Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and ...Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and 55%. Commonly encountered psychological issues include and are not limited to fear, anxiety, and emotional distress. Many sources of emotional distress in patients with cancer during the COVID-19 pandemic have been reported to include poorly controlled symptoms arising from a lack of access to symptom control services and treatment. Social distress is associated with social isolation, separation from family and loss of employment. Cancer patients and society have been reported to experience anxiety, despair, and stress due to the COVID-19 restrictions on community movement and hospital appointment rescheduling. The objective of this study was to explore psychosocial distress and social burdens experienced by cancer patients during the COVID-19 pandemic. Methods: A descriptive phenomenological design was employed to describe “lived experiences of patients with Cancer” during the COVID-19 Pandemic. A total of 20 participants with Cancer and COVID-19 positive were purposefully selected and interviewed. Thematic analysis was utilized for data analysis by the use of themes generated from participants’ responses. Findings: Five major themes emerged: fear, self-isolation compliance, anxiety, low income and emotional distress. The findings of the study indicated that participants experienced fear, emotional distress and anxiety when diagnosed with COVID-19. Conclusion: The experiences of psychosocial distress and social burdens were a result of a lack of psychosocial support by both caregivers and health care workers. This study recommends appropriate health education concerning psychosocial support for cancer patients and the need to have appropriate clinical protocols and materials in allaying anxiety and fear in cancer patients during the COVID-19 pandemic.展开更多
Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the...Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction(stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers(control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90(SCL-90), the social support by the Social Support Rating Scale(SSRS), and medication adherence by Morisky's self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group(P〈0.01). Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions(including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety) of SCL-90 were significantly higher in the stroke group than those in the control group(P〈0.05, or P〈0.01). The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group(P〈0.05, or P〈0.01). Those in the "SCL-90 total scores 〉150 group" were significantly higher than in the "SCL-90 total scores 〈100 group" and the "SCL-90 total scores between 100 to 150 group"(P〈0.05, or P〈0.01). Those in the "SCL-90 total scores between 100 to 150 group" were significantly higher than in the "SCL-90 total scores 〈100 group"(P〈0.05). In 90 patients with ischemic stroke, 26(28.89%) patients obtained high medication adherence, 47(52.22%) patients medium medication adherence, and 17(18.89%) patients low medication adherence, respectively. Among these stroke patients, there were 17(50.00%) patients with high medication adherence in the "SCL-90 total scores 〉150 group", 28(75.67%) patients with medium medication adherence in the "SCL-90 total scores between 100 to 150 group", and 12(61.16%) patients with low medication adherence in the "SCL-90 total scores 〈100 group", respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients(P〈0.05 or P〈0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.展开更多
文摘Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and 55%. Commonly encountered psychological issues include and are not limited to fear, anxiety, and emotional distress. Many sources of emotional distress in patients with cancer during the COVID-19 pandemic have been reported to include poorly controlled symptoms arising from a lack of access to symptom control services and treatment. Social distress is associated with social isolation, separation from family and loss of employment. Cancer patients and society have been reported to experience anxiety, despair, and stress due to the COVID-19 restrictions on community movement and hospital appointment rescheduling. The objective of this study was to explore psychosocial distress and social burdens experienced by cancer patients during the COVID-19 pandemic. Methods: A descriptive phenomenological design was employed to describe “lived experiences of patients with Cancer” during the COVID-19 Pandemic. A total of 20 participants with Cancer and COVID-19 positive were purposefully selected and interviewed. Thematic analysis was utilized for data analysis by the use of themes generated from participants’ responses. Findings: Five major themes emerged: fear, self-isolation compliance, anxiety, low income and emotional distress. The findings of the study indicated that participants experienced fear, emotional distress and anxiety when diagnosed with COVID-19. Conclusion: The experiences of psychosocial distress and social burdens were a result of a lack of psychosocial support by both caregivers and health care workers. This study recommends appropriate health education concerning psychosocial support for cancer patients and the need to have appropriate clinical protocols and materials in allaying anxiety and fear in cancer patients during the COVID-19 pandemic.
文摘Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction(stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers(control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90(SCL-90), the social support by the Social Support Rating Scale(SSRS), and medication adherence by Morisky's self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group(P〈0.01). Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions(including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety) of SCL-90 were significantly higher in the stroke group than those in the control group(P〈0.05, or P〈0.01). The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group(P〈0.05, or P〈0.01). Those in the "SCL-90 total scores 〉150 group" were significantly higher than in the "SCL-90 total scores 〈100 group" and the "SCL-90 total scores between 100 to 150 group"(P〈0.05, or P〈0.01). Those in the "SCL-90 total scores between 100 to 150 group" were significantly higher than in the "SCL-90 total scores 〈100 group"(P〈0.05). In 90 patients with ischemic stroke, 26(28.89%) patients obtained high medication adherence, 47(52.22%) patients medium medication adherence, and 17(18.89%) patients low medication adherence, respectively. Among these stroke patients, there were 17(50.00%) patients with high medication adherence in the "SCL-90 total scores 〉150 group", 28(75.67%) patients with medium medication adherence in the "SCL-90 total scores between 100 to 150 group", and 12(61.16%) patients with low medication adherence in the "SCL-90 total scores 〈100 group", respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients(P〈0.05 or P〈0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.