scholarly journals POS1472-HPR CLINICIANS’ PERSPECTIVES ON PSYCHOLOGICAL DISTRESS AND MEETING PATIENTS’ SUPPORT NEEDS IN RHEUMATOLOGY CARE SETTINGS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1021.2-1021
Author(s):  
C. Silverthorne ◽  
J. Daniels ◽  
M. Thompson ◽  
J. Robson ◽  
M. Ndosi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psychological Distress ◽  
Social Issues ◽  
Well Being ◽  
Psychological Support ◽  
Anxiety And Depression ◽  
Support Needs ◽  
Inflammatory Rheumatic Diseases ◽  
Main Theme ◽  
Musculoskeletal Care

Background:People with inflammatory rheumatic diseases (IRDs) face challenges that include fluctuations in pain, fatigue and flares of disease activity, complex medical regimens, and decisions about when to seek clinical help with symptoms [1,2]. Evidence suggests levels of anxiety and depression are higher in people with IRDs compared to the general population [3]. Rheumatology teams report that psychologically distressed patients can have additional support needs and require more time. Patients’ concerns include health-related anxiety and difficulty accepting the diagnosis. This group can have poor outcomes and poor adherence to treatments. However, little is currently known about optimal ways to meet these patients’ support needs.Objectives:To understand rheumatology clinicians’ perspectives on psychological distress in care settings with the long-term aim to develop a proposed model/pathway of support.Methods:Telephone interviews were conducted with members of UK rheumatology teams who have clinical experience with patients experiencing distress. The semi-structured interviews explored both ‘what happens now’ (current clinical practice) and ‘what should happen’ (acceptable models of future psychological support provision). The semi-structured format provided flexibility to probe more deeply and develop new lines of enquiry based on participants’ responses.Results:Fourteen interviews were conducted with rheumatology clinicians including 2 consultants, 4 nurses, 1 physiotherapist, 4 occupational therapists, 2 clinical psychologists and 1 podiatrist. Inductive thematic analysis was used to analyse the data. Two main themes represent the data (Table 1).Table 1.Main ThemeSub-themes1. ‘No one shoe fits all’ – the many manifestations of distress in patients.‘I pick up on distress as increased emotion…tearfulness and sadness I suppose, but also frustration, anger...A lot of helplessness comments’1. ‘Distress can be quite emotive and quite obvious, but then it can also hide away’2. ‘They’re [patients] trying to manage their own conditions, but they’re also trying to manage life’2. ‘If Rheumatology could be interwoven with psychological principles’ – the need to attend to the psychological impact of IRDs, alongside the physical impact.‘The physical and mental health side of things are so closely linked because one affects the other…after a while they [patients] don’t really know what’s affecting what’1. ‘Prioritising physical health…sometimes the stress gets not thought about’2. ‘Make best use of everyone in the team to work with patients who are struggling’3. ‘For the psychological side of things we don’t measure anything about that at all’Conclusion:Distress can be obvious or hidden and cause issues for both patient and clinician. It can lead to poor engagement with care provision. Clinicians differ in their perceptions of distress and in their thresholds for dealing with distress and have described the inconsistency of support offered for distressed patients. They described the powerful link between physical and mental distress, the vicious cycle that can develop, and the benefits of incorporating a psychological approach to treatment. This study suggests psychological support should be embedded within the team as it is felt there is a need for speciality understanding and for patients’ emotional wellbeing to consistently be given equal priority to their physical wellbeing.References:[1]Gettings L. Psychological well-being in rheumatoid arthritis: a review of the literature. Musculoskeletal care 2010;8(2):99-106. doi: 10.1002/msc.171 [published Online First: 2010/03/17][2]Homer D. Addressing psychological and social issues of rheumatoid arthritis within the consultation: a case report. Musculoskeletal care 2005;3(1):54-9. doi: 10.1002/msc.26 [published Online First: 2006/10/17][3]Isik A, Koca SS, Ozturk A, et al. Anxiety and depression in patients with rheumatoid arthritis. Clinical rheumatology 2007;26(6):872-8. doi: 10.1007/s10067-006-0407-y [published Online First: 2006/08/31]Disclosure of Interests:None declared

scholarly journals AB0177 ANXIETY-DEPRESSIVE SPECTRUM IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDILITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1114.2-1114
Author(s):  
M. Letaeva ◽  
M. Koroleva ◽  
J. Averkieva ◽  
O. Malyshenko ◽  
T. Raskina
Keyword(s):  
Rheumatoid Arthritis ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Well Being ◽  
Depressive Syndrome ◽  
Depression Screening ◽  
Anxiety And Depression ◽  
Control Group ◽  
Subjective Well Being ◽  
Anxiety Depression

