies concerning the association of cataract surgery or cataracts with anxiety or depression, four studies (9.1%) were interventional studies, and four studies (9.1%) were reviews. Cataract surgery notably enhances the mental health of individuals with impaired vision. However, the multifaceted nature of psychological well-being, influenced by various factors, suggests that cataract surgery may not address all aspects comprehensively. Additionally, preoperative anxiety and depression significantly impact cataract surgery outcomes. CONCLUSION Vision impairment in older adults is closely associated with increased symptoms of depression and anxiety. While surgical intervention for cataracts improves these symptoms, it might be less effective for mental disorders with multifactorial causes. Notably, anxiety or depression poses challenges to successful preoperative and intraoperative cataract surgeries.
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Affiliation(s)
- Shan Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Chunran Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Ishith Seth
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
| | - Yaxin Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yu Huang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Huiyi Liao
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences
| | - Xiayin Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
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Boutahar K, Ihbour S, Hadi K, Kaoutar K, Chetoui A, El Kardoudi A, Najimi M, Chigr F. Anxiety and Associated Factors during the COVID-19 Pandemic Confinement in the Moroccan Adult Celiac Disease Population. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2023; 40:163-171. [PMID: 39469255 PMCID: PMC11320108 DOI: 10.1159/000528164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 11/10/2022] [Indexed: 10/30/2024] Open
Abstract
Introduction The widespread lockdown due to the COVID-19 pandemic was insured by Moroccan authorities in early 2020 to preserve the health of citizens. The lockdown and the pandemic imposed psychological effects on the population including anxiety. Celiac disease (CeD), a chronic disease among the most common inflammatory intestinal disorders, has been linked to adult emotional disturbances. Hence, CeD patients may suffer from anxiety or increase this condition due to the concomitant situation. The objective of this study was to assess COVID-19-related anxiety in a sample of adults with CeD in comparison with a matched healthy group. Method CeD patients (103) and matched healthy group (101) were investigated using a web-based COVID-19 and related lockdown anxiety survey. Anxiety was assessed with the State and Trait Anxiety Inventory (STAI test: Y1 for state anxiety and Y2 for trait anxiety). Results State anxiety was present among 65.3% of CeD and 41.6% of the comparison group, and the difference was statistically significant. CeD women suffered more from state anxiety than their compeers in the comparison group (t = 3.23; p = 0.002), and a significant correlation between good compliance to GFD and less state anxiety was found among CeD patients (r = 0.31; p = 0.002). 61.8% of CeD participants thought they were at higher risk of contamination by COVID-19, and they were mostly women (χ2 = 7.66, p < 0.006) and had significantly higher state anxiety mean scores than their compatriots who did not express these thoughts (t = 2.93; p = 0.004). Additionally, 41.5% of CeD participants had anxiety as a trait against 26.7% in the comparison group and the difference between the two groups was statistically significant. Conclusion Results of this survey allow a better understanding of the health-related pandemic effects on Moroccan CeD patients. It demonstrates that COVID-19 and related lockdowns had a serious impact on the psychological balance of these patients by increasing their anxiety. The survey results underlined the need to improve the psychological care of CeD patients notably by considering remote medical visits during this ongoing pandemic to provide mental health support.
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Affiliation(s)
- Kaltoum Boutahar
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
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Cheng J, Yang D, Zuo Q, Peng W, Zhu L, Jiang X. Correlations between uncertainty in illness and anxiety, depression and quality of life in patients receiving maintenance haemodialysis: A cross-sectional study. Nurs Open 2022; 9:1322-1331. [PMID: 35088576 PMCID: PMC8859091 DOI: 10.1002/nop2.1177] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/29/2021] [Accepted: 01/09/2022] [Indexed: 02/05/2023] Open
Abstract
Aim To investigate the uncertainty in illness, anxiety, depression and quality of life in patients receiving maintenance haemodialysis and confirm the correlations between these variables. Design A cross‐sectional study was conducted among 396 patients receiving maintenance haemodialysis in four tertiary hospitals in China. Methods Uncertainty in illness was measured by Mishel's uncertainty in illness scale. The scores of self‐rating anxiety scale, self‐rating depression scale and medical outcomes study short form 36 were collected and compared with available norms. The Pearson correlation coefficient was calculated to investigate the correlation between uncertainties in illness with these vital variables. Results The mean score of uncertainty in illness was 78.16 out of 160. Compared with the norm, patients receiving maintenance haemodialysis had a statistically significantly lower score of depression and higher scores of most domains of quality of life. Uncertainty in illness is corrected with anxiety, depression positively and with quality of life negatively.
