Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents' psychological adjustment.

BACKGROUND: This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness. METHODS: A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis. RESULTS: Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45-0.48) were higher than parents (r = 0.18-0.23). In the line of congruence, there were positive linear (a1 = 1.09-1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01). CONCLUSION: The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.

Influencing Factors of Psychological Resilience in Stroke Patients: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically review the current status and influencing factors of psychological resilience in stroke patients and to provide a theoretical basis for future personalized rehabilitation support and psychological interventions. METHOD: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A comprehensive search of databases including PubMed, Web of Science, Medline, PsycINFO, CINAHL, Cochrane Library, CNKI, VIP, CMB, and WANGFANG was conducted from inception until November 22, 2023, resulting in the retrieval of 2099 studies. Literature screening and data extraction were performed by two independent evaluators based on pre-defined inclusion and exclusion criteria, and meta-analysis was performed using Review Manager 5.4 software. RESULTS: The final review included 23 studies. The results showed that self-efficacy, hope, confrontation coping, avoidance coping, functional independence, quality of life, and social support were positively associated with psychological resilience. Conversely, anxiety, depression, and resignation coping were negatively associated with psychological resilience. CONCLUSIONS: Patients with stroke have a low level of psychological resilience, which was influenced by a variety of factors. However, longitudinal and large sample studies are needed to further confirm these findings. These results should be integrated into clinical practice for early assessment and targeted intervention in psychological resilience to assist patients in coping with the rehabilitation process and life changes after a stroke.

The characteristics of suicide attempters in Chinese patients: Comparison of adolescents, youths, middle-aged and elderly.

BACKGROUND: Potential risk factors for suicide differ by age group. Therefore, this study aims to investigate the characteristics of patients with suicide attempts according to age group and any the relevant risk factors. METHODS: This study retrospectively reviewed the medical records of attempted suicide patients who were admitted to the emergency departments (ED) of the First Affiliated Hospital of Wenzhou Medical University between January 1, 2017, and December 31, 2021. Demographic information and clinical characteristics were collected. The participants were divided into four age groups and the characteristics of each group were compared. RESULTS: A total of 834 participants were included in this study. Suicide attempts were more prevalent in females, and the gender difference decreased with age. Having religious belief and less educated suicide attempts were concentrated in the elderly groups. Adolescents suicide attempts were more likely to occur in the spring, autumn and during non-office hours. Mental disorders were the major motivation for suicide among adolescents, and interpersonal and social problems were more prevalent among youths. Psychiatric medication was the leading suicidal substances among adolescents, while pesticides and herbicides were more prevalent in adults. The history of psychiatric diagnosis was more common in adolescents, while the history of somatic disorder was more prevalent in the elderly. CONCLUSION: This study confirmed differences in the demographic and clinical characteristics of patients in different age groups. Therefore, it is necessary to construct individualized intervention strategies for each age group based on the characteristics of the patients in order to reduce suicide.

Social support, family resilience and psychological resilience among maintenance hemodialysis patients: a longitudinal study.

