Journal of Psychosomatic Research最新文献_第5页

The factor structure of the Patient Health Questionnaire-9 in stroke: A comparison with a non-stroke population 中风患者健康问卷-9 的因子结构：与非脑卒中人群的比较

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-16 DOI: 10.1016/j.jpsychores.2024.111983

J.J. Blake , T. Munyombwe , F. Fischer , T.J. Quinn , C.M. Van der Feltz-Cornelis , J.M. De Man-van Ginkel , I.S. Santos , Hong Jin Jeon , S. Köhler , M.T. Schram , J.L. Wang , H.F. Levin-Aspenson , M.A. Whooley , S.E. Hobfoll , S.B. Patten , A. Simning , F. Gracey , N.M. Broomfield

Background

It is unclear if certain post-stroke somatic symptoms load onto items of the Patient Health Questionnaire-9 (PHQ-9), a self-report depression questionnaire. We investigated these concerns in a stroke sample using factor analysis, benchmarked against a non-stroke comparison group.

Methods

The secondary dataset constituted 787 stroke and 12,016 non-stroke participants. A subsample of 1574 comparison participants was selected via propensity score matching. Dimensionality was assessed by comparing fit statistics of one-factor, two-factor, and bi-factor models. Between-group differences in factor structure were explored using measurement invariance.

Results

A two-factor model, consisting of somatic and cognitive-affective factors, showed better fit than the unidimensional model (CFI = 0.984 versus CFI = 0.974, p < .001), but the high correlation between the factors indicated unidimensionality (r = 0.866). Configural invariance between stroke and non-stroke was supported (CFI = 0.983, RMSEA = 0.080), as were invariant thresholds (p = .092) and loadings (p = .103). Strong invariance was violated (p < .001, ΔCFI = −0.003), stemming from differences in the tiredness and appetite intercepts. These differences resulted in a moderate overestimation of depression in stroke when using a summed score approach, relative to the comparison sample (Cohen's d = 0.434).

Conclusions

The findings suggest that the PHQ-9 measures a single factor in stroke. Because stroke patients may report higher tiredness on item 4, caution is advisable when classifying patients as depressed if they are near the cut-off and have significant post-stroke fatigue. Caution is also advised when comparing total scores between stroke and other populations.

背景目前还不清楚中风后的某些躯体症状是否会对患者健康问卷-9（PHQ-9）（一种自我报告的抑郁问卷）的项目产生负荷。我们通过因子分析，以非中风对比组为基准，对中风样本中的这些问题进行了调查。方法二次数据集包括 787 名中风参与者和 12016 名非中风参与者。通过倾向得分匹配法选取了 1574 名对比参与者作为子样本。通过比较单因素、双因素和双因素模型的拟合统计量来评估维度。结果由躯体因素和认知情感因素组成的双因素模型比单维模型显示出更好的拟合度（CFI = 0.984 对 CFI = 0.974，p <.001），但因素之间的高相关性表明了单维性（r = 0.866）。中风和非中风之间的配置不变性得到了支持（CFI = 0.983，RMSEA = 0.080），不变阈值（p = 0.092）和负荷（p = 0.103）也得到了支持。由于疲劳和食欲截距的差异，出现了强不变量（p < .001，ΔCFI = -0.003）。这些差异导致在使用总分法时，相对于对比样本，中风患者的抑郁程度被中度高估（Cohen's d = 0.434）。研究结果表明，PHQ-9 测量的是脑卒中的单个因素。由于脑卒中患者可能会在第 4 项报告较多的疲倦感，因此如果患者接近临界值并有明显的脑卒中后疲倦感，在将其归类为抑郁时应谨慎。在比较中风患者和其他人群的总分时也应谨慎。

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引用次数: 0

Association of stressful life events with subjective age and the mediating role of depression: A cross-sectional study of older adults in China 生活压力事件与主观年龄的关系以及抑郁的中介作用：一项针对中国老年人的横断面研究。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-14 DOI: 10.1016/j.jpsychores.2024.111979

Xiaoting Liu , Jie Lin , Jiaming Shi , Qi Zhao

Objective

While previous studies have examined the relationship between stressful life events (SLEs) and subjective age (SA), the results were inconclusive and the mechanisms linking the association were unclear. This study investigated whether the experience of SLEs was associated with an older SA and the potential mediating role of depression linking this association in a cross-sectional study of older adults in China.