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Affiliation(s)
- Jingxia Cheng
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, China
| | - Dongju Yang
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, China
| | - Qiantao Zuo
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, China
| | - Weixu Peng
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, China
| | - Longling Zhu
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, China
| | - Xiaolian Jiang
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, China
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Cal A, Aydin Avci I. Turkish adaptation of the Mishel uncertainty in illness scale-community form. Perspect Psychiatr Care 2021; 57:2006-2013. [PMID: 34121185 DOI: 10.1111/ppc.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The study aims to conduct the Turkish validity and reliability study of the Mishel uncertainty in illness scale-community form. DESIGN AND METHODS This is a study with a methodological design. It was carried out in a family health center in a province in the Black Sea Region between May and October 2019. The sample of the study consisted of 479 individuals with chronic diseases. The data were analyzed with exploratory and confirmatory factor analysis. FINDINGS The Cronbach's alpha was found to be 0.79. The fit indices of the 20-item scale with three-factor structure are at an acceptable level (root mean square error of approximation: 0.056; comparative fit index: 0.926; incremental fix index: 0.927; goodness of fit index: 0.918; Tucker-Lewis index: 0.915; adjusted goodness of fit index: 0.896; χ2 /SD: 2.481, p < 0.001). PRACTICE IMPLICATIONS The level of uncertainty revealed by the scale gives information about the chronic disease management of individuals.
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Affiliation(s)
- Ayse Cal
- Department of Nursing, Ankara Medipol University School of Health Sciences, Ankara, Turkey
| | - Ilknur Aydin Avci
- Department of Public Health Nursing, Ondokuz Mayıs University Health School, Samsun, Turkey
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The Relationship Between Uncertainty in Illness and Quality of Life in Patients With Heart Failure: Multiple Mediating Effects of Perceived Stress and Coping Strategies. J Cardiovasc Nurs 2021; 37:257-265. [PMID: 33764941 DOI: 10.1097/jcn.0000000000000799] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous investigators have demonstrated that uncertainty in illness is associated with quality of life (QoL) in patients with chronic illness. However, little is known about the mechanism underlying the relationship in patients with heart failure. OBJECTIVE The aim of this study was to examine the multiple mediating effects of perceived stress and coping strategies on the relationship between uncertainty in illness and QoL in patients with heart failure. METHODS We conducted a cross-sectional study in 302 patients with heart failure recruited at a general hospital in China from October 2016 to September 2017. Uncertainty in illness, perceived stress, coping strategies, and QoL were assessed using self-reported questionnaires. The multiple mediation model was tested using the PROCESS macro for SPSS. RESULTS Of the 302 patients, 51.7% had poor physical QoL and 45.7% had poor mental QoL (physical component summary or mental component summary score of <50 points). Uncertainty in illness had a significantly negative indirect effect on mental QoL through perceived stress and acceptance-resignation (indirect effect, -0.02; 95% confidence interval, -0.04 to -0.01). Uncertainty in illness also had a significantly negative indirect effect on mental QoL via perceived stress only (indirect effect, -0.18; 95% confidence interval, -0.26 to -0.09). CONCLUSIONS Poor QoL is prevalent in patients with heart failure. Perceived stress and acceptance-resignation are important mediating factors between uncertainty in illness and mental QoL in patients with heart failure. Interventions aimed at reducing perceived stress and acceptance-resignation coping may be beneficial for improving mental QoL in patients with heart failure.
