Psychosocial Group Intervention at a Low-Resource Setting Environment for Women Who Are Diagnosed and Treated for Breast Cancer: A Systematic Review

Africa faces significant challenges in terms of material and personnel resources for oncology interventions. This is particularly evident in South Africa, where resources are divided into high- and low-resource settings. High-resource settings cater to those with financial means to access private oncology facilities. However, many breast cancer patients receive care in South Africa’s low-resource settings, such as public hospital oncology clinics. Unfortunately, these settings have limited service providers and fail to offer comprehensive interventions, resulting in poor outcomes. However, recent research has highlighted the significance of socially supportive relationships in promoting healing and overall individual well-being, and spirituality has been identified as a source of positive outcomes in cancer patients. This systematic review paper explores the feasibility of implementing support group cancer care and interventions that incorporate social support networks available in community settings, and spiritual practices facilitated by traditional healers, and religious/spiritual leaders. These interventions can be provided within low-resource settings to women diagnosed with breast cancer. Inclusive participation of spouses, children, and extended family in the support group cancer care can facilitate healing for the entire system. Focusing on the strengths and resources within communities and incorporating these complementary services, can enhance the well-being and quality of life for Black African women diagnosed with breast cancer, despite low-resource settings. This approach acknowledges the potential of community-based support networks and encourages collaboration between various stakeholders, including community health educators, nurses, lay counselors, and community volunteers, to address the complex needs of these patients.

Mediating role of social support in dysphoria,despondency,and quality of life in patients undergoing maintenance hemodialysis

BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.

A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus

Type 2 diabetes mellitus contributes to poor health outcomes including mortality,yet there is a gap in the literature when seeking to understand the influence of psychosocial factors on coping in this population.The paper presents a systematic review of quantitative studies that examined relationships among psychosocial determinants and coping in adults with type 2 diabetes.This review is the second layer of knowledge discovery for the concept,"Taking on a life-altering change is a rhythmical journey of experiencing ups and downs on the way to acceptance." The life-altering change was determined to be a diagnosis of type 2 diabetes,the journey is the ups and downs of coping with the diagnosis as people work toward acceptance of type 2 diabetes.The review includes a synthesis of findings from 22 quantitative studies of psychosocial factors and coping in adults with type 2 diabetes.Anxiety,depression,stress,and diabetes distress were identified as key influential psychosocial factors.Increased social support was inversely related to emotional distress and coping styles were related to social well-being,psychological health,and physical health outcomes.The positive coping style of problem-focused coping was linked to improved psychological and physical health.Emotional responses to diagnosis were related to depression and anxiety.Negative coping styles of resignation,protest,or isolation were higher in women and linked to poorer quality of life,while avoidance was linked to increased diabetes-related distress and depressive symptoms.

Relationship between Moral Elevation and Prosocial Behavior among College Students: The Mediating Role of Perceived Social Support and Moderating Role of Moral Identity

Objectives:The present study examined the relationship between college students’moral elevation and prosocial behavior.As well as the mediating role of perceived social support and the moderating role of moral identity.Methods:A sample of 489 college students were recruited for the study.They were asked to complete a series of questionnaires,including Moral Elevation Scale(MES),Perceived Social Support Scale(PSSS),Moral Identity Scale(MIS)and Prosocial Tendency Measure(PTM).As part of the data analysis,we used correlation analysis and the method of constructing latent variable structural equation model to explore the mechanism of action among variables.Results:After controlling for gender,discipline,the research found that:(1)Moral elevation positively predicted the prosocial behavior among the college students;(2)Perceived social support mediated the relationship between moral elevation and prosocial behavior;(3)Moral identity moderated the second half of the model(i.e.,the link between perceived social support and prosocial behavior).Specifically,the mediating effect of perceived social support was stronger for college students with high-level moral identity compared to those with low-level moral identity.Conclusions:Moral identity significantly moderates the mediating effect of perceived social support,and the mediating model with moderated is established.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Relationship between primary caregivers’social support function,anxiety,and depression after interventional therapy for acute myocardial infarction patients