Methods

Data were drawn from the 2018 China Longitudinal Aging Social Survey (CLASS), comprising 7643 participants aged 60 and older. The association between SLEs and SA was examined using multivariate linear regression, and the mediation effect of depression was evaluated.

Results

Experiencing SLEs over the past year was associated with a 0.018 increase in proportional felt age (95 % CI: 0.012, 0.024) and a 0.011 increase in proportional look age (95 % CI: 0.005, 0.016), respectively. Depression appeared to be a significant mediator, accounting for 22.2 % and 27.3 % of the association of SLEs with proportional felt age and proportional look age, respectively.

Conclusion

Findings revealed that having SLEs was associated with an older SA, partially through the pathway of depression. More attention and appropriate intervention should be given to the older adults incurring SLEs to prevent the adverse effect of older SA.

研究目的虽然以往的研究探讨了生活压力事件（SLEs）与主观年龄（SA）之间的关系，但结果并不确定，而且两者之间的关联机制也不清楚。本研究在一项针对中国老年人的横断面研究中，调查了SLEs经历是否与主观年龄（SA）偏大相关，以及抑郁在这一关联中的潜在中介作用：数据来自 2018 年中国老龄社会纵向调查（CLASS），共有 7643 名 60 岁及以上的参与者。采用多元线性回归研究了系统性红斑狼疮与自闭症之间的关联，并评估了抑郁的中介效应：结果：在过去一年中，患系统性红斑狼疮分别与感觉年龄比例增加 0.018（95 % CI：0.012，0.024）和外观年龄比例增加 0.011（95 % CI：0.005，0.016）有关。抑郁症似乎是一个重要的中介因素，分别占系统性红斑狼疮与感觉年龄和外观年龄比例关系的 22.2% 和 27.3%：研究结果表明，患系统性红斑狼疮与年长的 SA 有关，部分原因是通过抑郁这一途径。对于患有系统性红斑狼疮的老年人，应给予更多的关注和适当的干预，以防止老年自闭症的不利影响。

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引用次数: 0

Circadian rhythm regulation as a target for alleviating bridge symptoms in comorbid internalizing and functional disorders 以昼夜节律调节为目标，缓解合并内化和功能性障碍的桥接症状。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-14 DOI: 10.1016/j.jpsychores.2024.111981

Akhmad Rizkhi Ridhani , Rudi Haryadi , Hartono , Laelatul Anisah , Jarkawi , Eka Sri Handayani

引用次数: 0

A qualitative study exploring the experiences and needs of fear of disease progression in patients after open-heart surgery 一项定性研究，探索开胸手术后患者对疾病进展恐惧的经历和需求。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-14 DOI: 10.1016/j.jpsychores.2024.111980

Zilu Liang , Shaoyan Lin , Huimei Sun , Yingying Liao , Muchen Zhang , Cuishan Chen , Huijuan Song

Objective

Open-heart surgery (OHS) is a stressful event for patients, all of whom experience varying levels of worry and fear, leading to fear of disease progression (FoP). An in-depth understanding of the experiences and needs of FoP in patients after OHS is beneficial for healthcare providers to make optimal decisions, but this has not been reported. We aimed to explore the experiences and needs of FoP in patients after OHS by adopting a qualitative interview method.

Methods

A qualitative study was performed to recruit 18 qualified patients through purposive sampling and then conduct face-to-face, semi-structured interviews. The research setting was the cardiovascular surgery ward of a tertiary hospital in Guangdong, China, in 2024. The data were analyzed and extracted using conventional content analysis.

