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1
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Akbaş E, Filikci SB. The relationship between fatigue levels and psychosocial adjustment in elderly individuals with chronic obstructive pulmonary disease: A descriptive study. Ir J Med Sci 2025; 194:649-656. [PMID: 39873964 DOI: 10.1007/s11845-025-03882-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 01/13/2025] [Indexed: 01/30/2025]
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is associated with physical limitations and significant social, psychological, and behavioral challenges. This study investigates the relationship between fatigue levels and psychosocial adjustment in COPD patients, considering their sociodemographic characteristics. METHODS A descriptive study was conducted with 160 COPD patients hospitalized in the Pulmonology Department of a university hospital. Data were collected via face-to-face interviews using a patient information form, the COPD and Asthma Fatigue Scale (CAFS), and the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR). Statistical analyses included Independent Sample t-test, One-Way ANOVA, Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis, with significance set at p < 0.05. RESULTS The mean age of participants was 68.70 ± 9.41 years; 71.9% were male, and 67.9% had COPD for over six years. Most participants (74.4%) reported limitations in daily living activities due to the disease, and 91.9% reported having social support. Mean scores were 58.03 ± 15.80 on the CAFS and 64.19 ± 6.41 on the PAIS-SR. Significant differences were observed in fatigue and psychosocial adjustment scores based on gender, social support, and disease impact on daily activities (p < 0.05). A weak positive correlation was found between fatigue levels and psychosocial adjustment (p < 0.05). CONCLUSIONS COPD patients experience moderate-to-high fatigue levels and challenges in psychosocial adjustment, with fatigue negatively influencing adjustment. Interventions should focus on enhancing coping strategies, addressing psychosocial needs, and leveraging social support systems to improve patient outcomes.
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Affiliation(s)
- Ebru Akbaş
- Faculty of Health Sciences, Department of Gerontology, Mehmet Akif Ersoy University, Burdur, Turkey.
| | - Sümeyra Buse Filikci
- Nursing Department, School of Susehri Health High, Cumhuriyet University, Sivas, Turkey
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2
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Holas P, Figueira-Putresza E, Domagala-Kulawik J. Coping styles with stress and its relations to psychiatric and clinical symptoms in patients with sarcoidosis: A latent profile analysis. Respir Med 2023; 211:107171. [PMID: 36906186 DOI: 10.1016/j.rmed.2023.107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE Although stress and styles of coping with it can have a major impact on one's health and can determine the course and management of chronic diseases, no previous studies have evaluated coping strategies and their relation to emotional distress and clinical symptoms in sarcoidosis. METHODS In two consecutive studies, we investigated differences in coping styles of sarcoidosis patients in comparison to healthy control subjects and the association of identified profiles to an objective measurement of disease (Forced Vital Capacity) and symptoms such as dyspnoea, pain, anxiety and depressive symptoms in 36 patients with sarcoidosis (study 1) and 93 patients with sarcoidosis (study 2). RESULTS Across two studies we found that patients with sarcoidosis used emotion-focused and avoidant coping significantly less often than healthy individuals, and that in both groups the profile with dominant problem (task)-focus style was the most beneficial in terms of mental health. Further, the profile of sarcoidosis patients characterized by the lowest intensity of all coping strategies was found to be superior in terms of physical health status (dyspnoe, pain and FVC level). CONCLUSION These findings suggest that successful management of sarcoidosis should include coping styles assessment and call for a multidisciplinary approach in diagnosis and treatment of sarcoidosis patients.
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Affiliation(s)
- Pawel Holas
- University of Warsaw, Faculty of Psychology, Poland.