BACKGROUND An acute myocardial infarction(AMI)is often treated with direct coronary intervention and requires home-based rehabilitation.Caregivers of patients with AMI need adequate social support to maintain high-quality care;however,their social support function is low,and relevant indicators for intervention must be identified.AIM To analyze the correlation between social support for primary caregivers,their anxiety,and depression,when caring for patients with AMI after interventional therapy.METHODS Using convenience sampling,we selected 300 primary caregivers of patients with AMI who had undergone interventional therapy.The Social Support Rating Scale(SSRS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to assess the primary caregivers.A Pearson’s correlation analysis was used to analyze the correlations between the SSRS,SAS,and SDS,and a multiple logistic regression analysis was used to analyze the factors influencing the low social support function of primary caregivers.The receiver operating characteristic curve and area under the curve(AUC)were used to evaluate the predictive ability of the SAS and SDS for low social support function in primary caregivers.RESULTS Considering the norm among Chinese people,AMI caregivers’objective support,subjective support,support utilization,and SSRS scores were lower,while their SAS and SDS scores were higher.The SSRS scores of female caregivers were higher than those of the male caregivers(t=2.123,P=0.035).The Pearson correlation analysis showed that objective support,subjective support,support utilization,and SSRS total scores were significantly correlated with both SAS(r=-0.414,-0.460,-0.416,-0.535)and SDS scores(r=-0.463,-0.379,-0.349,-0.472).Among the 300 AMI caregivers,56 cases(18.67%)had a low level of support function(SSRS≤22 points).Logistic regression model analysis showed that SAS and SDS were independent risk factors for low social support function of AMI caregivers,regardless of adjustment for other variables(P<0.05).SAS and SDS predicted that the AUC of AMI caregivers with low support function was 0.84,sensitivity was 67.9 and 71.4,and specificity was 84.0 and 70.9,respectively.CONCLUSION The social support function of the primary caregiver of patients with AMI after interventional therapy was lower and negatively correlated with anxiety and depression in the primary caregiver.

Moderating Mechanism in the Relationship between Social Isolation and Mental Health among College Students during High-Risk Period of COVID-19 Transmission in Hubei, China

This study explored the effect of perceived social isolation on the mental health of college students during the high-risk period of COVID-19 transmission in Hubei,China and the role of social support from online friends in alleviating this effect.The questionnaire responses of 213 college students from four universities in Hubei were included.Measurement and structural models were constructed using structural equation modeling.The findings revealed that perceived social isolation while under home quarantine was a negative predictor of the mental health of college students in Hubei.Low social support from online friends may lead to a relatively strong relationship between perceived social isolation and mental health in these college students,whereas high social support from online friends may lead to a relatively weak relationship between perceived social isolation and mental health.

Preventing Health Anxiety:The Role of Self-Evaluation,Sense of Coherence,Self-Rated Health and Perceived Social Support

Background:Components of Self,completed with the perceived social support determine the individual differences in theevaluation of a stressor and the behavioral responses toward it,such as health-related anxiety.The study set as a goal theanalysis of associations between the components of Self,such as self-evaluation,sense of coherence,perceived social support,and reported health-related anxiety in an adult sample.Methods:147 adults from the 18–73 age group(mean age 37.5)voluntarily completed the questionnaire through Qualtrics online platform containing the Short Health Anxiety Inventory,Core Self-Evaluation Scale,Social Support Assessing Scale,and one Health Self-Evaluation Item.Results:ANOVA foundrelevant differences in total scores and subscales’scores of the health anxiety scale depending on the positive self-evaluation.Linear regression shows that the analyzed variables were responsible for the prediction of a higher value on the“Perceivedprobability of becoming ill”subscale in a proportion of 45.6%and for the“Perceived consequence of illness”subscale in aproportion of 20.2%The predictive value of the linear regression model for the total score on the health anxiety scale was46.3%.Our findings show that negative Core Self-Evaluation is linked with perceived health anxiety.Conclusions:Selfevaluation,sense of coherence and perceived social support influence the perceived health and can explain the differences inthe reported health-related anxiety.