Results

In the study, four themes emerged: a) sources of FoP; b) effects of FoP; c) attitudes towards FoP; d) supportive service needs. The desire to obtain meaningful assistance and the profound experiences of FoP in patients after OHS gave rise to these themes.

Conclusions

FoP following OHS is a subjective feeling characterized by fear and discomfort. Care workers must completely grasp the patients' fear and provide personalized interventions to support them through the difficult recovery phase, which will also be the focus of future efforts in this area.

目的：开胸手术（OHS）对患者来说是一个压力事件，所有患者都会经历不同程度的担忧和恐惧，从而导致对疾病进展的恐惧（FoP）。深入了解开胸手术后患者的恐惧经历和需求有利于医疗服务提供者做出最佳决策，但目前尚未有相关报道。我们的目的是采用定性访谈的方法，探讨老年性痴呆患者的恐惧经历和需求：方法：我们进行了一项定性研究，通过目的性抽样招募了 18 名合格患者，然后进行了面对面的半结构化访谈。研究环境为 2024 年中国广东省一家三级甲等医院的心血管外科病房。研究采用传统的内容分析法对数据进行分析和提取：在研究中，出现了四个主题：a) FoP 的来源；b) FoP 的影响；c) 对 FoP 的态度；d) 支持性服务需求。患者希望获得有意义的帮助以及在老年健康服务后对 FoP 的深刻体验产生了这些主题：老年健康服务后的 "恐惧 "是一种以恐惧和不适为特征的主观感受。护理人员必须完全理解患者的恐惧，并提供个性化的干预措施，以支持他们度过艰难的恢复阶段，这也将是该领域未来工作的重点。

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引用次数: 0

Non-pharmacologic interventions for treating fear of cancer recurrence in patients with cancer: A network meta-analysis of randomized controlled trials 治疗癌症患者癌症复发恐惧的非药物干预措施：随机对照试验的网络荟萃分析。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-10 DOI: 10.1016/j.jpsychores.2024.111970

Fei Dong , Di Yang , Na Dong , Yujing Li , Hongjuan Wan , Jiangxia Gao

Objective

This study aimed to evaluate the impact of non-pharmacological interventions on fear of cancer recurrence in patients with cancer by synthesizing evidence from various studies using the net meta-analysis (NMA) approach. Additionally, the study sought to rank the efficacy of these interventions.

Methods

Two investigators independently searched the PubMed, Cochrane Library, Embase, and Web of Science databases to identify randomized controlled trials(RCTs) that met the inclusion criteria. The search encompassed the period from the inception of the database to December 2023. The included studies were then subjected to a quality assessment, and a network meta-analysis was performed to evaluate and compare the effectiveness of the interventions.

Results

This study included 27 RCTs involving 3009 patients and examined seven types of non-pharmacological interventions. The NMA results indicated that, based on the Surface Under the Cumulative Ranking curve, Cancer and Living Meaningfully (CALM) was the most effective intervention (100 %), followed by Mindfulness Therapy (MT) at 76.5 % and Couples' Skills Training (CST) at 60.6 %. However, the league table results showed that, compared to the waitlist group, the effects of CALM [SMD = −4.83, 95 % CI (−5.93, −3.73)] and CST [SMD = −0.86, 95 % CI (−1.65, −0.07)] were significant, while MT [SMD = −1.52, 95 % CI (−3.46, 0.43)] did not reach statistical significance. Furthermore, CST was more effective than Cognitive Behavioral Therapy [SMD = −2.98, 95 % CI (−5.40, −0.56)].

Conclusion

The results of this study indicate that CALM is the most effective intervention for addressing mental health issues.