Objectives:to assess the frequency of occurrence of the anxiety-depressive spectrum in patients with rheumatoid arthritis and ankylosing spondylitis.Methods:A survey was conducted of 44 patients aged from 21 to 57 years (average age - 42.3 ± 6.7 years), who were treated at GAUZ KO OKGVV. All patients had a verified diagnosis of RA and AS according to the ACR criteria and received treatment with basic drugs. The control group consisted of 40 people comparable in age and sex, without concomitant pathology of RA and AS.The depression screening card, the subjective well-being scale, and the hospital anxiety and depression scale (HADS) were used to assess and detect anxiety-depressive syndrome. The assessment of the condition is carried out over the last 2 weeks, which corresponds to the temporary diagnostic criterion for depression.The Depression Screening Scale is a 35-item self-questionnaire that assesses 7 categories of signs: sleep and appetite disorders, anxiety, emotional instability, cognitive impairment, loss of self, guilt, and suicidal tendencies. A total score of 65 and above indicates a high likelihood of depression.The Subjective Well-Being Scale is a psychodiagnostic screening tool for measuring the emotional component of subjective well-being or emotional comfort.Hospital Anxiety and Depression Scale Zigmond A.S., Snaith R.P. was developed for the primary detection of depression and anxiety in a general medical practice. The HADS scale consists of 14 statements with 4 possible answers and includes two parts: anxiety and depression. The sum of points of 8 or more is regarded as “subclinically expressed anxiety / depression”, 11 or more points - “clinically expressed anxiety / depression”.Results:According to the results of the depression screening questionnaire, 34 (77.3%) patients with RA and AS showed signs of depression, while in the control group only 6 (15%) patients tested positive for the presence of depressive disorders. According to the data obtained when assessing the scale of well-being in the main group, 26 (59.1%) patients showed signs of emotional discomfort (the indicator was 80% or more), in the control group - in 6 (15%). Using the hospital scale of anxiety and depression HADS, anxiety-depressive syndrome was detected in 36 (81.8%) patients with RA and AS: 16 (44.4%) patients had anxiety, 20 (55.6%) - depression, of them, subclinically expressed anxiety and depression were observed in 10 (27.7%) and 12 (33.3%) people, respectively. Anxiety-depressive syndrome in the control group, according to the HADS questionnaire, was detected only in 8 (20%) patients, of whom 4 (10%) patients had subclinical anxiety and 4 (10%) had signs of depression. No clinically pronounced anxiety and depression were registered in the control group.Conclusion:In most patients with rheumatoid arthritis and ankylosing spondylitis, anxiety-depressive disorders have been identified, which can directly affect both the course of the disease itself and the development of various complications. Timely diagnosis of mental disorders and close cooperation of rheumatologists, psychiatrists and psychologists in the selection of adequate therapy can improve the course and prognosis of the disease.Disclosure of Interests:None declared

scholarly journals European refugee crisis: psychological trauma of refugees and care givers

2018 ◽  
Vol 14 (1) ◽  
pp. 106-116 ◽  
Author(s):  
Irena Papadopoulos ◽  
Sue Shea
Keyword(s):  
Social Issues ◽  
Psychological Impact ◽  
Psychological Trauma ◽  
Well Being ◽  
Psychological Support ◽  
Refugee Crisis ◽  
Emotional Trauma ◽  
Content Type ◽  
Rescue Workers ◽  
Care Givers

Purpose In recent years, the number of refugees and migrants entering Europe has increased dramatically. Such trauma may affect not only refugees themselves, but also care givers and rescue workers. The purpose of this paper is to discuss the intensity and psychological impact of the refugee crisis, with a view to suggesting ways of moving forward. Design/methodology/approach Based on recent literature, this paper briefly looks at the importance of attention to health and social issues, before discussing the psychological trauma of refugees and potential emotional trauma of those involved in rescue operations. Findings The provision of psychological support which is both compassionate and culturally competent should be viewed as essential. Furthermore, the development of resources and tools to assist with the current refugee crisis could enable care givers, rescue workers, and healthcare professionals to provide psychological support to migrants and refugees. Such resources could also encourage, and support, frontline responders in caring for their own personal psychological well-being. Originality/value The content of this paper could help to encourage further research in this field, including research into the emotional trauma of rescue workers. Furthermore, it is intended that this paper could contribute to an on-line knowledge base when considering the development of tools and resources to assist with the current refugee crisis.

scholarly journals Network Analysis of Mindfulness Facets, Affect, Compassion, and Distress

Mindfulness ◽  
2020 ◽  
Author(s):  
Oleg N. Medvedev ◽  
Matti Cervin ◽  
Barbara Barcaccia ◽  
Richard J. Siegert ◽  
Anja Roemer ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Network Analysis ◽  
Negative Affect ◽  
Positive Affect ◽  
Experimental Studies ◽  
Well Being ◽  
Anxiety And Depression ◽  
Acting With Awareness ◽  
Mindfulness Facets ◽  
Internal Experience

