The prevalence of depression and suicidal ideation among cancer patients in mainland China and its provinces, 1994-2021: A systematic review and meta-analysis of 201 cross-sectional studies.

To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %-47.01 %) and 24.95 % (95 % CI 10.96 %-38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression.

Nurses' Working Experiences of Their Provision of Cross-Cultural Services to Tibetan Patients With Kashin-Beck Disease: A Qualitative Study.

INTRODUCTION: Limited qualitative studies exist on nurses' experience in terms of communicating with and caring for patients with endemic diseases. The purpose of this study was to describe the working experiences of nurses caring for Tibetan patients with Kashin-Beck disease in China. METHOD: A qualitative design was used in this study. Sixteen nurses who worked in the orthopedics department of a large tertiary general hospital in Wuhan, China, constituting a purposive sample, were interviewed face-to-face using semi-structured guided questions. RESULTS: Three major themes and nine subthemes were identified. Major themes included the challenge in cross-cultural nursing, stress adjustment in cross-cultural nursing, and reshaping competencies in cross-cultural nursing. DISCUSSION: This study revealed that nurses encountered multifaceted challenges when caring for Tibetan patients with Kashin-Beck disease. In a multiethnic society, communication and language skills, cultural competency and cultural sensitivity, and diverse training methods to improve cross-cultural knowledge could increase ethnic minority patient satisfaction with cross-cultural care.

Psychiatric Distress and Suicidal Tendencies in Adult Cancer Survivors: Verifying the Validity of the Brief Symptom Inventory-18 for Identifying Suicidal Ideation in the Hospitalized Population of Mainland China.

The Brief Symptom Inventory-18 (BSI-18) is widely used to assess psychiatric distress but has not been verified in the Chinese population. From March to April 2019, 293 hospitalized cancer patients, aged 20-87, completed the cross-sectional survey with demographics questionnaire, BSI-18, and PHQ-9. We analyzed the single suicide-related item of PHQ-9 with the full score clinical outpoint for BSI-18 and PHQ-9 using SPSS 22.0 and R 2.15, including Pearson's χ2 test and ROC curve analyses. A Pearson's χ2 test was carried out to compare the three different methods with the gold screening criteria. The p-value was correspondingly to .006, .066, .838. When the PHQ-9 ≥ 10 criteria for the BSI-18, receiver operating characteristic analysis revealed that AUC values were 0.839, optimal cut-off points for both BSI-18 ≥ 50, the sensitivity of 85.8%, and 62.5%, respectively. The BSI-18 is suitable for a screening tool for psychological distress and could also be used in clinical settings for preliminary screening of hospitalized cancer patients.

Effectiveness of internet-based cognitive behavioral therapy for suicide: a systematic review and meta-analysis of RCTs.

Suicidal individuals rarely seek help and receive professional psychological intervention on their initiative. Internet-based cognitive behavioral therapy(iCBT) can increase availability and reduce stigma compared to face-to-face interventions for suicide.However, conclusions about the effectiveness of iCBT on suicide are controversial. The review aimed to determine the effectiveness of iCBT on reducing suicidal ideation (primary outcomes) and other outcomes related to suicide like suicide attempts(secondary outcomes). PubMed, the Cochrane Library, EMBASEwere searched up to March 2020 for RCTs of iCBT which aimed to reduce suicide.The potential bias was assessed by the Cochrane risk of bias tool. Data analyses wereperformed by RevMan5.3.Four studies meeting the eligibility criteria were included which reported data on a total of 1225 participants. We found iCBT was associated with reducing an individual's suicidal ideation, and first indications suggest that the treatment effect might be even more pronounced in the short term and in adults.Additionally, there was insufficient evidence to prove its effectiveness in reducing suicide attempts and suicide death.Overall, iCBT can overcome the disadvantages of traditional interventions and show promise on suicidal ideation. While ensuring safety and ethics, further studies are warranted, focusing on suicide specific behavior like suicide attempts.

Experiences of clinical first-line nurses treating patients with COVID-19: A qualitative study.