研究目的本研究旨在通过使用净荟萃分析（NMA）方法综合各项研究的证据，评估非药物干预对癌症患者癌症复发恐惧的影响。此外，该研究还试图对这些干预措施的疗效进行排序：两名研究人员独立检索了 PubMed、Cochrane Library、Embase 和 Web of Science 数据库，以确定符合纳入标准的随机对照试验（RCT）。检索时间从数据库建立之初到 2023 年 12 月。然后对纳入的研究进行了质量评估，并进行了网络荟萃分析，以评估和比较干预措施的有效性：本研究纳入了 27 项研究性临床试验，涉及 3009 名患者，考察了七种非药物干预措施。NMA结果表明，根据累积排名曲线下表面，癌症与有意义地生活（CALM）是最有效的干预措施（100%），其次是正念疗法（MT）（76.5%）和夫妻技能培训（CST）（60.6%）。然而，列表结果显示，与候补名单组相比，正念疗法[SMD = -4.83，95 % CI (-5.93, -3.73)]和夫妻技巧训练[SMD = -0.86，95 % CI (-1.65, -0.07)]的效果显著，而MT[SMD = -1.52, 95 % CI (-3.46, 0.43)]没有达到统计学意义。此外，CST 比认知行为疗法[SMD = -2.98，95 % CI (-5.40，-0.56)]更有效：本研究结果表明，CALM 是解决心理健康问题最有效的干预措施。

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引用次数: 0

Meaning in life and all-cause and cause-specific mortality in the UK Biobank 英国生物库中的生命意义与全因和特定原因死亡率。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-10 DOI: 10.1016/j.jpsychores.2024.111971

Angelina R. Sutin , Martina Luchetti , Selin Karakose , Yannick Stephan , Antonio Terracciano

Objective

To determine the association between meaning in life and all-cause and cause-specific mortality, and whether associations vary by depression or sociodemographic factors.

Methods

Participants were UK Biobank cohort members who reported on their meaning in life in the mental health assessment from October 2016 to July 2017 (N = 153,505). All-cause mortality and cause-specific mortality were identified from ICD-10 codes from national death registries through December 2022.

Results

Over the up to six-year follow-up, every standard deviation higher in meaning in life was associated with a 15 % decreased risk of death from any cause (HR = 0.87, 95 % CI = 0.85–0.90, p < .001). The association was attenuated but remained significant accounting for socioeconomic, clinical, and behavioral risk factors (HR = 0.91, 95 % CI = 0.88–0.94, p < .001). Meaning in life was associated with reduced risk of death from 7 of the 8 cause-specific deaths examined: external cause (47 %), respiratory (41 %), nervous (32 %), digestive (25 %), or circulatory (15 %) systems, COVID-19 (28 %), and cancer (8 %). Depression concurrent with the meaning assessment did not explain or moderate these associations, which indicated that meaning was similarly protective when concurrently experiencing psychological distress. The association between meaning and all-cause mortality was similar across age, ethnicity, and socioeconomic status but slightly stronger among female than male participants.

Conclusion

Feeling that one's life has meaning is associated with lower risk of mortality, particularly causes of death due to the respiratory system, nervous system, or COVID-19. Given that meaning in life can be modified through intervention, future research could address whether it could be a useful target of intervention.

目的确定生命意义与全因死亡率和特定原因死亡率之间的关系，以及这种关系是否因抑郁或社会人口因素而异：参与者为英国生物库队列成员，他们在2016年10月至2017年7月期间的心理健康评估中报告了自己的人生意义（N = 153,505）。根据截至2022年12月的国家死亡登记中的ICD-10编码确定了全因死亡率和特定原因死亡率：在长达六年的随访中，生活意义每提高一个标准差，任何原因导致的死亡风险就会降低 15%（HR = 0.87，95 % CI = 0.85-0.90，p 结论：在随访中，生活意义每提高一个标准差，任何原因导致的死亡风险就会降低 15%（HR = 0.87，95 % CI = 0.85-0.90，p 结论）：认为自己的生命有意义与较低的死亡风险有关，尤其是呼吸系统、神经系统或 COVID-19 导致的死亡。鉴于生命意义可以通过干预来改变，未来的研究可以探讨生命意义是否可以成为一个有用的干预目标。

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引用次数: 0

A cultural adaptation and validation study of the Intentional Nonadherence Scale (INAS) among people with type 2 diabetes in Singapore 新加坡 2 型糖尿病患者故意不坚持治疗量表 (INAS) 的文化适应和验证研究。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-08 DOI: 10.1016/j.jpsychores.2024.111969

Vivien Teo , John Weinman , Kai Zhen Yap

Aims

To examine the psychometric properties of the Intentional Non-adherence Scale (INAS) among people with type 2 diabetes mellitus (PwT2D) in Singapore.