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ASLAN H, ÇETKİN T, DEMİR R. Effects of chronic illness adaptation on the healthy lifestyle behaviours of patients in internal services. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.913997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bakan G, Inci FH. Predictor of self-efficacy in individuals with chronic disease: Stress-coping strategies. J Clin Nurs 2021; 30:874-881. [PMID: 33400329 DOI: 10.1111/jocn.15633] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/09/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This study aims to investigate the relationship between stress-coping strategies of individuals with chronic diseases and their self-efficacy. BACKGROUND Self-efficacy and coping with stress in chronic diseases affect the course of the disease. DESIGN The sample of this methodological study consisted of 178 patients who were hospitalised in a university hospital between November 2017 and November 2018. METHODS Data were collected by the face-to-face interview method using a Patient Information Form, Stress-Coping Styles Scale and Self-Efficacy Scale. This study followed STROBE checklist for cross-sectional studies. RESULTS The study found that there was a strong relationship between patients' coping strategies and their self-efficacies and that the variables that predict self-efficacy in order of importance were self-confident approach (β = .41), the helpless approach (β = -0.24) and the submissive approach (β = -0.15), respectively. The study also found that the optimistic approach and the seeking social support approach had no significant contribution to the model. CONCLUSIONS The most important predictor of self-efficacy in individuals with chronic disease was the self-confident approach, which was one of the problem-oriented coping strategies. Therefore, patients should be taught to use effective methods to cope with stress to increase their self-efficacy, and their self-confidence should be supported. RELEVANCE TO CLINICAL PRACTICE In individuals with chronic disease, self-efficacy has an important role to get better psycho-social adaptation. To determine patients' self-efficacy levels and predictors will guide nursing initiatives.
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Affiliation(s)
- Gulcan Bakan
- Internal Medicine Nursing Department, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| | - Fadime Hatice Inci
- Department of Public Health Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
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Ng WI, Smith GD. Effects of a self-management education program on self-efficacy in patients with COPD: a mixed-methods sequential explanatory designed study. Int J Chron Obstruct Pulmon Dis 2017; 12:2129-2139. [PMID: 28790816 PMCID: PMC5530051 DOI: 10.2147/copd.s136216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Self-management education programs (SMEPs) are potentially effective in the symptomatic management of COPD. Little is presently known about the effectiveness of these programs in Chinese COPD patients. The objective of this study was to evaluate the effectiveness of a specifically designed SMEP on levels of self-efficacy in Chinese patients with COPD. MATERIALS AND METHODS Based on the Medical Research Council framework for evaluating complex interventions, an exploratory phase randomized controlled trial was employed to examine the effects of an SMEP. Self-efficacy was the primary outcome using the COPD Self-efficacy Scale, measured at baseline and 6 months after the program. Qualitative data were sequentially collected from these patients via three focus groups to supplement the quantitative findings. RESULTS The experimental group displayed significant improvement in their general self-efficacy (Z =-2.44, P=0.015) and specifically in confronting 1) physical exertion (Z =-2.57, P=0.01), 2) weather/environment effects (Z =-2.63, P<0.001) and 3) intense emotions (Z =-2.54, P=0.01). Three themes emerged from the focus groups: greater disease control, improved psychosocial well-being and perceived incapability and individuality. The connection of the quantitative and qualitative data demonstrated that individual perceptual constancy of patients could be a determining factor modulating the effectiveness of this type of intervention. CONCLUSION These findings highlight the potential putative benefits of an SMEP in Chinese patients with COPD. Further attention should be given to cultural considerations when developing this type of intervention in Chinese populations with COPD and other chronic diseases.
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Affiliation(s)
- Wai I Ng
- Education Department, Kiang Wu Nursing College of Macau, Macau SAR, People’s Republic of China
| | - Graeme Drummond Smith
- Education Department, School of Health & Social Care, Edinburgh Napier University, Edinburgh, Midlothian, UK
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Rzadkiewicz M, Bråtas O, Espnes GA. What else should we know about experiencing COPD? A narrative review in search of patients' psychological burden alleviation. Int J Chron Obstruct Pulmon Dis 2016; 11:2295-2304. [PMID: 27695316 PMCID: PMC5033607 DOI: 10.2147/copd.s109700] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The present paper is a narrative review focusing on the psychological impact, identification of protective factors, and interventions minimizing the psychological burdens of chronic obstructive pulmonary disease (COPD). The research reviews studies on neurocognitive functions, personality, emotional problems, and health-related quality of life. This is done with regard to resources as well as activities enabling or enhancing a patient's adaptation. PubMed and PsychArticles databases were searched for relevant medical (eg, CODP, emphysema), psychopathology (eg, depression), and psychological (eg, personality) keywords, followed by hand search. After application of the inclusion and exclusion criteria, the search resulted in 82 articles and book chapters. The choice was based on evidence accepted by evidence-based medicine, although at different levels of strength. Psychological experiencing of COPD appears to be very unequally represented with scientific research on emotional problems and functioning decrease significantly outnumbering those addressing resources or effective interventions. As our initial literature search called for an urgent need for further exploration, we have carefully pointed out numerous areas where the knowledge on how to protect or restore psychological well-being among COPD patients should be broadened.