Effect of Online Social Networking on Emotional Status and Its Interaction with Offline Reality during the Early Stage of the COVID-19 Pandemic in China

Background:During the early stages of the COVID-19 pandemic in China,social interactions shifted to online spaces due to lockdowns and social distancing measures.As a result,the impact of online social networking on users’emotional status has become stronger than ever.This study examines the association between online social networking and Internet users’emotional status and how offline reality affects this relationship.Methods:The study utilizes cross-sectional online survey data(n=3004)and Baidu Migration big data from the first 3 months of the pandemic.Two dimensions of online networking are measured:social support and information sources.Results:First,individuals’online social support(β=0.16,p<0.05)and information sources(β=0.08,p<0.01)are both positively associated to their emotional status during the epidemic.Second,these positive associations are moderated by social status and provincial pandemic control interventions.With regards to the moderation effect of social status,the constructive impact of information sources on emotional well-being is more pronounced among individuals from vulnerable groups compared to those who are not.With regard to the moderation effect of provincial interventions,online social support has the potential to alleviate the adverse repercussions of high rates of confirmed COVID-19 cases and strict lockdown measures while simultaneously augmenting the favorable effects of recovery.Conclusion:The various dimensions of social networking exert distinct effects on emotional status through diverse mechanisms,all of which must be taken into account when designing and adapting pandemic-control interventions.

The Relationship between Rural Left-Behind Children’s Physical Activity and Hope:The Mediating Effects of Perceived Social Support

It has been confirmed in previous studies that there is a positive correlation between physical activity and hope.In this study,rural left-behind children in China was taken as the participants to investigate the impact of physical activity on hope in rural left-behind children and examine the mediating role of perceived social support in the relationship between physical activity and hope.797 valid copies of the questionnaire were collected from China.Pearson correlation coefficient was employed to analyze the relationship between physical activity and hope;SEM and Bootstrap were used to test the mediating effect of perceived social support.The results show that physical activity can not only directly and positively predict the level of hope in rural leftbehind children but can also predict the level of hope through perceived social support;perceived social support plays a mediating role in the relationship between physical activity and hope.These results highlight the necessity to pay more attention to the physical activity of left-behind children and the possibility to improve the level of hope by increasing their physical activity;at the same time,the acquisition of more material,emotional and psychological support from teachers and guardians is more conducive to improving the sense of hope in left-behind children.These findings can deepen the understanding of the sense of hope in left-behind children,and provide new methods for and enlightenments on improving the level of hope in left-behind children.

Effect of Family Cohesion on Depression of Chinese College Students in the COVID-19 Pandemic: Chain Mediation Effect of Perceived Social Support and Intentional Self-Regulation

Individuals’perceptions,attitudes,and patterns of getting along with family members are important factors influencing Chinese people’s self-evaluation.The aim of this study was to investigate the effect of family cohesion on depression and the role of perceived social support and intentional self-regulation in this association.A hypothesized model of the association of family cohesion,perceived social support,intentional self-regulation,and depression was examined.A convenience sampling method was used to survey 1,180 college students in Yunnan Province using self-report.Data were collected using the Family Cohesion Scale,the Perceived Social Support Scale,the Intentional Self-Regulation Scale,and the Center for Epidemiological Studies Depression Scale.The findings revealed low to moderate correlation between the variables studied.College students’family cohesion was a negative predictor of their depression.This association was also mediated by the knock-on effect of perceived social support and intentional self-regulation.These findings show how family cohesion affects college students’depressive status.Specifically,these results help demonstrate the importance of family cohesion,perceived social support,and intentional self-regulation in optimizing students’depression,which in turn can promote better psychological states.