BACKGROUND: Psychological distress is common in maintenance hemodialysis patients, and high psychological resilience can promote psychological well-being. The current research focuses on psychological resilience protective factors such as family resilience and social support. However, the trajectories of psychological resilience, family resilience, and social support over time and their longitudinal relationships in maintenance hemodialysis patients have not been fully explored yet. Therefore, this study aims to explore the longitudinal relationship between these factors. METHODS: Patients who received regular hemodialysis treatment for more than three months at dialysis centers of three tertiary hospitals in Zhejiang, China, were recruited from September to December 2020. A total of 252 patients who met the inclusion and exclusion criteria completed three follow-up surveys, including social support, family resilience, and psychological resilience assessments. A repeated measures ANOVA was used to explore differences in their respective scores at different time points. The cross-lagged analysis was performed in AMOS using the maximum likelihood method to examine the the reciprocal predictive relationships between these factors. RESULTS: Social support and psychological resilience remained relatively stable over time, whereas family resilience indicated a little increasing trend. According to the cross-lagged analysis, higher T1 social support predicted higher family resilience at T2 [ß = 0.123, 95% CI (0.026-0.244)]. Further, the effects of T2 social support to T3 family resilience [ß = 0.194, 95%CI (0.039-0.335)] and psychological resilience [ß = 0.205, 95%CI (0.049-0.354)] were significant. Finally, the effects of T2 family resilience to T3 social support [ß = 0.122, 95%CI (0.010-0.225)] and psychological resilience [ß = 0.244, 95%CI (0.119-0.359)] were also significant. CONCLUSIONS: The study showed that the directionality of the relationship appears to be from social support or family resilience to patients' psychological resilience but not vice versa. This finding reminds healthcare professionals to emphasize the vital role of social and family resources in providing appropriate support and interventions for maintenance hemodialysis patients to promote psychological resilience and mental health development.

Perceptions of adult patients with cancer towards telemedicine: A qualitative meta-synthesis.

Objective: This study aims to systematically identify, evaluate, and synthesize published qualitative research on the views and attitudes of adult cancer patients toward telemedicine and, consequently to better inform the future development of telemedicine technology and interventions. Methods: A meta-synthesis review was conducted to identify qualitative studies that reported adult cancer patients' perceptions toward telemedicine applications using nine electronic databases, including PubMed, MEDLINE, Web of Science, the Cochrane Library, PsycINFO, CINAHL, Wan Fang, VIP, and CNKI, from inception to November 2022. Quality appraisal was guided by the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist for Qualitative Research. Data were synthesized using "thematic synthesis" to identify themes and concepts. Results: A total of 3518 articles were retrieved, of which 23 met the inclusion and exclusion criteria. These studies identified three key meta-themes and 11 key sub-themes: (1) Benefits of telemedicine: obtaining information and social support, maintaining the continuity of treatment, receiving professional assistance, having greater flexibility, and promoting physical and mental health; (2) Limitations of telemedicine: interference with normal life, privacy and security issues, auxiliary function issues, and increased psychological burden; (3) Expectations for future telemedicine: more personalized intervention, more specific and diverse information. Conclusions: The study showed that the benefits and limitations coexisted in the process of telemedicine application among adult cancer patients. It is necessary to develop personalized applications that are better suited to the needs and characteristics of adult cancer patients. Future telemedicine interventions should focus on information diversification and provide patients with more diverse and effective information. Systematic review registration: PROSPERO, CRD42022324528.

Development of a theory-based family resilience intervention program for parents of children with chronic diseases: A Delphi study.

BACKGROUND: Long-term illness exposes children with chronic diseases to a high risk of deterioration of physical and mental health. Developing an effective family resilience intervention program is a critical concern. OBJECTIVE: To develop a theory-based family resilience intervention program for parents of children with chronic diseases and provide a reference for clinical intervention. METHODS: A two-phased research design, guided by the Walsh family resilience process model, was employed to develop the intervention program. In phase 1, a scoping literature review was conducted to identify the possible elements of family resilience interventions. In phase 2, a three-round Delphi survey was conducted with experts (n = 14) using an online electronic survey to obtain their consensus on the intervention content. RESULTS: Three main components were identified: (1) strengthening family beliefs, (2) adjusting the family organization pattern, and (3) improving the family communication process. And 8 modules were developed: "introducing adversity and family resilience", "finding and strengthening positive family beliefs, and building confidence to live with the disease", "analyzing and adjusting family structure", "assisting families to increase and utilizing internal and external resources", "optimizing communication skills", "strengthening collaborative problem-solving capacity", "enhancing the family narrative ability", and "enhancing emotional expression". After 3-round Delphi, the findings indicated that the intervention program is applicable and feasible for parents of children with chronic diseases in China. CONCLUSION: The principal merit of this study lies in the development of a family resilience intervention program for parents of children with chronic diseases. The intervention's usability and efficacy should be investigated in future studies. IMPLICATIONS TO PRACTICE: Developing a family resilience intervention program is a critical first step toward providing effective care for parents of children with chronic diseases, and evaluating the program's feasibility and suitability in the target population is warranted.