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Affiliation(s)
- Marta Rzadkiewicz
- Second Faculty of Medicine with The English Division and The Physiotherapy Division, Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland
| | - Ola Bråtas
- Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Geir Arild Espnes
- Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
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Stoilkova A, Wouters EFM, Spruit MA, Franssen FME, Janssen DJA. The relationship between coping styles and clinical outcomes in patients with COPD entering pulmonary rehabilitation. COPD 2014; 10:316-23. [PMID: 23713594 DOI: 10.3109/15412555.2012.744389] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Symptoms of anxiety, depression and exercise intolerance contribute to an impaired health status in patients with Chronic Obstructive Pulmonary Disease (COPD). Coping styles may also be related to symptoms and health status. Objectives of this study were to assess the distribution of coping styles in patients entering pulmonary rehabilitation (PR) with and without anxiety and/or depression; and to assess whether coping styles contribute to exercise intolerance and reduced health status. METHODS Coping styles were studied in 698 patients using the Utrecht Coping List (UCL). Disease-specific health status (St. George's Respiratory Questionnaire, SGRQ), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), exercise tolerance (6-minute walking distance, 6MWD) and clinical characteristics were assessed. RESULTS High levels (16.5%) of active confronting coping style were rarely reported. A minority of patients used low levels (17.5%) of passive reaction pattern coping style. Differences in coping profiles were present between patients with and without anxiety and/or depression. A higher level of active confronting coping style was associated with a higher 6MWD (Beta 0.092, p < 0.01), while a higher level of avoidance coping style was associated with a lower 6MWD (Beta -0.074, p = 0.017). The UCL subscales were not related to SGRQ total score (p > 0.05). CONCLUSIONS In COPD patients entering PR, coping styles were associated with symptoms of anxiety, depression and exercise intolerance, but not associated with disease-specific health status. Future studies should examine whether interventions aiming at optimizing coping styles during PR can improve outcomes for patients with COPD.
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Affiliation(s)
- Ana Stoilkova
- Department of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
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8
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Cooke M, Campbell M. Comparing patient and professional views of expected treatment outcomes for chronic obstructive pulmonary disease: a Delphi study identifies possibilities for change in service delivery in England, UK. J Clin Nurs 2014; 23:1990-2002. [DOI: 10.1111/jocn.12459] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Mary Cooke
- School of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| | - Malcolm Campbell
- School of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
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Hsu WC, Hsu HC. The effects of comorbidities on the trajectory of depressive symptoms among older adults in Taiwan. J Psychosom Res 2013; 75:414-8. [PMID: 24182628 DOI: 10.1016/j.jpsychores.2013.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 07/16/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aimed to identify depressive symptoms among older Taiwanese adults and to explore the relationships between different comorbidities and depressive symptoms. METHODS The data used herein were obtained from four waves of a longitudinal nationwide survey of the older Taiwanese population conducted from 1996 to 2007. Two-level hierarchical linear modeling was employed to identify the trajectory of depressive symptoms predicted by comorbidities when controlling for time-constant and time-varying covariates. RESULTS The time slope had an increasing tendency of depressive symptoms across time. The older adults with cardiovascular disease (CVD), gastrointestinal disease, chronic respiratory disease (CRD), and the combination of two of these three diseases had a higher effect on the intercept of depressive symptoms. Only the older adults with CRD combined with CVD or with GI disease had a significant negative effect on the slope of depressive symptoms over time. Participants with higher emotional-social support had lower depressive symptoms, and the effect of this support could reduce depressive symptoms even more over time. CONCLUSIONS Different patterns of comorbidities might have an additive or modifying effect on depressive symptoms. Emotional social support had a buffering or moderating effect on the prevention of depressive symptoms. This information is helpful for further studies that would address the relationships between different comorbidities and depressive symptoms.