Relationship between perceived social support and post-traumatic growth in coronavirus disease 2019 patients discharged from the hospital

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has affected mental health and physical health negatively in some individuals.Examining perceived social support and post-traumatic growth(PTG)in COVID-19 patients could facilitate our understanding of how patients maintain their mental health.AIM To examine the relationship between the level of perceived social support and PTG in COVID-19 patients discharged from the hospital.METHODS This descriptive study was carried out between August and September 2022 with patients who were hospitalized due to COVID-19 in a university hospital in Erzurum and who were discharged at least 3 mo prior to the beginning of the study.The study was completed by 196 patients.Study data were collected faceto-face using a personal information form,multidimensional scale of perceived social support and PTG inventory.RESULTS The total mean score of the multidimensional scale of perceived social support was 63.82±15.72.The PTG inventory total mean score was 47.77±19.85.In addition,a direct significant correlation was found between perceived social support in COVID-19 patients and PTG.CONCLUSION The study results showed that perceived social support variables affected PTG significantly.Therefore,it is recommended for healthcare professionals to implement interventions to promote social support from healthcare professionals and the patient’s family and friends.Considering the negative effects of the ongoing COVID-19 pandemic,it is very important and necessary to implement effective public health interventions to promote PTG to reduce mental health problems.

Gender Differences in the Incidence and Related Factors of Low Social Support among Adolescents with Subthreshold Depression

Background:Social support is related to depression,but the gender differences and related factors that contribute to low social support among adolescents with subthreshold depression remain to be elucidated.This study explores the relationship between social support and depression,in addition to the gender difference in the incidence of low social support among adolescents with subthreshold depression and its related factors.Methods:A total of 371 Chinese adolescents with subthreshold depression were recruited.All subjects were rated on the Social Support Scale for Adolescents,the Response Style Scale,the Self-Perception Profile for Children,the Individualism-collectivism scale.Results:Binary logistic regression indicated that the stability dimension of cognitive style,the generality dimension of the Cognitive Style Questionnaire,and the social acceptance dimension of the Self-Perception Profile for Children scale were significantly correlated with social support level in male adolescents with subthreshold depression.In contrast,the total score of the Self-Perception Profile for Children scale,the social acceptance of the Self-Perception Profile for Children scale,total individualism,and total collectivism were significantly correlated with social support level in female adolescents with subthreshold depression.Limitations:This study is a cross-sectional study,and its effectiveness in explaining factors that influence levels of social support is limited.Conclusions:The gender difference between low social support among adolescents with subthreshold depression is related to cognitive style,self-perception,and collectivism–individualism.

Application of Social Support System in the Rehabilitation of Vagrants and Beggars with Mental Illness

Objective:Analyze the specific role of social support in vagrants and beggars with mental illness.Methods:80 patients with vagrant psychosis admitted into our hospital from April 2020 to April 2021 were randomly selected.The patients were treated for more than 6 months.The patients were randomly divided into two groups by drawing lots,with 40 cases in each group.The control group received routine nursing,and the observation group received routine nursing along with social support.The objective support,subjective support,and the utilization of support,which were combined into total social support of the two groups were compared after different nursing interventions.Results:After different nursing interventions,through the comparison of social support scale,the scores of objective support,subjective support,and utilization of support,and the total social support in the observation group were higher than the control group,and the differences were statistically significant(P<0.05).Conclusion:The application of social support system and while providing routine nursing among vagrants and beggars with psychosis can effectively improve their mental status,make them feel more valued and supported,and help improve their mental health and quality of life.