Analyzing the Symptom Clusters Among Children With Acute Lymphoblastic Leukemia During Chemotherapy Based on Electronic Nursing Records.

BACKGROUND: Children with acute lymphoblastic leukemia often experience various physical and psychological symptoms during chemotherapy. Previous studies have used predetermined symptom inventories to analyze the complex relationships between these symptoms, which has certain limitations. OBJECTIVE: The aim of this study was to explore the dynamic changes in symptom clusters among children with acute lymphoblastic leukemia during chemotherapy using electronic nursing records. METHODS: Electronic nursing records for 2021 (N = 14 490) were obtained from a pediatric hematology department. A natural language processing tool was used to identify the presence of 46 symptoms in 3 chemotherapy phases of induction, consolidation, and maintenance. Incidence of symptom documentation was calculated by notes and patients, and principal component analysis and cluster analysis were performed for symptoms with an incidence above 15%. RESULTS: The most common symptoms included bleeding, cough, and vomiting. The number of symptom clusters in each chemotherapy period was 7, 6, and 4, respectively. There were upper gastrointestinal, respiratory system, lower gastrointestinal, skin-related, psychological, self-image disorder, and other discomfort symptom clusters in the induction period. Notably, the upper gastrointestinal, respiratory system, lower gastrointestinal, and skin-related symptom clusters persisted through the consolidation and maintenance periods. Neurological and other discomfort symptom clusters were observed during the consolidation period. CONCLUSION: Symptom clusters of children with acute lymphoblastic leukemia at various stages of chemotherapy showed a certain level of stability and dynamics, informing healthcare providers in developing continuous symptom management. IMPLICATIONS FOR PRACTICE: Medical staff should explore targeted intervention programs based on characteristics of symptom clusters at different chemotherapy stages, to improve the efficiency of symptom management and alleviate the symptom burden of children.

The relationship between psychological distress and professional identity in graduate nursing students during COVID-19: A longitudinal cross-lagged analysis / Relación entre la salud mental y la identidad ocupacional de los estudiantes de posgrado en enfermería durante la enfermedad del coronavirus 2019: análisis de retraso cruzado longitudinal

There is growing evidence that the COVID-19 pandemic has had an impact on the mental health and professional identity of nursing students. This study aimed to explore the trajectories of psychological dis-tress and professional identity and examine their causal relationship among graduate nursing students. A prospective longitudinal study was conducted with 556 graduate nursing students in China who were asked to complete the Questionnaires for Emergent Events of Public Health and the Profes-sional Identity Questionnaire for Nursing Students at three timepoints during the pandemic (T1 = onset of the outbreak, T2 = state-wide isolation, T3 = school reopening). The results showed that psychological distress and psychological identity changed over time, with the lowest psychologi-cal distress and highest professional identity at T3. The cross-lagged analy-sis showed that professional identity at T1 and T2 negatively predicted psychological distress at T2 and T3. We concluded that nurse educators should develop programs and strategies to cultivate professional identity in graduate nursing education to improve mental health during public health crises.(AU)

