Clinical utility of demoralization: A systematic review of the literature.

Demoralization is a complex clinical phenomenon which has raised a growing interest in clinical and research realms. The present systematic review of the literature aimed at (1) updating on demoralization prevalence in different populations, (2) identifying the instruments more largely used to assess demoralization, and (3) verifying whether new tools of assessment have been proposed. PubMed and Web of Science were searched from inception to April 2022. Search terms were: demoralization/demoralized/demoralizing/demoralised/demoralising. PRISMA guidelines were followed. GRADE rating system was used. A total of 188 papers were included. Demoralization appeared to be a distinctive psychological state common in medical, psychiatric, and non-clinical settings, thus not limited to life-threatening diseases. Diagnostic Criteria for Psychosomatic Research (DCPR) and Demoralization Scale (DS) are the most commonly used tools to assess it. DCPR allow to diagnose demoralization as a manifestation of dealing with chronic stress. DS captures dimensionally a psychological distress related to end of life. Demoralization is associated with clinical features encompassing allostatic overload, quality of life, wellbeing/euthymia. Implications on health outcomes and treatment are discussed. Demoralization warrants careful consideration in clinical contexts through valid assessment procedures. DCPR are recommended to diagnose it, DS can be helpful to capture clinical details.

Who will treat older patients? Should medical education focus more on activities aimed at displaying positive attitudes toward older people? The prevalence of ageism among students of medical and health sciences.

In the conditions of an aging society, a justification is found to explain the issue of the attitude of future health care workers, who are to care for elderly people in the future, toward these people, which will make it possible to predict in advance what problems related to the care of seniors may soon arise. After clarifying this issue, it will be important to distinguish the individual factors influencing this attitude in order to determine which social phenomena will require special attention. Eight hundred and three medical and health sciences students participated in the research from various fields of medical studies. A Survgo system was used, where an online questionnaire was placed and then posted in social media. Only students of medicine and healthcare facilities participated in the study. The first questionnaire contained socio-demographic questions. Then, the KOAP questionnaire and Welch's t-test were used, and finally the proprietary questionnaire on contact with seniors. Analyses were conducted using the R Statistical language. Scores on the KAOP questionnaire ranged from 122.4 to 134.57. The highest scores were shown for physiotherapy students and the lowest for pharmacy students. The highest level of attitude toward elderly was reported in students of 1st to 3rd year of study. For 4th-5th year or supplementary level students, attitude levels were decreasing. Welch's t-test showed that the level of attitude toward old people in men was significantly higher than in women. There was no significant correlation between the age factor on the quotient scale and the KOAP score. Married individuals had significantly higher KAOP scores compared to singles and those in an informal relationship. No significant differences between the study stage factor and KAOP score have been found. Those who live and/or have regular contact with the elderly were characterized by higher KAOP questionnaire scores. The attitude toward the elderly depends on many factors, such as the chosen field of study, stage of education, contact with the elderly, gender or marital status. In order to develop proper contact with seniors, the solution may be to influence modifiable factors, especially the correct education of future health care workers.

Cross-cultural validity of the WHO-5 Well-Being Index and Euthymia Scale: A clinimetric analysis.

BACKGROUND: The assessment of psychological well-being and euthymia represents an emerging issue in clinical psychology and psychiatry. Rating scales and indices such as the 5-item version of the World Health Organization Well-Being Index (WHO-5) and the Euthymia Scale (ES) were developed but insufficient attention has been devoted to the evaluation of their cross-cultural validity. This is the first study using Clinimetric Patient-Reported Outcome Measures (CLIPROM) criteria to assess cross-cultural validity and sensitivity of five different versions of the WHO-5 and ES. METHODS: A multicenter cross-sectional study involving a total of 3762 adult participants from different European (i.e., Italy, Poland, Denmark) and non-European (i.e., China, Japan) countries was conducted. Item Response Theory models (Mokken and Rasch analyses) were applied. RESULTS: Mokken coefficients of scalability were found to range from 0.42 to 0.84. The majority of the versions of the WHO-5 fitted the Rasch model expectations. Paired t-tests revealed that the Italian and Danish WHO-5 versions were unidimensional. Person Separation Reliability indices showed that the Polish, Danish, and Japanese ES versions could reliably discriminate between subjects with different levels of euthymia. LIMITATIONS: A convenience sampling was used, thus limiting the generalizability of study findings. In addition, no measures of negative mental health were administered. CONCLUSIONS: WHO-5 can be used in international studies for cross-cultural comparisons since it covers transcultural components of subjective well-being. Findings also suggest that the ES can be used as a cross-cultural screening tool since it entailed the clinimetric property of sensitivity.