Factors influencing quality of life in Chinese patients with dementia: a systematic review

Background:Dementia is a group of nervous system diseases characterized by progressive cognitive decline,leading to a loss of self-care ability and a decline in well-being.This places a significant burden on the global healthcare system,with Chinese patients accounting for approximately one-quarter of the world’s dementia cases.Therefore,it is crucial to identify factors that impact the quality of life(QOL)among elderly Chinese individuals with dementia.Method:To achieve this,we conducted a comprehensive search of several databases,including PubMed,Embase,Web of Science,the Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,China VIP Database and China Biomedical Literature Database.We reviewed cross-sectional studies from the inception of these databases until March 27,2022.QOL outcomes were assessed using standardized scales in the studies included in this review.Results:The search yielded a total of 1,235 relevant articles,from which we finally included 21 cross-sectional studies and one longitudinal study after rigorous quality assessment.Among these,10 studies were classified as high quality,while 12 were classified as fair quality.Through our analysis,we identified 28 patient-rated QOL factors and 14 caregiver-rated QOL factors.These factors were categorized into three groups:patient,disease-related and caregiver.Factors commonly found to influence patient-rated QOL included age,education,marital status,depression,self-care ability,dementia severity,cognitive function,behavioral and psychological symptoms of dementia and caregiver burden.Similarly,factors commonly influencing caregiver-rated QOL included economic status,depression,self-care ability,dementia severity,cognitive function,behavioral and psychological symptoms of dementia and caregiving time.Conclusion:This review clarifies the factors that influence the QOL of Chinese individuals with dementia.When implementing interventions,it is crucial to consider the differences between patient-rated QOL and caregiver-proxy-rated QOL,as well as their respective influencing factors.

A Clinical Investigation: Study on Psychosocial Characteristics, Social Support and Intervention Strategies of Outpatient Cancer Pain Patients

Background and Objective: The presence of pain in cancer patients is a prevalent concomitant symptom, exerting significant impacts on their physical, psychological, and social functioning. However, the psychological and social aspects are often overlooked. This study aims to explore the factors influencing the provision of psychological and social support for patients experiencing cancer-related pain while proposing intervention measures to enhance treatment compliance, confidence levels, and overall quality of life. Materials and Methods: According to the inclusion and exclusion criteria, a total of 108 patients with moderate to severe advanced cancer pain who had received outpatient analgesia treatment for at least one month were selected as the study subjects. The psychological characteristics and social support of these patients were further examined using the Self-Rating Symptom Scale (SCL-90) and Social Support Rating Scale (SSRS). The influencing factors were compared with the national norms. Results: The total score of SCL-90 was significantly different from that of the domestic norm (P < 0.05), and the total score of social support was significantly different from that of the domestic norm (P < 0.01). In addition to hostile symptoms, Somatic, obsessive, sensitive, depression, anxiety, terror, paranoia, psychosis and other symptoms were correlated with subjective support (P 0.05). Conclusion: Patients with cancer pain are more vulnerable to physical symptoms, psychological distress, lack of social support, and other contributing factors. Implementing standardized treatment protocols can effectively alleviate physical symptoms while also emphasizing the importance of psychosocial interventions to address negative emotions and enhance social support. By bolstering patient confidence through these measures, we can ultimately improve treatment outcomes and enhance patients’ overall quality of life.

Assessing the current situation and the influencing factors affecting perceived stigma among older patients after leukemia diagnosis