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Gaebel J, Wu HG, Oeser A, Cypko MA, Stoehr M, Dietz A, Neumuth T, Franke S, Oeltze-Jafra S. Modeling and processing up-to-dateness of patient information in probabilistic therapy decision support. Artif Intell Med 2020; 104:101842. [PMID: 32499009 DOI: 10.1016/j.artmed.2020.101842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 02/05/2020] [Accepted: 03/04/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Probabilistic modeling of a patient's situation with the goal of providing calculated therapy recommendations can improve the decision making of interdisciplinary teams. Relevant information entities and direct causal dependencies, as well as uncertainty, must be formally described. Possible therapy options, tailored to the patient, can be inferred from the clinical data using these descriptions. However, there are several avoidable factors of uncertainty influencing the accuracy of the inference. For instance, inaccuracy may emerge from outdated information. In general, probabilistic models, e.g. Bayesian Networks can depict the causality and relations of individual information entities, but in general cannot evaluate individual entities concerning their up-to-dateness. The goal of the work at hand is to model diagnostic up-to-dateness, which can reasonably adjust the influence of outdated diagnostic information to improve the inference results of clinical decision models. METHODS AND MATERIALS We analyzed 68 laryngeal cancer cases and modeled the state of up-to-dateness of different diagnostic modalities. All cases were used for cross-validation. 55 cases were used to train the model, 13 for testing. Each diagnostic procedure involved in the decision making process of these cases was associated with a specific threshold for the time the information is considered up-to-date, i.e. reliable. Based on this threshold, outdated findings could be identified and their impact on probabilistic calculations could be reduced. We applied the model for reducing the weight of outdated patient data in the computation of TNM stagings for the 13 test cases and compared the results to the manually derived TNM stagings in the patient files. RESULTS With the implementation of these weights in the laryngeal cancer model, we increased the accuracy of the TNM calculation from 0.61 (8 out of 13 cases correct) to 0.76 (10 out of 13 cases correct). CONCLUSION Decision delay may cause specific patient data to be outdated. This can cause contradictory or false information and impair calculations for clinical decision support. Our approach demonstrates that the accuracy of Bayesian Network models can be improved when pre-processing the patient-specific data and evaluating their up-to-dateness with reduced weights on outdated information.
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Affiliation(s)
- Jan Gaebel
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany.
| | - Hans-Georg Wu
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany
| | - Alexander Oeser
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany
| | - Mario A Cypko
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany
| | - Matthaeus Stoehr
- University Hospital Leipzig, Dept. of Otolaryngology, Head and Neck Surgery, Leipzig, Germany
| | - Andreas Dietz
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany; University Hospital Leipzig, Dept. of Otolaryngology, Head and Neck Surgery, Leipzig, Germany
| | - Thomas Neumuth
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany
| | - Stefan Franke
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany
| | - Steffen Oeltze-Jafra
- University of Leipzig, Medical Faculty, ICCAS, Leipzig, Germany; Department of Neurology, University of Magdeburg, Germany
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Barberis N, Quattropani MC, Cuzzocrea F. Relationship between motivation, adherence to diet, anxiety symptoms, depression symptoms and quality of life in individuals with celiac disease. J Psychosom Res 2019; 124:109787. [PMID: 31443802 DOI: 10.1016/j.jpsychores.2019.109787] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/21/2019] [Accepted: 07/21/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Celiac disease is an immuno-mediated pathogenesis disease characterised by a malabsorption of nutrients that causes partial or total atrophy of intestinal villi and the alteration of the absorbing epithelium. Several studies have demonstrated the presence of anxiety and depression symptoms and poor quality of life in people with celiac disease and emphasised the importance of diet in modulating these effects. However, few studies have investigated the role of motivation and the relationship it has with these factors. The purpose of this study was to fill this gap and investigate the relationship between motivation, diet adherence, anxiety symptoms, depression symptoms and physical functioning in people with celiac disease. METHODS Questionnaires were administered to 433 people with celiac disease aged between 18 and 79 years (M = 32.73, DS = 11.54) to measure anxiety symptoms (State-Trait Anxiety Inventory-Y2), depression symptoms (Beck Depression Inventory), physical functioning (Scale of Physical Functioning), adherence to diet (Celiac Dietary Adherence Test) and motivation (Treatment Self-Regulation Questionnaire). RESULTS We used Structural Equation Modelling to examine the relationships of variables. Results revealed a direct relationship between motivation and diet adherence, anxiety symptoms, depression symptoms and physical functioning. They also illustrated the role played by diet adherence in mediating the relationship between motivation and anxiety symptoms, depression symptoms and physical functioning. CONCLUSION The results highlight the vital role played by motivation in people; indeed, analysis showed that motivation correlated to adherence to diet. It is therefore necessary to take this factor into account in the treatment of individuals with celiac disease.