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Affiliation(s)
- Wei-Chung Hsu
- Department of Radiation Oncology, Chung-Kang Branch, Cheng-Ching General Hospital, Taiwan, ROC; Department of Health Care Administration, Center for Health Policy and Management Research, Asia University, Taiwan, ROC
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Szymczyk I, Wojtyna E, Lukas W, Kępa J, Pawlikowska T. How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: A study in Polish primary care. BMC FAMILY PRACTICE 2013; 14:165. [PMID: 24175983 PMCID: PMC3818445 DOI: 10.1186/1471-2296-14-165] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 10/29/2013] [Indexed: 11/24/2022]
Abstract
Background Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. Methods A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined. Results We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important. Conclusions Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR.
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Affiliation(s)
| | - Ewa Wojtyna
- Institute of Psychology, University of Silesia in Katowice, ul, Grażyńskiego 53, 40-126 Katowice, Poland.
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Lee H, Yoon JY, Kim I, Jeong YH. The effects of personal resources and coping strategies on depression and anxiety in patients with chronic obstructive pulmonary disease. Heart Lung 2013; 42:473-9. [PMID: 23981471 DOI: 10.1016/j.hrtlng.2013.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 07/17/2013] [Accepted: 07/18/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Little is known about how personal resources and coping strategies influence depression and anxiety in patients with COPD. The purpose of this study was to examine the effect of personal resources on the coping strategies and psychological responses and the mediating role of coping strategies on the relationship of personal resources to depression and anxiety in patients with COPD using a path model. METHODS This was a cross-sectional correlational study. The participants were 209 patients diagnosed with COPD in South Korea. Personal resources were defined as knowledge of COPD, self-efficacy, and social support. Coping includes both problem-oriented and affect-oriented coping strategies. RESULTS Higher levels of knowledge of the disease were associated with fewer depressive symptoms; and this relationship was partially mediated by problem-oriented coping strategies. Higher levels of self-efficacy were related to less depression and anxiety. Patients with more perceived social support experienced fewer depressive symptoms through the use of problem-oriented coping strategies. CONCLUSIONS Our findings suggest that problem-oriented coping strategies may explain the mechanism of how knowledge of the disease and social support influence depressive symptoms for patients with COPD. Further interventions focusing on modifiable factors, including personal resources and problem-oriented coping strategies, are warranted to improve psychological outcomes for patients with COPD.
