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Objective:To explore the changes and influencing factors of psychological distress in patients with primary acute myocardial infarction (AMI) in different periods, and to provide reference for the management of psychological distress in patients with primary AMI.Methods:This was a longitudinal, prospective, observational study. From June 2021 to September 2022, 118 patients with primary AMI in Peking Union Medical College Hospital and Peking University First Hospital were selected as the research objects. The psychological distress level of patients was investigated on the points of 24 hours after illness (T 1), before discharge (T 2), 1 month after discharge (T 3), 3 months after discharge (T 4), 6 months after discharge (T 5) and 12 months after discharge (T 6), and the influencing factors were analyzed. Results:The detection rate of psychological distress in 6 follow-up survey nodes was 66.95% (79/118), 48.31% (57/118), 29.66% (35/118), 24.58% (29/118), 19.49% (23/118) and 15.25% (18/118) respectively. Education level, family per capita income and disease awareness had significant effects on the psychological distress of patients with primary AMI at the time points from T 1 to T 6 ( β values were - 1.262 to - 0.212, all P<0.05). Conclusions:The level of psychological distress in primary AMI patients decreased with time. Nursing staff should pay attention to the trajectory and influencing factors of psychological pain, and formulate targeted intervention measures to reduce the level of psychological pain and promote the comprehensive rehabilitation of patients.
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Objective:To investigate the status of hypoglycemia fear, diabetes distress, self-regulatory fatigue and self-management in type 2 diabetes patients. The chain mediating effects of self-regulated fatigue and psychological distress on hypoglycemic fear and self-management were investigated.Methods:The Hypoglycemia Fear Survey-Worry Subscale (CHFSII-WS), Diabetes Distress Scale (DDS), Self-Regulatory Fatigue Scale (SRF-S) and Summary of Diabetes Self-Care Activities (SDSCA) were used to investigate the type 2 diabetes patients from the department of Endocrinology of the First Affiliated Hospital in Jinzhou Medical University. And constructed the structural equation model.Results:The scores of fear of hypoglycemia in type 2 diabetes patients were positively correlated with psychological pain and self-regulating fatigue ( r=0.739, 0.625, P<0.05), but negatively correlated with self-management level ( r=-0.602, P<0.05). The psychological pain score was positively correlated with the self-regulating fatigue score ( r=0.669, P<0.05) and negatively correlated with the self-management level score ( r=-0.609, P<0.05). The score of self-regulation fatigue was negatively correlated with the score of self-management ( r=-0.596, P<0.05). Pathway analysis showed that hypoglycemia fear could directly affect self-management behavior, indirectly predict self-management level through self-regulation fatigue and psychological pain respectively, and negatively affect self-management behavior through chain mediation of self-regulation fatigue and psychological pain ( χ2/ df=3.079, GFI=0.920, CFI=0.961, NFI=0.943, IFI=0.961, RMSEA=0.078). Conclusions:The Self-regulated fatigue and psychological distress acts as the chain mediators of hypoglycemic fear and self-management in patients with type 2 diabetes.
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@#Objective To evaluate the degree of psychological pain for cancer patients undergoing surgical treatment and analyze the contributory factors to provide the theoretical basis for psychological intervention for cancer patients with surgical treatment. Methods The clinical data of 455 cancer patients who received surgeries in our hospital from November 2020 to January 2021 were retrospectively analyzed, including 225 males and 230 females aged 53.80±13.50 years. By applying the method of convenient sampling, a cross-sectional survey was carried out by gathering the general information of the patients and evaluating their mental condition with the distress thermometer. The contributory factors were discussed by logistic regression analysis. Results The score for the psychological pain of the patients was 4.11±2.49 points. The main factors contributing to the psychological pain were physical problems, emotional problems and family matters. The logistic regression analysis showed that the main factors related to the degree of psychological pain were cancer types (P=0.023), religious belief (P=0.046), number of niduses (P=0.016), respiratory status (P=0.004), medical expense (P=0.007), grief (P=0.001) and anxiety (P=0.040). Conclusion Nearly half of the patients have been subjected to apparent psychological pain, and emotion and physical problems are the main factors. It is crucial to pay attention to the patients’ mental problems, seek convenient tools for psychological evaluation, and take actions to deal with the psychological problems and physical symptoms.