Existe una evidencia creciente de que la pandemia de covid-19 puede afectar la salud mental y la identidad profesional de los estudiantes de enfermería. Sin embargo, sabemos muy poco sobre los cursos longitudinales de salud mental e identidad profesional para estudiantes de posgrado en enfermería en diferentes etapas de una pandemia. Por lo tanto, el propósito de este estudio fue explorar el desarrollo y la interacción de la salud mental y la identidad ocupacional de los estudiantes de enfermería de posgrado durante la enfermedad del coronavirus 2019. Un estudio prospectivo longitudinal de 556 estudiantes de enfermería en China. Se les pidió que completaran el cuestionario de emergencia de salud pública para la pandemia y el cuestionario de identidad profesional para estudiantes de enfermería durante el brote T1 = tres fases, T2 = aislamiento estatal y T3 = reapertura escolar. Los resultados mostraron que los problemas de salud mental de los postgraduados de enfermería tendían a caer, con el puntaje más alto en T2, mientras que el nivel de identidad ocupacional aumentaba en T3 y alcanzaba su punto máximo. El análisis de retraso cruzado mostró que la identidad ocupacional de T1 y T2 predice negativamente los problemas de salud mental de T2. Nuestra conclusión es que los estudiantes de posgrado en enfermería necesitan intervenciones para mejorar su identidad profesional a fin de reducir sus problemas de salud mental durante una crisis pública de emergencia.(AU)

The resilient process of the family after diagnosis of childhood chronic illness: a qualitative meta-synthesis.

PROBLEM: Childhood chronic illness has a serious effect on the whole family. As there is yet little known about how the families adjust to the diagnosis of childhood chronic illness, this qualitative meta-synthesis aims to further our knowledge regarding the resilient process. ELIGIBILITY CRITERIA: A meta-synthesis review was conducted to explore the resilient process of the family after diagnosis of childhood chronic illness using nine electronic databases PubMed (MEDLINE), Web of Science, the Cochrane Library, SCOPUS, PsycINFO, CINAHL, Wan Fang, CBM, and CNKI from each database's inception to December 31,2020. Snowball sampling and manual search were performed to identify other relevant studies. SAMPLE: Seventeen qualitative studies met the inclusion criteria and were analyzed into meta-synthesis. RESULTS: Three key meta-themes were identified across the studies: (a) disintegration and vulnerability: emotional fluctuation and household chaos; (b) adjustment and adaptation: struggle with family needs; (c) recovery and reconstruction: growth and expectation. CONCLUSION: Family adjustment to childhood chronic illness presents a complex, multifaceted and dynamic process. Identifying characteristics of family processes provides some practical interventions for families with a chronically ill child. IMPLICATIONS: There is a need for all health professionals and social care services to be aware of the experience of family adjustment of children diagnosed with chronic illness. The specific intervention targeted at different periods of the family adjustment process is warranted to help families to recover from crises and deal better with challenges.

Self-neglect among older adults admitted to a Chinese comprehensive hospital in the COVID-19 pandemic era: a cross-sectional study.

This study aims to explore the prevalence of self-neglect and associated factors among older adults admitted to the hospital in the COVID-19 pandemic context. The cross-sectional study conducted at a Chinese comprehensive hospital between January and April 2021, 452 older adults were recruited to complete the Abrams Geriatric Self-Neglect Scale, Social Support Rate Scale, FRAIL scale, Barthel index, Patient Health Questionnaire-9, and 10-item Connor-Davidson Resilience Scale. Multivariate logistic regression was used to explore the factors associated with elder self-neglect. The results showed that the prevalence of self-neglect among our sample was 30.3%. Factors that were associated with the risk of elder self-neglect included male, having multiple children (≥4), receiving infrequent visits from children, frailty, and depression. There is a need to screen for self-neglect among older adults admitted to the hospital in the COVID-19 pandemic context. Tailored interventions are warranted to improve the quality of life of older adults.

The Role of Socioeconomic Status, Family Resilience, and Social Support in Predicting Psychological Resilience Among Chinese Maintenance Hemodialysis Patients.