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Affiliation(s)
- Haejung Lee
- College of Nursing, Pusan National University, Yangsan, South Korea
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Deng GJ, Liu FR, Zhong QL, Chen J, Yang MF, He HG. The effect of non-pharmacological staged interventions on fatigue and dyspnoea in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Int J Nurs Pract 2013; 19:636-43. [PMID: 24330215 DOI: 10.1111/ijn.12116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to examine the effect of non-pharmacological staged interventions on fatigue and dyspnoea in patients with chronic obstructive pulmonary disease. A randomized controlled trial was conducted with 64 patients in a tertiary hospital in China from 2010 to 2011. Patients were randomly assigned to the control group (n = 32), who received routine care, and the intervention group (n = 32), who received additional non-pharmacological staged interventions. The Multidimensional Fatigue Inventory and the five-grade Medical Research Council dyspnoea scale were used to collect data at baseline and after 6 weeks. Compared with the control group, patients in the intervention group had significantly lower scores on general fatigue (P < 0.001), physical fatigue (P < 0.001), reduced activity (P < 0.001) and reduced motivation (P = 0.03) and had better relief of dyspnoea (P = 0.02). Our study showed that non-pharmacological staged interventions were effective in relieving fatigue and dyspnoea in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Guo-jin Deng
- School of Nursing, Nanchang University, P.R. China
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Cooke M, Thackray S. Differences between community professional and patient perceptions of chronic obstructive pulmonary disease treatment outcomes: a qualitative study. J Clin Nurs 2012; 21:1524-33. [PMID: 22594385 DOI: 10.1111/j.1365-2702.2012.04094.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study aims to define, compare and order 'assessed needs and defined outcomes' of professional providers of chronic obstructive pulmonary disease services with patients' 'prioritised needs and defined outcomes' and relate these to service provision. BACKGROUND Long-term morbidity and death rates from respiratory diseases in the UK are increasing. Few studies report patient views and perceptions of needs or priorities for respiratory conditions in primary care. None compare patient's and health professional's perceptions of patient needs, which may identify specific changes for service delivery. DESIGN A qualitative study using focus group discussion and nominal group technique to define, compare and order professional's and patient's groups' statements to prioritise perceptions. METHOD Specialist professionals and patients with chronic obstructive pulmonary disease were recruited to focus groups using systematic purposive sampling. Nominal group ordering of agreed statements occurred after the discussions followed by presentation of results to groups for validation. RESULTS Four key perceptions ordered and compared show both professionals and patients agreed that access to equitably provided services included more respiratory rehabilitation; other priorities indicate key differences between professional's and patient's perceptions of financial support, the communication of health education and the need for better provision of palliative care at end of life. CONCLUSIONS The study offers new knowledge about what patients in all stages of the disease process consider important for services that will retain their independence. This qualitative study illuminates and compares professional's and patient's priorities for service delivery and their perceptions of chronic obstructive pulmonary disease services. RELEVANCE TO CLINICAL PRACTICE Changing respiratory services to support patient's perceived needs enhances their independence.
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Affiliation(s)
- Mary Cooke
- School of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK.
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Green MR, Emery CF, Kozora E, Diaz PT, Make BJ. Religious and spiritual coping and quality of life among patients with emphysema in the National Emphysema Treatment Trial. Respir Care 2011; 56:1514-21. [PMID: 21513606 DOI: 10.4187/respcare.01105] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although prior research indicates that religious and spiritual coping is associated with positive health outcomes, few studies have examined religious and spiritual coping among patients with emphysema. OBJECTIVE To describe the utilization of religious and spiritual coping and its relationship to quality of life among patients with emphysema, in a 2-year longitudinal follow-up study. METHODS Forty patients with emphysema (mean age 63.5 ± 6.0 y, 8 women) who participated in the National Emphysema Treatment Trial were matched on age, sex, race, and education with 40 healthy individuals recruited from the community. We conducted baseline assessment of overall coping strategies, psychological functioning, quality of life, pulmonary function, and exercise capacity, and we assessed overall coping strategies and religious and spiritual coping at 2-year follow-up. RESULTS Ninety percent of the patients with emphysema considered themselves at least slightly religious and spiritual. The patients reported using both negative religious coping (eg, questioning God) and positive religious coping (eg, prayer) more than the healthy control subjects at follow-up. However, greater use of religious and spiritual coping was associated with poorer illness-related quality of life. CONCLUSIONS Patients with emphysema appear to use various coping strategies in responding to their illness. Future research should investigate if patients using religious and spiritual coping would benefit from interventions to address emotional distress and reduced quality of life.
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Affiliation(s)
- Marquisha R Green
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210, USA.
