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OBJECTIVES@#The interaction between elderly people with disabilities and their caregivers and the improvement of caregiver burden is important for elderly people with disabilities and their caregivers. This study aims to explore the multiple mediating roles of caregiver's caring ability and resilience in depression in the elderly people with disabilities on caregiver burden.@*METHODS@#A total of 246 elderly people with disabilities at home and their family caregivers from 5 regions were investigated by questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire, the Family Caregiver Task Inventory, the Resilience Scale, and the Caregiver Burden Interview. A multiple mediation model was constructed and tested.@*RESULTS@#Univariate analysis showed that the caregiver burden of disabled elderly men is higher than that of women; the lower the level of self-care of disabled elderly individuals, the greater the burden on their caregivers (both P<0.05). Correlation analysis showed that depression of the disabled elderly people was positively correlated with the caregiver burden (P<0.01). Caregiver's caring ability was positively correlated with caregiver's resilience (P<0.01), and both were negatively correlated with caregiver burden (both P<0.01). The multiple mediating effects of caregiver caring capacity and resilience between depression of the disabled elderly people and caregiver burden were significant, with the mediating effects of caregiver caring capacity and resilience accounting for 68.9% and 26.2% of the total effect, respectively.@*CONCLUSIONS@#Depression in the elderly people with disabilities can indirectly affect caregiver burden through the caregiver's caring ability and resilience. Families of older people with disabilities need to focus on both the elderly and their caregivers. It is possible to reduce the caregiver burden and improve the physical and mental health of the dyads by empowering the caregiver's caring ability and resilience.
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Male , Humans , Female , Aged , Caregiver Burden , Disabled Persons , Caregivers , Surveys and Questionnaires , Mental HealthABSTRACT
Objective:To establish a questionnaire to assess symptom of embolization syndrome after transcatheter hepatic arterial chemoembolization (TACE) in patients with liver cancer, so as to provide a tool of assessing and managing symptom management after TACE.Methods:From March 2020 to June 2021, through literature review, qualitative interview and Delphi expert consultation, the first draft of symptom assessment questionnaire for TACE post-operative embolism syndrome was prepared. The reliability and validity of the questionnaire were tested in 200 patients with liver cancer treated by TACE in department of Liver Oncology, Zhongshan Hospital affiliated to Fudan University.Results:According to the feedback from Delphi expert consultation a draft questionnaire with 9 items of physiological symptoms and 6 items of psychological and social symptoms was formed. Item analysis showed that each item in the questionnaire had a good degree of differentiation. There was significant correlation between each item and the total score of the questionnaire. Three factors were extracted by exploratory factor analysis, naming psychosocial symptom group as factor 1, somatic discomfort symptom group as factor 2 and gastrointestinal reaction symptom group as factor 3, and the cumulative variance contribution rate was 62.592%. Spearman correlation coefficient between this questionnaire and the Anderson Symptom Assessment Scale was 0.855( P<0.05). The Cronbach α of the total questionnaire was 0.898, and. The Cronbach α of the three factors were 0.885, 0.771 and 0.870 respectively. Conclusions:The symptom assessment questionnaire of embolization syndrome after TACE in liver cancer patients prepared in this study has good reliability and validity, which can provide an evaluation basis for the symptom management of TACE.
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BackgroundLittle is known about the dynamics of SARS-CoV-2 antigen burden in respiratory samples in different patient populations at different stages of infection. Current rapid antigen tests cannot quantitate and track antigen dynamics with high sensitivity and specificity in respiratory samples. MethodsWe developed and validated an ultra-sensitive SARS-CoV-2 antigen assay with smartphone readout using the Microbubbling Digital Assay previously developed by our group, which is a platform that enables highly sensitive detection and quantitation of protein biomarkers. A computer vision-based algorithm was developed for microbubble smartphone image recognition and quantitation. A machine learning-based classifier was developed to classify the smartphone images based on detected microbubbles. Using this assay, we tracked antigen dynamics in serial swab samples from COVID patients hospitalized in ICU and immunocompromised COVID patients. ResultsThe limit of detection (LOD) of the Microbubbling SARS-CoV-2 Antigen Assay was 0.5 pg/mL (10.6 fM) recombinant nucleocapsid (N) antigen or 4000 copies/mL inactivated SARS-CoV-2 virus in nasopharyngeal (NP) swabs, comparable to many rRT-PCR methods. The assay had high analytical specificity towards SARS-CoV-2. Compared to EUA-approved rRT-PCR methods, the Microbubbling Antigen Assay demonstrated a positive percent agreement (PPA) of 97% (95% confidence interval (CI), 92-99%) in symptomatic individuals within 7 days of symptom onset and positive SARS-CoV-2 nucleic acid results, and a negative percent agreement (NPA) of 97% (95% CI, 94-100%) in symptomatic and asymptomatic individuals with negative nucleic acid results. Antigen positivity rate in NP swabs gradually decreased as days-after-symptom-onset increased, despite persistent nucleic acid positivity of the same samples. The computer vision and machine learning-based automatic microbubble image classifier could accurately identify positives and negatives, based on microbubble counts and sizes. Total microbubble volume, a potential marker of antigen burden, correlated inversely with Ct values and days-after-symptom-onset. Antigen was detected for longer periods of time in immunocompromised patients with hematologic malignancies, compared to immunocompetent individuals. Simultaneous detectable antigens and nucleic acids may indicate the presence of replicating viruses in patients with persistent infections. ConclusionsThe Microbubbling SARS-CoV-2 Antigen Assay enables sensitive and specific detection of acute infections, and quantitation and tracking of antigen dynamics in different patient populations at various stages of infection. With smartphone compatibility and automated image processing, the assay is well-positioned to be adapted for point-of-care diagnosis and to explore the clinical implications of antigen dynamics in future studies.