Objectives: Evidence regarding the possible influence of social factors on psychological resilience among maintenance hemodialysis patients is scarce. The aim of this study was to explore the relationship among socioeconomic status, family resilience, and social support, and psychological resilience among Chinese maintenance hemodialysis patients. Methods: This cross-sectional study was conducted in the hemodialysis centers of three comprehensive hospitals in China from September to December 2020 using convenience sampling. Two hundred fifty-eight patients receiving maintenance hemodialysis were investigated using a sociodemographic questionnaire, the Chinese version of the Medical Outcomes Study-Social Support Survey (MOS-SSS), Chinese Family Resilience Assessment Scale (C-FRAS), and Chinese version of the Conner and Davidson resilience scale (CD-RISC). Results: Maintenance hemodialysis patients reported a low level of physical resilience, with a score of (58.92 ± 15.27). Hierarchical linear regression analysis showed that education level (ß = 0.127, p = 0.018), maintenance of a positive outlook by the family (ß = 0.269, p = 0.001), positive social interaction support from the family (ß = 0.233, p = 0.002), and tangible support (ß = -0.135, p = 0.037) were significantly associated with psychological resilience. Conclusion: SES, family resilience and social support may be potential predictive factors of psychological resilience. Interventions to improve the family resilience and social support may be beneficial to promote the psychological resilience of Chinese maintenance hemodialysis patients.

A genome scale metabolic network for rice and accompanying analysis of tryptophan, auxin and serotonin biosynthesis regulation under biotic stress.

BACKGROUND: Functional annotations of large plant genome projects mostly provide information on gene function and gene families based on the presence of protein domains and gene homology, but not necessarily in association with gene expression or metabolic and regulatory networks. These additional annotations are necessary to understand the physiology, development and adaptation of a plant and its interaction with the environment. RESULTS: RiceCyc is a metabolic pathway networks database for rice. It is a snapshot of the substrates, metabolites, enzymes, reactions and pathways of primary and intermediary metabolism in rice. RiceCyc version 3.3 features 316 pathways and 6,643 peptide-coding genes mapped to 2,103 enzyme-catalyzed and 87 protein-mediated transport reactions. The initial functional annotations of rice genes with InterPro, Gene Ontology, MetaCyc, and Enzyme Commission (EC) numbers were enriched with annotations provided by KEGG and Gramene databases. The pathway inferences and the network diagrams were first predicted based on MetaCyc reference networks and plant pathways from the Plant Metabolic Network, using the Pathologic module of Pathway Tools. This was enriched by manually adding metabolic pathways and gene functions specifically reported for rice. The RiceCyc database is hierarchically browsable from pathway diagrams to the associated genes, metabolites and chemical structures. Through the integrated tool OMICs Viewer, users can upload transcriptomic, proteomic and metabolomic data to visualize expression patterns in a virtual cell. RiceCyc, along with additional species-specific pathway databases hosted in the Gramene project, facilitates comparative pathway analysis. CONCLUSIONS: Here we describe the RiceCyc network development and discuss its contribution to rice genome annotations. As a case study to demonstrate the use of RiceCyc network as a discovery environment we carried out an integrated bioinformatic analysis of rice metabolic genes that are differentially regulated under diurnal photoperiod and biotic stress treatments. The analysis of publicly available rice transcriptome datasets led to the hypothesis that the complete tryptophan biosynthesis and its dependent metabolic pathways including serotonin biosynthesis are induced by taxonomically diverse pathogens while also being under diurnal regulation. The RiceCyc database is available online for free access at http://www.gramene.org/pathway/.

Gramene database in 2010: updates and extensions.

Now in its 10th year, the Gramene database (http://www.gramene.org) has grown from its primary focus on rice, the first fully-sequenced grass genome, to become a resource for major model and crop plants including Arabidopsis, Brachypodium, maize, sorghum, poplar and grape in addition to several species of rice. Gramene began with the addition of an Ensembl genome browser and has expanded in the last decade to become a robust resource for plant genomics hosting a wide array of data sets including quantitative trait loci (QTL), metabolic pathways, genetic diversity, genes, proteins, germplasm, literature, ontologies and a fully-structured markers and sequences database integrated with genome browsers and maps from various published studies (genetic, physical, bin, etc.). In addition, Gramene now hosts a variety of web services including a Distributed Annotation Server (DAS), BLAST and a public MySQL database. Twice a year, Gramene releases a major build of the database and makes interim releases to correct errors or to make important updates to software and/or data.

