Chronic Illness最新文献

ObjectivesIncreased psychological support is required to assist the long-term well-being of the adult Cystic Fibrosis (CF) population. This research aimed to identify relationships between mindfulness, psychological flexibility, and wellbeing, as well as potential mediating effects of mindfulness to increase wellbeing in adults with CF.MethodsIn a cross-sectional study, 114 (56 female, 58 male) adults with CF completed and returned a series of validated questionnaires that assessed mindfulness, psychological flexibility, and wellbeing.ResultsParticipants who demonstrated better psychological flexibility also had higher levels of mindfulness and wellbeing, and similarly, those who reported higher levels of mindfulness had better wellbeing. Mindfulness subscale scores indicated additional associations. Mindfulness partially mediated the relationship between psychological flexibility and wellbeing. A second mediation model suggested that specifically 'acting with awareness' (i.e., a mindfulness subscale) also partially mediated the relationship between psychological flexibility and wellbeing, highlighting the significance of mindfulness within promoting wellbeing through psychological flexibility.DiscussionThis research demonstrates the importance of mindfulness in the relationship between psychological flexibility and wellbeing. The findings provide promising preliminary evidence to suggest that Acceptance and Commitment Therapy (ACT), a therapy enhancing psychological flexibility through mindfulness, to be beneficial for enhancing the wellbeing of adults with CF.

ObjectivesTo understand individuals' experiences of living with, and attempting to manage, trigeminal neuralgia (TN), a rare neurological disorder characterised by sudden episodes of intense, incapacitating unilateral facial pain.MethodsWe undertook in-depth interviews with (n = 25) individuals living with TN in the United Kingdom recruited via online forums. Data were analysed thematically.ResultsParticipants described the far-reaching impact of TN on their everyday lives, with their experiences broadly fitting into three overarching themes: "enduring pain", "avoiding pain" and "treatment burdens". Taken together, these three overlapping experiences comprise what we term the "triple burden" of TN: namely, the burden and assault to self, arising from being in intense and intractable pain; the burden and loss of self-identity resulting from avoiding pain triggers; and the additional burden resulting from having to balance pain relief with severe medication side effects.DiscussionLiving with TN can be a highly disruptive and distressing experience because TN pain and the strategies people employ to try to avoid triggering it can assault and undermine their self-identities and sense of self-worth. We argue that applying sociological concepts, such as Bury's work on biographical disruption, may help to shed light on people's lived experiences of TN and inform the care and support provided to them.

AimsIn this study, the aim is to explore how adolescents with inflammatory bowel disease cope with the challenges posed by the illness through psychological adjustment, with the goal of providing insights for the implementation of targeted interventions.MethodsFrom June to August 2023, semi-structured interviews were conducted with patients. Data were analyzed using the Colaizzi seven-step method.ResultsThe psychological adaptation process for adolescents with IBD can be categorized into five main themes: 1) Denial phase: Disbelief in the reality of the disease; 2) Despair Phase：Struggling with the negative emotions brought about by the disease; 3) Rebuilding Phase: Reshaping of cognitive perspective; 4) Adaptation phase: Proactive behavioral response; and 5) Growth phase: Strengthening of psychological resilience.ConclusionHealthcare staff should place emphasis on the patients' positive experiences, foster connections between patients and their individual selves, families, and society, thereby strengthening their psychological adaptability.

ObjectivesQuality of life (QoL) is a significant health outcome for the older adults, especially during the COVID-19 pandemic. The demand for health care from older adults who use home care services often increases sharply due to a lack of healthy behaviors, which harms their QoL to various degrees. Thus, this study aimed to examine the predictors of the QoL of disabled older adults using home care services during the COVID-19 pandemic.MethodsA cross-sectional survey study was conducted. A total of 214 older adults were collected from five home care support centers in the central region of Taiwan from October 1, 2021, to July 8, 2022.ResultsStepwise multiple regression analysis showed that the health promotion of healthy behavior (11.9%), financial status (8.6%), activities of daily living (4.5%), community care services (3.5%), and could explain 28.5% of the variance in predicting the overall QoL.DiscussionMaintaining health-promoting behaviors, having a better financial status, engaging in suitable activities of daily life level, and receiving daycare services could effectively improve the QoL.

ObjectivesContinuity of care is a critical component of successful hypertension management. With the growing prevalence of people living with both hypertension and disabilities, it is essential to explore how disability impacts continuity of care. This study aimed to investigate whether disability is associated with continuity of care among people with hypertension.MethodsThis study was a retrospective observational cross-sectional analysis using the 2019 Korea National Health Insurance Service-National Sample Cohort database. A total of 104,280 individuals diagnosed with hypertension aged 30 years and older were included. Multivariate logistic regression was used to examine the impact of disability on the odds of having higher continuity of care, measured using the Bice-Boxerman index, adjusting for sociodemographic factors.ResultsPeople with hypertension who also have physical disabilities were 6.6% less likely to achieve optimal COC compared to those without disabilities (Odds ratio = 0.934; 95% confidence interval = 0.875, 0.998).ConclusionPhysical disability significantly reduces the likelihood of achieving optimal COC in hypertension management. Targeted interventions addressing barriers faced by people with disabilities and hypertension are critical for improving care coordination and health outcomes.DiscussionThis study highlights the need for disability-inclusive healthcare policies and practices to reduce disparities in hypertension care.