Methods

This study consisted of Phase 1: translation and adaptation of the questionnaire into local Mandarin and English and Phase 2: a longitudinal validation study at the outpatient clinics of a hospital in Singapore. In Phase 1, cognitive interviews were conducted with 20 PwT2D and healthcare providers to examine the content validity of the INAS. In Phase 2, 290 PwT2D were recruited. Fifty-three of them were involved in test-retest reliability analysis, while 185 were followed-up in 3–6 months to assess the predictive validity of the INAS. The INAS was also evaluated for its structural validity, construct validity and internal reliability.

Results

Exploratory factor analysis revealed four factors, namely “Resisting illness and medication”, “Sensitivity to medication”, “Testing treatment” and “Inconvenience”. All INAS factors showed good internal consistency (Cronbach's alpha = 0.84–0.94) and moderate test-retest reliability (intraclass correlation coefficient = 0.50–0.62). Construct validity of the INAS was demonstrated in its relationship with medication adherence, glycated haemoglobin (HbA1c), beliefs about medications, illness perception and mood. Quantile and linear regression for medication adherence and HbA1c in 3–6 months did not show statistical associations with the INAS after adjusting for potential confounders.

Conclusions

Our study supports the reliability and most aspects of validity of the INAS, which revealed new factors that may affect medication adherence and HbA1c. In clinical settings, healthcare providers may consider using this questionnaire to evaluate potential intentional nonadherence.

目的：研究新加坡2型糖尿病患者有意不坚持治疗量表（INAS）的心理测量特性：本研究包括两个阶段：第一阶段：将问卷翻译和改编为当地普通话和英语；第二阶段：在新加坡一家医院的门诊部进行纵向验证研究。在第 1 阶段，对 20 名残疾人和医疗服务提供者进行了认知访谈，以检验 INAS 的内容有效性。在第 2 阶段，共招募了 290 名残疾人。其中 53 人参与了测试-再测试可靠性分析，185 人接受了 3-6 个月的随访，以评估 INAS 的预测有效性。此外，还对 INAS 的结构效度、构造效度和内部信度进行了评估：探索性因子分析显示了四个因子，即 "抗拒疾病和药物治疗"、"对药物治疗敏感"、"测试治疗 "和 "不便"。所有 INAS 因子均显示出良好的内部一致性（Cronbach's alpha = 0.84-0.94）和适度的测试-再测可靠性（类内相关系数 = 0.50-0.62）。INAS 与用药依从性、糖化血红蛋白（HbA1c）、用药信念、疾病认知和情绪之间的关系证明了 INAS 的结构有效性。在对潜在的混杂因素进行调整后，3-6 个月的用药依从性和 HbA1c 的定量回归和线性回归并未显示出与 INAS 的统计学关联：我们的研究证实了 INAS 的可靠性和大部分有效性，并揭示了可能影响服药依从性和 HbA1c 的新因素。在临床环境中，医疗服务提供者可以考虑使用该问卷来评估潜在的有意不依从性。

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引用次数: 0

Mapping the 9-year sleep trajectory and its implications for chronic disease risks among middle-aged and older adults 绘制中老年人 9 年睡眠轨迹及其对慢性疾病风险的影响。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-02 DOI: 10.1016/j.jpsychores.2024.111967

Qian Li , Ngan Yin Chan , Liping Zhang , Samuel Yeung-shan Wong , Xue Yang

Objective

To identify the 9-year trajectories of sleep duration and to assess the relationship between time-dependent sleep duration and sleep trajectories with 14 chronic diseases in adults.