Gramene QTL database: development, content and applications.

Gramene is a comparative information resource for plants that integrates data across diverse data domains. In this article, we describe the development of a quantitative trait loci (QTL) database and illustrate how it can be used to facilitate both the forward and reverse genetics research. The QTL database contains the largest online collection of rice QTL data in the world. Using flanking markers as anchors, QTLs originally reported on individual genetic maps have been systematically aligned to the rice sequence where they can be searched as standard genomic features. Researchers can determine whether a QTL co-localizes with other QTLs detected in independent experiments and can combine data from multiple studies to improve the resolution of a QTL position. Candidate genes falling within a QTL interval can be identified and their relationship to particular phenotypes can be inferred based on functional annotations provided by ontology terms. Mutations identified in functional genomics populations and association mapping panels can be aligned with QTL regions to facilitate fine mapping and validation of gene-phenotype associations. By assembling and integrating diverse types of data and information across species and levels of biological complexity, the QTL database enhances the potential to understand and utilize QTL information in biological research.

Gramene: a growing plant comparative genomics resource.

Gramene (www.gramene.org) is a curated resource for genetic, genomic and comparative genomics data for the major crop species, including rice, maize, wheat and many other plant (mainly grass) species. Gramene is an open-source project. All data and software are freely downloadable through the ftp site (ftp.gramene.org/pub/gramene) and available for use without restriction. Gramene's core data types include genome assembly and annotations, other DNA/mRNA sequences, genetic and physical maps/markers, genes, quantitative trait loci (QTLs), proteins, ontologies, literature and comparative mappings. Since our last NAR publication 2 years ago, we have updated these data types to include new datasets and new connections among them. Completely new features include rice pathways for functional annotation of rice genes; genetic diversity data from rice, maize and wheat to show genetic variations among different germplasms; large-scale genome comparisons among Oryza sativa and its wild relatives for evolutionary studies; and the creation of orthologous gene sets and phylogenetic trees among rice, Arabidopsis thaliana, maize, poplar and several animal species (for reference purpose). We have significantly improved the web interface in order to provide a more user-friendly browsing experience, including a dropdown navigation menu system, unified web page for markers, genes, QTLs and proteins, and enhanced quick search functions.

Gramene: a bird's eye view of cereal genomes.

Rice, maize, sorghum, wheat, barley and the other major crop grasses from the family Poaceae (Gramineae) are mankind's most important source of calories and contribute tens of billions of dollars annually to the world economy (FAO 1999, http://www.fao.org; USDA 1997, http://www.usda.gov). Continued improvement of Poaceae crops is necessary in order to continue to feed an ever-growing world population. However, of the major crop grasses, only rice (Oryza sativa), with a compact genome of approximately 400 Mbp, has been sequenced and annotated. The Gramene database (http://www.gramene.org) takes advantage of the known genetic colinearity (synteny) between rice and the major crop plant genomes to provide maize, sorghum, millet, wheat, oat and barley researchers with the benefits of an annotated genome years before their own species are sequenced. Gramene is a one stop portal for finding curated literature, genetic and genomic datasets related to maps, markers, genes, genomes and quantitative trait loci. The addition of several new tools to Gramene has greatly facilitated the potential for comparative analysis among the grasses and contributes to our understanding of the anatomy, development, environmental responses and the factors influencing agronomic performance of cereal crops. Since the last publication on Gramene database by D. H. Ware, P. Jaiswal, J. Ni, I. V. Yap, X. Pan, K. Y. Clark, L. Teytelman, S. C. Schmidt, W. Zhao, K. Chang et al. [(2002), Plant Physiol., 130, 1606-1613], the database has undergone extensive changes that are described in this publication.