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Affiliation(s)
- N Barberis
- Università degli Studi di Messina, Dipartimento di Medicina Clinica e Sperimentale, Messina, IT, Italy.
| | - M C Quattropani
- Università degli Studi di Messina, Dipartimento di Medicina Clinica e Sperimentale, Messina, IT, Italy.
| | - F Cuzzocrea
- Università degli Studi di Messina, Dipartimento di Medicina Clinica e Sperimentale, Messina, IT, Italy.
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Montalvo Prieto AA, Florez Torres IE, Romero Massa E. Asociación entre el nivel de incertidumbre y el tipo de enfermedad en pacientes hospitalizados en UCI. AVANCES EN ENFERMERÍA 2018. [DOI: 10.15446/av.enferm.v36n3.66508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: determinar la asociación entre el nivel de incertidumbre y el tipo de enfermedad en pacientes hospitalizados en unidades de cuidado intensivo de Cartagena, Colombia.Materiales y métodos: estudio observacional de corte transversal.La muestra estuvo constituida por 72 pacientes a quienes les fue aplicada la escala de incertidumbre de Merle Mishel. Se estimaron las asociaciones entre el tipo de enfermedad y la incertidumbre mediante la prueba no paramétrica Kruskal-Wallis.Resultados: la edad promedio de los participantes fue 58,3 años (DE = 19,4), con predominio del sexo femenino en el 54,2 %, la mediana de estancia hospitalaria correspondió a seis días. El 27,8 % presentó enfermedades cardiovasculares, seguidas de las metabólicas en un 19,4 %. El nivel de incertidumbre fue regular en el 63,9 % y alto en el 34,7 %. Respecto a la asociación entre variables, no se encontraron diferencias significativas entre los puntajes promedios de la escala según tipo de enfermedad (Prob. de Kruskal-Wallis > 0,05).Conclusión: la complejidad de la situación, las expectativas relacionadas con el compromiso de la salud, la presentación de los síntomas y los tratamientos médicos o quirúrgicos instaurados originaron incertidumbre independiente del tipo de enfermedad
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Illness uncertainty, anxiety and depression in Chinese patients with glaucoma or cataract. Sci Rep 2018; 8:11671. [PMID: 30076311 PMCID: PMC6076255 DOI: 10.1038/s41598-018-29489-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/08/2018] [Indexed: 12/15/2022] Open
Abstract
This study evaluated illness uncertainty, anxiety and depression among glaucoma patients and cataract patients in China. 263 patients with primary glaucoma and 100 patients with age-related cataract were recruited sequentially from Zhongshan Ophthalmic Center between October 2013 and March 2016. All the participants completed questionnaires for socio-demographic information, Mishel Uncertainty in Illness Scale (MUIS) and Hospital Anxiety and Depression Scale (HADS). 25 of the 263 glaucoma patients and 21 of the100 cataract patients finished two copies of the same questionnaires before and after surgery. Statistics were analyzed using SPSS17.0 software. We observed that glaucoma patients had higher MUIS and HADS score than did cataract patients. Multivariate logistic regression analysis indicated risk factors for illness uncertainty, anxiety and depression for glaucoma patients were high HADS score, poor visual acuity (VA) in the better eye and education level respectively. Risk factors for the same parameters of cataract patients were high HADS-A score, poor VA in the better eye and high illness uncertainty respectively. Scores of MUIS and HADS both decreased after surgery, but the change in HADS score among glaucoma patients was not significant. Clinical workers should take these factors into account to improve therapy, especially for glaucoma patients who undergo surgery.
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Choi M, Lee J, Oh EG, Chu SH, Sohn YH, Park CG. Factors Associated With Uncertainty in Illness Among People With Parkinson's Disease. Clin Nurs Res 2018; 29:469-478. [PMID: 30019611 DOI: 10.1177/1054773818788492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
People with Parkinson's disease (PD) reported to experience uncertainty because of gradually progressive disease characteristics with no cure, and variably manifesting and unpredictable symptoms. This study was designed to identify illness-related variables influencing uncertainty in PD patients and to analyze direct and indirect paths between these variables. Data were collected from 206 participants using a structured questionnaire. Path analysis revealed the direct and/or indirect effects of economic status, disease severity, social support, and resilience on uncertainty in people with PD. Disease severity, social support, and resilience were shown to have significant direct effects on uncertainty. Economic status and disease severity had indirect effects on uncertainty, which were mediated by social support. Disease severity and social support also had indirect effects on uncertainty, which were mediated by resilience. Therefore, the efforts of health care professionals should be directed not only toward managing PD symptoms, but also toward facilitating social support and resilience.