Methods

This study used five waves of data of the China Health and Retirement Longitudinal Survey. Participants with complete sleep duration data and at least one record of 14 chronic diseases were included. The group-based trajectory model was used to identify sleep trajectories from 2011 to 2020. Time-dependent survival analysis and logistic regression were used to examine the relationship between time-dependent sleep duration and sleep trajectories with chronic diseases.

Results

A total of 9063 participants were included, with a mean (standard deviation, SD) sleep duration of 6.37 (1.83) h/d. Sleeping <7 h/d predicted higher risks of 11 chronic diseases at follow-up, with hazard ratios (HR) and 95 % confidence intervals (CI) ranging from 1.71 (1.26–2.33) for psychiatric disease to 1.15 (1.04–1.27) for dyslipidemia. Five sleep trajectories were identified and labeled as group 1–5 based on ascending order of sleep duration. Consistently sleeping <4 h/d (group 1) and 4–6 h/d predicted higher risks of most chronic diseases, with the highest HR (95 %CI) of 3.50 (1.73–6.92) and 2.94 (1.82–4.49) for psychiatric diseases, respectively. Consistently sleeping 6–7 h/d (group 3) predicted higher risks of digestive diseases and arthritis. Decreasing sleep (group 4) predicted higher risks of psychiatric diseases and memory-related diseases.

Conclusions

Consistently sleeping <6 h/d predicted higher risks of most chronic diseases, especially psychiatric diseases. Digestive disease and arthritis were more sensitive to consistently inadequate sleep.

目的确定成人睡眠时间的 9 年轨迹，并评估随时间变化的睡眠时间和睡眠轨迹与 14 种慢性疾病之间的关系：本研究使用了中国健康与退休纵向调查的五波数据。方法：本研究使用了中国健康与退休纵向调查的五次波次数据，纳入了具有完整睡眠时间数据和至少一次 14 种慢性病记录的参与者。采用基于群体的轨迹模型来识别2011年至2020年的睡眠轨迹。采用时间依赖性生存分析和逻辑回归来研究时间依赖性睡眠时间和睡眠轨迹与慢性疾病之间的关系：结果：共纳入 9063 名参与者，平均（标准差，SD）睡眠时间为 6.37 (1.83) h/d。睡眠结论持续睡眠

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引用次数: 0

Network structure of functional somatic symptoms 功能性躯体症状的网络结构

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-11-01 DOI: 10.1016/j.jpsychores.2024.111968

Alexandra Litzenburger , Yannick Rothacher , Kay-Uwe Hanusch , Ulrike Ehlert , Urs M. Nater , Susanne Fischer

Objective

The overlap among functional somatic syndromes (FSS) is substantial, which is why various empirical attempts at an improved understanding of related symptoms have been undertaken. Network analyses are particularly valuable from a clinical point of view, since they focus on the extent to which symptoms expression is co-dependent. The aim of this study was to provide the first estimation of the network structure of symptoms in 17 FSS.

Methods

N = 3054 young adults participated in an online survey. The Questionnaire on Functional Somatic Syndromes (FSSQ) was used to diagnose FSS and to assess related symptoms. The Patient Health Questionnaire (PHQ-9) was used to assess (comorbid) depression. Various R packages were used for network analysis, which yielded correlations between symptoms (edges), symptom groups (communities), and measures of centrality for individual symptoms (e.g., node strength).

Results

The final network had a relatively small number of edges, with small (46.5 %) or small- to medium-sized (47.1 %) correlations. Ten communities were identified: cognitive problems/fatigue/depression, sensory problems, facial pain, head/neck/upper back pain, dizziness/nausea, throat pain/problems with swallowing, chest pain, widespread pain, abdominal pain/problems with digestion, and genital pain. The highest node strength in the network was found for the symptoms “tired”, “down, depressed, or hopeless”, and “tired after minimal exertion”.