BACKGROUND Psychological problems are becoming increasingly prominent among older patients with leukemia,with patients potentially facing stigmatization after diagnosis.However,there is limited research on the stigma experienced by these patients and the factors that may contribute to it.AIM To investigate the stigma faced by older patients after being diagnosed with leukemia and to analyze the potential influencing factors.METHODS A retrospective analysis was conducted using clinical data obtained from questionnaire surveys,interviews,and the medical records of older patients with leukemia admitted to the Hengyang Medical School from June 2020 to June 2023.The data obtained included participants’basic demographic information,medical history,leukemia type,family history of leukemia,average monthly family income,pension,and tendency to conceal illness.The Chinese versions of the Social Impact Scale(SIS),Perceived Social Support Scale(PSSS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to assess indicators related to stigma,social support,and mental health status.We used Pearson’s correlation coefficient to analyze the strength and direction of the relationship between the scores of each scale,and regression analysis to explore the factors related to the stigma of older patients with leukemia after diagnosis.RESULTS Data from 120 patients with leukemia aged 65-80 years were analyzed.The total score on the SIS and PSSS was 43.60±4.07 and 37.06±2.87,respectively.The SAS score was 58.35±8.32 and the SDS score was 60.58±5.97.The stigma experienced by older leukemia patients was negatively correlated with social support(r=-0.691,P<0.05)and positively correlated with anxiety and depression(r=0.506,0.382,P<0.05).Age,education level,smoking status,average monthly family income,pension,and tendency to conceal illness were significantly associated with the participants’level of stigma(P<0.05).Age,smoking status,social support,anxiety,and depression were predictive factors of stigmatization among older leukemia patients after diagnosis(all P<0.05),with a coefficient of determination(R2)of 0.644 and an adjusted R2 of 0.607.CONCLUSION Older patients commonly experience stigmatization after being diagnosed with leukemia.Factors such as age,smoking status,social support,and psychological well-being may influence older patients’reported experience of stigma.

Factors influencing discharge readiness among patients with mild-to-moderate ischemic stroke:a cross-sectional study

Objective:To describe discharge readiness and determine whether self-efficacy,social support,and the quality of discharge teaching can predict discharge readiness among patients with mild-to-moderate ischemic stroke.Methods:A total of 120 patients with mild-to-moderate ischemic stroke were recruited using simple random sampling.Five instruments,namely,the Demographic Data Questionnaire,the Chinese version of the Readiness for Hospital Discharge Scale(RHDS_C),the SelfEfficacy for Managing Chronic Disease 6-Item Scale(SES6),the Perceived Social Support Scale(PSSS),and the Quality of Discharge Teaching Scale(QDTS),were used for data collection.Descriptive statistics and standard multiple linear regression were used for data analysis.Results:The mean score of discharge readiness among patients with mild-to-moderate ischemic stroke was at a moderate level(M=7.6,SD=0.92),and 75.8%of the participants felt ready for discharge.Standard multiple linear regression revealed that selfefficacy(β=0.62,P<0.001)and the quality of discharge teaching(β=0.28,P<0.001)were the influencing factors.However,social support could not predict discharge readiness significantly.All the factors combined explained 64.9%of the variance in discharge readiness.Conclusions:Intervention programs aimed at improving self-efficacy and the quality of discharge teaching may be helpful in promoting discharge readiness in patients with mild-to-moderate ischemic stroke,especially in coping ability.

Health-related quality of life among congestive heart failure patients with preserved and reduced ejection fraction

Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used for this study.The stratified random sampling was applied for each subgroup.HRQOL was measured with the Minnesota Living with Hear t Failure Questionnaire.The data were analyzed using chi-square,Spearman's correlation analysis,and independent t-test.Results:A number of 67 respondents participated in the recent study.The total mean scores of HRQOL were significantly different(P=0.001)between heart failure(HF)patients with reduced and preserved ejection fractions,41.07±7.54 and 54.97±4.36,respectively.It related with the physical(mean±standard deviation[SD]=10.4±2.14;t=-10.08,95%CI=-12.46 to-8.34;P-value=0.001)and psychological(mean±SD=3.5±0.5;t=-6.68,95%CI=-4.55 to-2.45;P-value=0.001)domain.Strong correlation was found between age(r=-0.898,P<0.05),NYHA functional classes(r=-0.858,P<0.01),duration of HF(r=-0.807,P<0.01),family support(r=0.927,P<0.01),and quality of life(Qo L).Conclusions:HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction.Family suppor t is a fur ther determinant factor that has a positive correlation to the Qo L.

Psychological Distress, Social Support and Medication Adherence in Patients with Ischemic Stroke in the Mainland of China

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.