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Affiliation(s)
- MoonKi Choi
- Department of Nursing, Bucheon University, South Korea
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Eui Geum Oh
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Young H Sohn
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Chang Gi Park
- College of Nursing, The University of Illinois at Chicago, USA
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Blake A, Asnani V, Leger RR, Harris J, Odesina V, Hemmings DL, Morris DA, Knight-Madden J, Wagner L, Asnani MR. Stigma and illness uncertainty: adding to the burden of sickle cell disease. Hematology 2017; 23:122-130. [PMID: 28766464 DOI: 10.1080/10245332.2017.1359898] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Alphanso Blake
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | - Vikram Asnani
- Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston 7, Jamaica
| | | | - June Harris
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | | | - Daileann L. Hemmings
- Department of Health Sciences and Nursing, University of Hartford, West Hartford, CT, USA
| | | | - Jennifer Knight-Madden
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | | | - Monika Rani Asnani
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
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Reeves EM. Misdiagnosis of epilepsy: A patient’s perspective on Maria Oto’s review. Seizure 2017; 50:18. [DOI: 10.1016/j.seizure.2017.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022] Open
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Barberis N, Cernaro V, Costa S, Montalto G, Lucisano S, Larcan R, Buemi M. The relationship between coping, emotion regulation, and quality of life of patients on dialysis. Int J Psychiatry Med 2017; 52:111-123. [PMID: 28792286 DOI: 10.1177/0091217417720893] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Previous studies have investigated constructs that facilitate adaptation to chronic disease and improve quality of life and constructs that lead to psychopathological complications. The purpose of this research is to investigate the impact of coping and emotional regulation on the quality of life of patients on dialysis. Three questionnaires were administered to 78 patients on dialysis: Coping Orientations to Problems Experienced, Short Form (36), and Cognitive Emotion Regulation Questionnaire. Regressions analyses indicated that age, Rumination, Positive Refocusing, Avoidance Strategies, Approach to the Problem, and Transcendent Orientation predicted Physical Health. With regard to Mental Health, the predictors were gender, Self-Blame, Acceptance, Rumination, Positive Reappraisal, Catastrophizing, Avoidance Strategies, and Transcendent Orientation. This study confirms the relationship between emotional regulation, coping, and quality of life. The results highlight the need for total care of the patients, including an assessment of both physical state and psychological functioning in order to promote total well-being.
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Affiliation(s)
- Nadia Barberis
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Valeria Cernaro
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Sebastiano Costa
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gaetano Montalto
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Silvia Lucisano
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Rosalba Larcan
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Michele Buemi
- 1 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Coping, uncertainty and health-related quality of life as determinants of anxiety and depression on a sample of hospitalized cardiac patients in Southern Italy. Qual Life Res 2016; 25:2941-2956. [PMID: 27245776 DOI: 10.1007/s11136-016-1323-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Being hospitalized often causes psychological distress and compromises patients' psychological well-being, thereby augmenting the burden of illness. The aim of this paper is to investigate two possible determinants of anxiety and depression among hospitalized cardiac patients, namely uncertainty in illness, and coping strategies, controlling for the perceived health-related quality of life, and distinguishing between borderline and pathological levels of anxiety and depression. METHODS Data on anxiety, depression, coping style, uncertainty in illness and self-assessed quality of life concerning 200 cardiac inpatients from a university hospital were collected through validated questionnaires. A biprobit analysis, whose dependent variables are hospital anxiety and depression, was carried out. RESULTS Uncertainty in illness has a significant impact on the possibility of crossing the borderline level of both anxiety and depression. The coping strategy of Positive Reappraisal and Growth is inversely and significantly correlated to anxiety and depression, be it borderline or pathological; the Restraint Coping strategy is positively and significantly related to borderline anxiety. CONCLUSIONS The reduction of uncertainty in illness and the development of adequate coping strategies should be promoted in order to decrease the patients' risk of crossing the borderline threshold of anxiety and depression.
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