Conclusions

The network analyses pointed to ten distinct groups of moderately associated symptoms in individuals with FSS. Fatigue and depression emerged as important symptoms connecting groups. Future studies should test whether (transdiagnostic) interventions specifically targeting these symptoms are particularly potent in alleviating FSS.

目的：功能性躯体综合征（FSS）之间存在大量重叠现象，因此人们尝试通过各种实证研究来加深对相关症状的理解。从临床角度来看，网络分析尤其有价值，因为它侧重于症状表达的共同依赖程度。本研究的目的是首次估算 17 种 FSS 症状的网络结构：方法：3054 名年轻人参与了在线调查。功能性躯体综合征问卷（FSSQ）用于诊断 FSS 和评估相关症状。患者健康问卷（PHQ-9）用于评估（合并）抑郁症。使用各种 R 软件包进行网络分析，得出症状（边）、症状组（群落）之间的相关性，以及单个症状的中心性度量（如节点强度）：最终网络的边缘数量相对较少，相关性较小（46.5%）或中小型（47.1%）。确定了 10 个群组：认知问题/疲劳/抑郁、感觉问题、面部疼痛、头部/颈部/上背部疼痛、头晕/恶心、喉咙痛/吞咽困难、胸痛、广泛性疼痛、腹痛/消化不良和生殖器疼痛。网络中节点强度最高的症状是 "疲倦"、"沮丧、抑郁或绝望 "和 "极度劳累后疲倦"：结论：网络分析显示，FSS 患者有十组不同的中度相关症状。疲劳和抑郁是连接各组的重要症状。未来的研究应测试专门针对这些症状的（跨诊断）干预措施是否能有效缓解 FSS。

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引用次数: 0

Caregiving, caring intensity, and allostatic load: A comparison of caring to others inside and outside the home 护理、护理强度和异质负荷：家庭内外对他人的关爱比较

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-10-22 DOI: 10.1016/j.jpsychores.2024.111966

Stephen Gallagher , Aoife Bowman Grangel , Ailbhe Dempsey , Siobhán Howard

Objective

Caregiving to a sick or disabled relative is a key chronic stress model in health psychology. However, caregiving is not uniformly stressful, and this study tested whether caregiving effects on life satisfaction and allostatic load varies by caring intensity, i.e., caring within the home, outside the own home, or both (e.g. Dual caring).

Method

Using data from the UK Understanding Society Wave 2, a sample of non-caregivers (N = 3149) and caregivers (N = 562) met inclusion criteria and completed measures of life satisfaction and provided blood samples for capturing endocrine, cardiovascular and immune parameters for assessment of allostatic load.

Results

Dual caregivers had lower life satisfaction compared to non-carers, and other caregiver groups. Further, dual caregivers had higher levels of allostatic load compared to non-carers and those caring within the home and those caring outside the home. These group differences withstood adjustment for several co-variates including gender, education, income and lifestyle factors.

Conclusions

These results confirm that caregiving is not uniformly stressful with dual caring, an index of caring intensity being more damaging for health. The findings are also discussed in relation to the caregiver-control model of chronic stress.

目的护理生病或残疾的亲属是健康心理学中的一种重要的慢性压力模式。本研究测试了护理对生活满意度和异质负荷的影响是否会因护理强度（即在家中护理、在家中以外护理或两者兼有（如双重护理））而有所不同、方法利用英国 "了解社会 "调查第 2 波的数据，抽样调查了符合纳入标准的非照顾者（3149 人）和照顾者（562 人），他们填写了生活满意度调查表，并提供了血液样本，用于采集内分泌、心血管和免疫参数，以评估变态反应负荷。此外，与非照护者、在家照护者和外出照护者相比，双重照护者的异位负荷水平更高。这些群体差异经受住了包括性别、教育、收入和生活方式因素在内的若干共变因素的调整。研究结果还与慢性压力的照顾者-控制模型进行了讨论。

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引用次数: 0