AIM: To explore the work experience of clinical first-line nurses treating patients with coronavirus disease 2019 (COVID-19). BACKGROUND: COVID-19 has been listed as an international public health emergency. Clinical first-line nurses are at a high risk of infection, and they face a lack of experience and inadequate preparation for COVID-19, leading to physical and psychological disorders. METHODS: A qualitative study was conducted from January to February 2020 at a COVID-19-designated hospital in Wuhan, China. Thirty nurses were selected for the study using a purposive sampling method. Data were collected by semi-structured interviews and analysed using content analysis. RESULTS: Two main categories were defined in the study from the perspective of nurses: negative experiences during clinical first-line work and positive impacts of clinical first-line work. Under the first category, two subcategories were included: psychological experiences of clinical first-line work and difficulties faced during clinical first-line work. The analysis further yielded two subcategories for the second category: the needs of clinical first-line work and the impact of clinical first-line work on professional attitudes. CONCLUSIONS: The results demonstrate that success depends upon strengthening emergency training and knowledge of infectious diseases for nurses, providing adequate protective equipment and improving the emergency response plans of hospitals for public health emergencies. IMPLICATIONS FOR NURSING MANAGEMENT: It is believed that our findings will guide hospital managers to make improvements in personal, administrative and institutional areas and that they will provide a reference and inspiration for nurses with regard to public health emergencies in the future.

The mechanism of family adaptability and cohesion in suicidal ideation among Chinese cancer patients.

PURPOSE: The purpose of this cross-sectional survey was to investigate how family adaptability and cohesion, coping styles and depression affect suicide ideation in patients with malignant tumors. This study also aimed to examine the potential mechanisms of family adaptability and cohesion in suicidal ideation. METHODS: From January 2019 to May 2019, 357 patients with malignant tumors who were admitted to a Chinese general hospital were surveyed. Patient Health Questionnaire-9 and the Chinese version of the Family Adaptability and Cohesion Evaluation Scale II, Medical Coping Modes Questionnaire were used. Student's t-test, chi-square test, Mann-Whitney U test, Spearman's rho correlation, and logistic regression analysis were used. Path analysis was used to examine the relationships among family adaptability and cohesion, coping styles, depression and suicidal ideation. RESULTS: A total of 55 (15.4%) cancer patients reported suicidal ideation in the prior 2 weeks. Logistic regression analysis showed that cancer stage, depression, family cohesion, and avoidance were independently associated with suicidal ideation. Path analysis demonstrated that family adaptability and cohesion indirectly affected suicidal ideation, as mediated by coping styles and depression. Family cohesion also directly affected suicidal ideation among cancer patients. CONCLUSIONS: This study suggested that family adaptability, family cohesion and confrontation coping strategies are protective factors against suicidal ideation in cancer patients. Improving the family support system and coping styles may be used to prevent suicide ideation in cancer patients in the future. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS OR POLICY: Enhancing the family adaptability and cohesion of patients will help medical staff improve family support function effectively and eliminate suicidal ideation.

Relationship of Suicidal Ideation With Demoralization, Depression, and Anxiety: A Study of Cancer Patients in Mainland China.

Demoralization is a form of psychological distress that may cause suicidal ideation. Demoralization syndrome is common among cancer patients, but there has been little empirical study on the association of suicidal ideation with demoralization, depression, and anxiety in this population. This study aims to investigate the prevalence of high demoralization among cancer patients in mainland China and the contribution of high demoralization to suicidal ideation beyond the impact of self-report depression and anxiety. In this cross-sectional study, 303 patients with cancer were invited to complete questionnaires. In total, 14.5% participants reported suicidal ideation and 49.50% high demoralization. Logistic regression analysis identified high demoralization as an independent risk factor for suicidal ideation. Only depression (odds ratio [OR], 6.68) had a stronger influence on suicidal ideation than demoralization (OR, 5.85), and patients with both depression and high demoralization were most likely to experience suicidal ideation. These findings suggest that measures of demoralization can help identify cancer patients at high suicide risk and that such patients require further attention and measures targeting demoralization for suicide prevention.