ObjectivesLong-term health effects of Omicron infection, particularly persistent Long COVID in hospitalized patients, require further investigation.MethodsPatients hospitalized for Omicron infection (Dec 2022-Mar 2023) underwent follow-ups at 6 months and 1 year post-discharge. Univariate/multivariate analyses identified mortality predictors, symptom trends, and optimal CRP levels (mg/L) thresholds.ResultsAmong 410 patients, 59 died; mortality predictors included age (OR = 1.070), ICU admission (OR = 15.748), diabetes (OR = 3.363), antibacterial use (OR = 0.283), and lymphocyte count (OR = 0.099). At 6 months, 86.0% reported ≥1 symptom (83.5% at 1 year). Fatigue, cough, and snoring were most common, with symptom counts decreasing significantly over time. Symptomatic patients had longer hospital stays (P = 0.022), lymphopenia (P = 0.036), and elevated CRP levels (P = 0.010). A CRP level ≥15.38 mg/L was associated with a greater risk of symptom persistence and may serve as a potential predictive marker.ConclusionHospitalized Omicron survivors experience prolonged symptoms, with ICU admission, age, and diabetes as key mortality risks. Fatigue and snoring may persist despite overall improvement. Elevated CRP and prolonged hospitalization in symptomatic patients underscore the need for long-term monitoring and interventions targeting high-risk groups.

ObjectivesTo evaluate religion and spirituality (R/S) and spiritual/religious coping (SRC) in patients with type 2 diabetes mellitus (T2DM).MethodsThis is a study of 124 patients with T2DM, performed in a diabetes outpatient clinic of a teaching hospital in a medium-sized city in Minas Gerais, Brazil. Patients answered a socioeconomic classification questionnaire, the Duke University Religion Index (DUREL), and a validated Portuguese version of the Brief Spiritual/Religious Coping (Brief-SRCOPE) Scale.ResultsThe DUREL scores showed that the studied patients presented mean high levels of organizational religious activity (4.31, SD = 1.43), non-organizational activity (4.68, SD = 1.22), as well as intrinsic religiosity (13.90, SD = 1.94). The SRC total score was 3.67 (SD = 0.36) and the positive coping scale score 3.54 (SD = 0.55); both values were considered elevated. R/S played an important role in the lives of the T2DM patients.ConclusionThe SRC scores showed that R/S were being used in a positive way in addressing the challenges posed by this chronic disease.

ObjectivesThis study aimed to develop and validate a generic, non-disease-specific, self-assessment measure that recognizes patients' health capacities and their empowering process of health promotion in chronic illness by using Bodyknowledging as the theoretical frame.MethodsItem generation and expert content validity analysis were the first steps in instrument development. Potential items were then validated in focus group interviews with six patients diagnosed with various chronic diseases. The research team reviewed the resulting items and undertook item reduction. A sample of adults (n = 357) with chronic disease surveyed the instrument items. Exploratory factor analysis with Oblimin rotation was conducted.ResultsA 3-factor solution was identified: nine items on the regaining health and wellness subscale, seven items on the uncertainty and bereavement subscale, and eight items on the loss of control and distancing subscale. Cronbach alpha for the scale was .92. The final 24-item instrument is non-disease-specific and broadly applicable for use in health promotion within the context of chronic disease. The instrument demonstrates high internal consistency reliability with initial face and construct validity.DiscussionThe new instrument has the potential for measuring patients' empowering process of health promotion in chronic disease and the outcomes of person-centered interventions and may guide clinicians in tailoring individual support.

ObjectiveTo document the occurrence of post-intensive care syndrome (PICS) in intensive care unit (ICU) survivors with coronavirus disease-2019 (COVID-19) up to one year.MethodsRetrospective observational study at a university hospital post-ICU outpatient clinic. Patients were followed up in-person at 1 month, 3 months, 6 months and one-year after hospital discharge. Cognitive, physical and psychological domains of PICS were evaluated. PICS was defined as at least one dysfunction in the assessment tools in each domain.ResultsSixty-four patients were evaluated during the study period. Median age was 62.5 (55.0-71.0). Fifty-eight percent of them were male. Median APACHE II and admission SOFA scores were 13 (10-16) and 3 (3-4), respectively. Sixty-four, 54, 44, 20 patients were evaluated during the 1 -month, 3-month, 6-month and one-year visits. 94% of patients had PICS at the 1st visit and this declined to 75% in one-year. The ratio of patients who fulfilled all PICS domains were 15%, 10%, 13% and 13%, respectively at 4 follow-up visits. Physical impairment was the most commonly observed dysfunction during all visits.DiscussionThis study showed that at least one domain of PICS persisted in 75% of patients at one-year in COVID-19 ICU survivors.

ObjectivesMany factors affect caregiver burden. Limited studies exist on the effect of social support and fatigue on family caregivers. This study aims to explore the impact of fatigue and social support on the burden experienced by family caregivers of palliative care patients.MethodsThe study was conducted with 80 family caregivers. Data were collected using the Piper Fatigue Scale, the Burden Interview, and the Multidimensional Scale of Perceived Social Support. Regression analysis was used to evaluate the data.ResultsThe regression analysis revealed that higher scores on the MSPSS were significantly associated with lower Burden Interview scores (p < 0.05). Conversely, higher PFS scores were significantly correlated with increased Burden Interview scores (p < 0.05).DiscussionBoth fatigue and social support play a critical role in shaping the caregiving burden experienced by family caregivers. Interventions aimed at reducing caregiver fatigue and enhancing social support may help alleviate this burden.