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OBJECTIVES@#There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression.@*METHODS@#A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory.@*RESULTS@#The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables.@*CONCLUSIONS@#Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.
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Child , Humans , Adaptation, Psychological , China/epidemiology , Extraversion, Psychological , Only Child , Surveys and QuestionnairesABSTRACT
Objective:To investigate the relationship between social support and depression of only-child-lost (OCL) people,and the mediation role of self-efficacy in this relationship.Methods:By stratified cluster sampling,214 OCL people were enrolled,with 80 males and 134 females,ages from 49 to 83 years old.They were assessed by General Self-Efficacy Scale,Social Support Rating Scale,and Self-rating Depression Scale.Results:Univariate analysis showed that there were significant differences in age groups (t=2.85,P＜0.05),with or without spouse (t=5.62,P＜0.05),family location (t=3.95,P＜0.05),per capita monthly income (F=3.48,P＜0.05) among the social support scores.There was significant difference between the per capita monthly income and self-efficacy scores in QCL people (F=5.46,P＜0.05).Correlation analysis showed self-efficacy and social support were positively correlated (r=0.26,P＜0.01).Self-efficacy (r=-0.59,P＜0.01) and social support (r=-0.59,P＜0.01) negatively correlated with depression in OCL people.Self-efficacy partially mediated the relationship between social support and depression.Conclusion:The person who is ＜60 years old,with spouse and the high per capita monthly income,and lives the rural area,would have high social support levels among QCL people.The person who has high per capita monthly income would have high self-efficacy.Self-efficacy is one of the direct prediction for depression,and plays an indirect role between social support and depression.Intervention of depression among OCL people could be applied to change their cognition,and to enhance their self-efficacy.
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Objective To investigate the relationship between social support and subjective well-be-ing in only-child-lost ( OCL ) people, and the mediating effect of self-efficacy in this relationship. Methods By stratified cluster sampling,206 only-child loss people were investigated with Social Support Rating Scale ( SSRS) ,General Self-Efficacy Scale ( GSES) and Index of Well-Being ( IWB) ,and data were analyzed with SPSS19.0 software and Amos17.0 software. Results ①Scores of SSRS,GSES and IWB in only-child-lost people were(31.78±8.18),(24.12±0.67) and (8.38±3.05). ②Correlation analysis showed that scores of GSES,SSRS and 3 dimensions of SSRS were positively correlated with scores of IWB ( r=0. 542,0.332,0.214,0.332,0.216;P<0.05) . ③Self-efficacy partially mediates the relationship between social support and subjective well-being through mediating effect test(χ2/ df=1.986,GFI=0.985,AGFI=0.942, RMSEA=0.069),mediating effect accounted for 16.08%.Conclusion Social support is an important factor which plays a direct or indirect role in subject well-being. Self-efficacy is the intermediate link between social support and subject well-being.
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Objective To analyze the characteristics of resilience among empty-nest elderly in community with exploratory latent class analysis method and provide a basis for making targeted intervention measures according to different characteristics.Methods This study enrolled 203 empty-nest elderly people as the study respondents.The general information,resilience of empty-nest elderly were investigated using the general information questionnaire,Connor-Davidson resilience scale in Chinese version.Latent class analyze (Mplus 7.0) was used to discuss the characteristics of resilience among empty-nest elderly.Results The results showed that the resilience of empty-nest elderly had obvious group characteristics and the statistical indicators(AIC,BIC,Entropy and so on) can support the three categories of potential model(P=0.006).Based on the conditional probability on the various items of the questionnaire in each category,they were respectively named high resilience group (54 cases (26.6％)) and low pressure resilience group (82 cases (40.4％)) and low resilience group(67 cases (33.0％)).Further study showed that high resilience and low resilience group had a significant effect of age (P＜0.05),low pressure resilience and low resilience group had a significant effect of gender(P＜0.05).Conclusion The resilience of empty-nest elderly in communities can be divided into three categories according to its characteristics.Each category has different proportion of gender and age.
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Objective To analyze the status quo and hot spots in studies on family caregivers by bibliometric analy-sis. Methods PubMed-covered papers on family caregivers from 2011-01-01 to 2016-07-01 were retrieved and analyzed by BICOMS and gCLUTO to generate subject heading clustering curve, subject heading clustering matrix and subject heading tree. Results Six hot spots were detected in studies on family caregivers from 4945 papers from which 82 subject headings were extracted with a frequency≥36 , including social and psychological intervention of family caregivers for ischemic stroke patients, intervention of family caregivers for mental disease patients, mental health of family caregivers, mental health intervention of family caregivers for PD patients, mental health of family caregivers for AIDS patients, and mental health of family caregivers for tumor patients. Conclusion Importance is attached to the studies on family caregivers by foreign and domestic scholars with their studies focused on the inves-tigation and intervention of mental health in family caregivers.