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Wei YC, Zhou FL, He DL, Bai JR, Hui LY, Wang XY, Nan KJ. The level of oxidative stress and the expression of genes involved in DNA-damage signaling pathways in depressive patients with colorectal carcinoma. J Psychosom Res 2009; 66:259-66. [PMID: 19232240 DOI: 10.1016/j.jpsychores.2008.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Revised: 07/22/2008] [Accepted: 09/02/2008] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This study investigated the connection among the oxidative stress, depression and expression of specific genes involved in DNA-damage signaling pathways in patients with colorectal carcinoma (CRC). METHODS A unique Dukes'C subset of patients with newly diagnosed colorectal adenocarcinoma were assessed using the Hamilton Depression Rating Scale (HAMD), Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale (SAS), Symptom Checklist 90 (SCL-90) and other multiple-item questionnaires. Oxidative-stress-related parameters in sera and the expression of genes were monitored during a pretreatment period. RESULTS Eighty-two eligibility cases were divided into 2 groups based on an HAMD score cutoff of 20: the mean score was 28.29 in Group A (depression, n=52) and 16.50 in Group B (nondepression, n=30). The serum total antioxidant capacity, catalase, and superoxide dismutase concentrations were lower in Group A, whereas those of nitric oxide and malondialdehyde were higher in Group A. Importantly, the 8-hydroxy-deoxyguanosine level was higher in Group A than in Group B (P<.05). Microarray analysis revealed that the expressions of p34, PA26, and ABL were higher in Group A, whereas those of HRAD51, CR6, and XRCC3 were higher in Group B. CONCLUSION Oxidative stress is capable of causing neuronal toxicity via lipid peroxidation, DNA damage, and abnormalities of gene expression, and therefore is a possible pathogenic mechanism underlying depression in patients with CRC.
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Affiliation(s)
- Yong-chang Wei
- Department of Clinical Oncology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
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Zhou FL, Zhang WG, Wei YC, Xu KL, Hui LY, Wang XS, Li MZ. Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers. World J Gastroenterol 2005; 11:2313-8. [PMID: 15818744 PMCID: PMC4305817 DOI: 10.3748/wjg.v11.i15.2313] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: A study was performed to investigate the impact of comorbid anxiety and depression (CAD) on quality of life (QOL) and cellular immunity changes in patients with digestive tract cancers.
METHODS: One hundred and fifty-six cases of both sexes with cancers of the digestive tract admitted between March 2001 and February 2004 in the Department of Medical Oncology, First Affiliated Hospital of Xi’an Jiaotong University were randomly enrolled in the study. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. All adult patients were evaluated with the Hamilton depressive scale (HAMD, the 24-item version), the Hamilton anxiety scale (HAMA, a modified 14-item version), quality of life questionnaire-core 30 (QLQ-C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ), and other questionnaires, respectively. In terms of HAMD ≥ 20 and HAMA ≥ 14, the patients were categorized, including CAD (n = 31) in group A, anxiety disorder (n = 23) in group B, depressive disorder (n = 37) in group C, and non-disorder (n = 65) in group D. Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared among the four groups.
RESULTS: The incidence of CAD was 21.15% in patients with digestive tract cancers. The average scores of social support was 43.67±7.05 for 156 cases, active coping 20.34±7.33, and passive coping 9.55±5.51. Compared with group D, subjective support was enhanced slightly in group A, but social support, objective support, and utilization of support reduced, especially utilization of support with significance (6.16 vs 7.80, P<0.05); total scores of active coping decreased, while passive coping reversed; granulocytes proliferated, monocytes declined, and lymphocytes declined significantly (32.87 vs 34.00, P<0.05); moreover, the percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was in lower level, respectively, and CD56 showed a significant decline in group A (26.02 vs 32.20, P<0.05), however, CD4/CD8 ratio increased. Physical function, role function, fatigue, sleeplessness and constipation had significant changes among different groups by one-way ANOVA, and group A was in poor QOL. It revealed that global health-related quality of life (QL) were positively correlated with active coping and CD56; CAD was negatively correlated with QL, active coping and CD56. Furthermore, the step-wise regression analysis suggested that utilization of support, CD56, active coping, fatigue, sleeplessness and depression were significant factors contributing to QOL.
CONCLUSION: CAD, which can impair QOL and cellular immunity, occurs with a higher incidence in patients with digestive tract cancers. Hence, it is essential to improve mental health for them with specifically tailored interventions.
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Affiliation(s)
- Fu-Ling Zhou
- Department of Hematology and Oncology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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