Empathy as a Factor Conditioning Attitudes towards the Elderly among Physiotherapists-Results from Poland.

Attitudes of healthcare workers towards the elderly significantly affect the quality of care dedicated to this group of patients. The purpose of this study was to assess the approach of Polish physiotherapists to the elderly and to analyze the factors influencing these attitudes. The study was based on a cross-sectional Internet-based survey that was conducted in the period from May to September 2021. It was completed by 252 subjects: 189 women and 63 men. The study was based on the involvement of physiotherapists with the right to practice their profession in accordance with the law in force in Poland. The tools used in the study were The Kogan Attitudes towards the Elderly (KAOP) score and The Jefferson Empathy Scale (JSE). To model the KOAP score as a function of the predictors, Bayesian linear regression was used. The average KOAP score in the sample was M (SD) = 100.7 (17.46), with the central 50% of the observations ranging from 81 to 113 points. We observed one statistically credible relationship: relevance of contacts with elderly people was positively and moderately related to KOAP. Additionally, we observed that the JSE scale was positively, but very weakly, associated with KOAP. Empathy and own experience of health care providers may protect against negative attitudes towards the elderly, meaning empathy in healthcare professionals is crucial.

Attitudes Towards the Elderly in Polish Society: Is Knowledge About Old Age and Personal Experiences a Predictor of Ageism?

PURPOSE: The aim of the study was to determine the prevalence and characteristics of ageism in Polish society. In addition, the relationships of opinions with demographic data, knowledge about aging and individual contact with the elderly, in the context of knowledge about their exclusion, were examined. PATIENTS AND METHODS: The study involved 923 individuals in Poland. Their demographic characteristics were recorded, and all subjects were assessed using Kogan's Attitudes toward Old People (KOAP) scale and asked to complete the Facts on Aging Quiz. Subjects were also asked about their knowledge of the definition of ageism and asked to explain it. RESULTS: The KOAP scale as a function of predictors was modeled using Bayesian robust linear regression with t distribution. The subjects had a mean (SD) KAOP score of 90.88 (17.41), with the central 50% of the observations ranging from 83 to 101 points. Three statistically credible relationships with responses to the questionnaires were observed. Respondents attending school had slightly lower average KAOP scores than respondents with other professional status. In addition, FAQ was negatively and moderately related to KAOP, whereas contacts with elderly people were positively and moderately related to KAOP. CONCLUSION: Knowledge of aging and contact with elderly individuals significantly affected attitudes and behaviors regarding ageism. Many study subjects were characterized by having unfavorable attitudes towards the elderly.

Health and Protective Measures for Seniors during the COVID-19 Pandemic in the Opinion of Polish Society.

The aim of the study was to determine the opinion of society on the individual care and protection measures towards seniors during the COVID-19 pandemic. In addition, the relationship of opinions with demographic data, knowledge about aging and own experience in contacts with the elderly was examined. The study involved 923 attendees from Poland. The tools used to assess the research problem were: demographic characteristics, a Facts on Aging Quiz (FAQ), the author's questionnaire about preventive and protective measures for seniors during the COVID-19 pandemic. We observed that over 50% of participants were against designating shopping hours for seniors. The analysis showed that negative attitudes were more often expressed by women than by men; younger people and those declaring that they do not spend too much time with the elderly. In the matter of vaccination priority for the elderly, over 70% participants replied "rather yes" or "definitely yes". The use of the age criterion in situations of limited access to medications and ventilators was supported mainly by learners, with high results of the FAQ, and professionals dealing with seniors. Finally, almost 56% of participants declared that their contacts with seniors were the same as before the pandemic, while merely 1.6% indicated that they avoid contact with them entirely.