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Psychological pain is a subjective experience, mainly from the psychological needs of frustration. It is characterized by the perception of negative changes in self and its functions, accompanied by strong negative emotions. Psychological pain is often associated with the decline of mental health, which is considered to be the core of the suicide process. A higher level of psychological pain is closely related to suicidal ideation and suicidal behavior. Therefore, the measurement and evaluation of psychological pain plays an important role in outpatient screening, clinical treatment and crisis intervention. In order to improve the recognition of psychological pain and the accuracy of suicide risk prediction, after more than 20 years of application and development, more than 10 methods of measuring psychological pain can be included in clinical risk assessment. The traditional assessment methods are mostly based on Shneidman ’s definition of psychological pain and suicide theory, which are used to measure the intensity and frequency of psychological pain. In recent years, the development of suicide model and theory provides a new perspective and theoretical basis for the assessment of psychological pain. The latest assessment methods tend to be shorter and more convenient, or present the specific clinical characteristics of psychological pain. In addition, thematic apperception test, visual analogue scale, pictorial representation of illness and self measure and structured interview make up for the limitations of self-report. In the future, the assessment can be further combined with neurobiology, mobile internet and other means, while considering the application in diverse environments such as special populations and cross-cultural groups.
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Objective:To investigate the degree of psychological pain in patients with gastrointestinal cancer after multiple chemotherapy, and analyze the influencing factors of psychological pain.Methods:Totally 130 patients with gastrointestinal tumors admitted from December 2017 to December 2019 admitted to the People′s Hospital of Jiangsu Province were included, and all patients received multiple chemotherapy. Using the psychological pain screening tools to evaluate the degree of psychological pain of patients. The data of patients were collected and statistically analyzed by single factor and binary logistics regression model.Results:Among the 130 patients, 32 cases(24.62%) had no psychological pain and 98 cases (75.38%) had psychological pain. There were differences in the age, pathological stage, distant metastasis, monthly family income, accompanying staff, hospitalization time, and personality type of the mentally distressed and psychologically distressed ( χ2 values were 4.598-12.404, P<0.05). Binary logistics regression model analysis suggested that age, pathological stage, distant metastasis, family monthly income, accompany status, length of hospital stay, and personality type were the influencing factors of patients' psychological pain ( P<0.05). Conclusions:Psychological pain of patients with gastrointestinal tumors after multiple chemotherapy is more common, and its occurrence is mainly related to the patient′s age, pathological stage, distant metastasis, family monthly income, accompanying staff, hospitalization time and personality type.
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Objective To investigate the degree of psychological distress in patients with lower extremity arteriosclerosis obliterans, and to understand the causes and to analyze the influencing factors. Methods The general information questionnaire, psychological distress thermometer, family APGAR index and family burden scale questionnaire were used to conduct a cross-sectional survey in 145 patients with obliterans in hospital during the period from July 2015 to July 2017. Results The average score of psychological pain of all patients was (4.7±2.2) points, the patients with significant psychological distress was 102 cases, accounting for 70.3% (DT score≥4 points). The main reason caused by lower extremity arterial occlusive disease in patients with psychological distress among the top 10 were: pain, anxiety, sleep problems, physical activity, work/ school, restricted travel, numbness, fatigue, constipation, economic problems. Multiple linear regression analysis showed that the hospitalization, duration of illness, family care and family burden of the disease affected the scores of psychological pain in different seasons (P＜0.05). Conclusions The patients with lower extremity arteriosclerosis obliterans have severe psychological pain, so the targeted measures should be taken to prevent and treat the risk factors.
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Objective To evaluate the psychological distress of patients with retinal detachment and analyze its causes and related factors. Method We adopted a general information questionnaire and psychological distress thermometer (DT) to do a cross-sectional survey among patients undergoing retinal detachment reduction surgery between February 2016 and May 2017 in West China Hospital in Sichuan Province. Results The average score of psychological pain in the patients with retinal detachment was 4.3 ±2.0. Significant psychological distress was observed in 83 cases, which accounted for 67.5% (DT score was greater than 4). The top 5 factors for the psychological distress caused by the retinal detachment were edema, physical activity restricted, worry, bathing/dressing, and sleep problem. Multivariate linear regression analysis showed that age, sports, time of retinal detachment and combination of chronic diseases had an effect on psychological pain score (all P＜0.05). Conclusions The psychological distress of patients treated in retinal detachment reduction surgery is severe, and the physical problems are the main causes of psychological distress. In order to effectively prevent the emergence of psychological problems, psychological intervention measures should be taken in patients at young age, long time of retinal detachment, doing sports, and combination with other chronic diseases.