Fear of stinging insects in relation to state anxiety and trait anxiety in a group of patients with hymenoptera venom allergy undergoing immunotherapy.

INTRODUCTION: The level of fear of hymenoptera associated with stinging or envenomation may depend on situational factors and on trait anxiety characteristic of each patient. AIM: To assess the relationship between fear of stinging insects on the one hand and state anxiety and trait anxiety on the other in a group of patients with hymenoptera venom allergy. MATERIAL AND METHODS: The study was conducted by the Department of Allergy, Clinical Immunology and Internal Diseases, Dr J. Biziel University Hospital No. 2 in Bydgoszcz, Poland. A total of 114 patients (71 women (63%) and 43 men (37%)) with hymenoptera venom allergy undergoing immunotherapy participated in the study. The State-Trait Anxiety Inventory (STAI) and a dedicated scale developed by the authors for this study were used. RESULTS: State anxiety was found to significantly (p < 0.05) correlate with anxiety in the present moment (R = 0.247), in a situation of real danger (appearance of an insect) (R = 0.223) and during the spring and summer seasons (R = 0.278). Trait anxiety was found to significantly (p < 0.05) correlate with anxiety before immunotherapy (R = 0.261), in the present moment (R = 0.257), in a situation of real danger (appearance of an insect) (R = 0.254), and after an insect sting (R = 0.236). These were also weak correlations. The correlation between trait anxiety and anxiety during the spring and summer seasons was moderate (R = 0.331). CONCLUSIONS: The levels of trait and state anxiety are associated with the magnitude of the fear of the danger. Respondents showed a higher level of anxiety in a situation of danger and after an insect sting.

[Psychological factors affecting medical conditions--a method of measurement]. / Psychologiczne czynniki oddzialujace na stan somatyczny--metoda pomiaru.

Improving the way of diagnosing diseases is reflected in changes which are being introduced into the existing systems of classifications. Researchers aim to create such a system that will be free of assumptions that are controversial and difficult to approve on the medical basis. Currently completed works associated with the preparation and introduced the DSM-5, in which they prepared criteria for the assessment psychological factors affecting medical conditions and their method of measurement. An interview which is presented in this article has been created for the evaluation of those groups of syndromes and has been translated into the Polish language.

The relation between type D personality and the clinical condition of patients suffering from psoriasis.

INTRODUCTION: TYPE D PERSONALITY IS THE LAST DISTINGUISHED SPECIFIC TYPE OF PERSONALITY THAT IS CHARACTERISED BY TWO DIMENSIONS: a tendency for feeling negative emotions - depression, anxiety, anger or hostility, and a tendency for withdrawal from the society. The latest research shows the significant role played by type D personality in the aetiology and course of a variety of diseases. AIM: The article discusses the problem of the occurrence of type D personality in the group of patients suffering from psoriasis. Diversities in the clinical condition of psoriasis patients due to increasing type D personality traits are specified. MATERIAL AND METHODS: Ninety psoriasis patients and 86 healthy subjects participated in the research. In the research questionnaires, the scale for assessing increasing psoriasis complaints and the DS-14 scale to assess type D personality were applied. RESULTS: Research results made it possible to corroborate more frequent occurrence of type D personality among psoriasis patients. Moreover, it was found that with increasing negative affectivity - one of type D personality components - complaints increase as far as the clinical condition of psoriasis patients is concerned. CONCLUSIONS: Monitoring of psychological well-being of psoriasis patients, especially within type D personality, seems to be a vital element, irrespective of purely medical treatment.