Abstract Objectives Mindfulness, positive affect, and compassion may protect against psychological distress but there is lack of understanding about the ways in which these factors are linked to mental health. Network analysis is a statistical method used to investigate complex associations among constructs in a single network and is particularly suitable for this purpose. The aim of this study was to explore how mindfulness facets, affect, and compassion were linked to psychological distress using network analysis. Methods The sample (n = 400) included equal numbers from general and student populations who completed measures of five mindfulness facets, compassion, positive and negative affect, depression, anxiety, and stress. Network analysis was used to explore the direct associations between these variables. Results Compassion was directly related to positive affect, which in turn was strongly and inversely related to depression and positively related to the observing and describing facets of mindfulness. The non-judgment facet of mindfulness was strongly and inversely related to negative affect, anxiety, and depression, while non-reactivity and acting with awareness were inversely associated with stress and anxiety, respectively. Strong associations were found between all distress variables. Conclusions The present network analysis highlights the strong link between compassion and positive affect and suggests that observing and describing the world through the lens of compassion may enhance resilience to depression. Taking a non-judging and non-reacting stance toward internal experience while acting with awareness may protect against psychological distress. Applicability of these findings can be examined in experimental studies aiming to prevent distress and enhance psychological well-being.

The relation between the experience of time and psychological distress in patients with hematological malignancies

2006 ◽  
Vol 4 (4) ◽  
pp. 357-363 ◽  
Author(s):  
MARC WITTMANN ◽  
TANJA VOLLMER ◽  
CLAUDIA SCHWEIGER ◽  
WOLFGANG HIDDEMANN
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Hematological Malignancies ◽  
Well Being ◽  
Anxiety And Depression ◽  
Life Threatening Illness ◽  
Experience Of Time ◽  
Spiritual Well Being ◽  
Life Threatening

Objective: The experience of time is strongly related to our momentary mood states. Patients with a life-threatening illness experience an extreme change in mood and suffer from psychological distress that can develop into clinically relevant psychiatric disorders, like anxiety and depression. The aim of this study was to investigate the associations among the subjective perception of time, psychological distress, and quality of life in patients with hematological malignancies.Methods: Eighty-eight inpatients with hematological malignancies rated how fast time passes subjectively on a visual analog scale and prospectively estimated a time span of 13 min. The Hospital Anxiety and Depression Scale (HADS) self-report measures of health-related quality of life (FACT-G) and spiritual well-being (FACIT-Sp) were employed to assess psychological distress and quality of life.Results: Those patients who reported a lower quality of life, less spiritual well-being, and more anxiety experienced a slower passage of subjective time and overestimated the 13-min time interval.Significance of results: Our interpretation of the results is that patients with a life-threatening illness who show symptoms of psychological distress draw attention away from meaningful thoughts and actions and, thus, experience time as passing more slowly. An altered sense of time can be a sign of mental suffering, which should be addressed within psycho-oncological interventions. As this is the first study to demonstrate this relation in cancer patients, further research is needed to investigate the experience of time and its relation to meaning as an issue in clinical diagnostics.

scholarly journals 204 - Psychological distress and support needs of community residing older adults in urban India – An exploratory study

2021 ◽  
Vol 33 (S1) ◽  
pp. 8-9
Author(s):  
Jayashree Dasgupta ◽  
Meenakshi Chopra
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Psychological Distress ◽  
Coping Strategies ◽  
Help Seeking ◽  
Public Awareness ◽  
Well Being ◽  
Support Needs ◽  
Urban India ◽  
And Coping

Background:COVID pandemic in India, lockdowns and an unprepared health system has affected wellbeing of older adults. Low public awareness about mental health issues and stigma also contribute to low help seeking. Exploring impact of COVID on mental health of older adults and understanding support needs is essential.Research Objective:To examine mental wellbeing and coping strategies used by urban community residing older adults during the pandemic in India.Method:As part of an ongoing community engagement initiative with older adults and their families, an online survey was conducted during the first wave of the pandemic in April/May 2020. Sociodemographic details and information on coping strategies were gathered. The five-item General Health Questionnaire (GHQ) was used to screen for psychological distress and data were analyzed using descriptive statistics. Respondents were contacted again in May 2021 during the second COVID wave for a telephonic interview to understand current levels of distress and coping strategies. Consent was taken for audio recording and interviews were conducted using a semi-structured interview guide. Interviews were transcribed and analyzed using thematic analysis.Preliminary results of the ongoing study:Respondents (N=54) aged between 40-86 years (Mn = 60; SD = 18.9). Majority were male (61%), retired or homemakers (57%) and widowed/unmarried (52%). Of the sample 70% had one or more pre-existing medical conditions. A score of ≥ 2 on GHQ in 66% respondents indicates psychological distress. Stressors included health and well-being of family (62%), difficulty managing household work (42%) and increase in family conflicts (17%). Although 72% discussed their worries with family/friends, only 25% considered speaking with a mental health professional indicating low help seeking. Of respondents contacted again, 40% citied ill health or being busy as reasons for refusal to participate. Of those who agreed, 33% reported psychological distress. In-depth interviews, showed use of online mental wellness sessions and yoga/meditation to be beneficial coping strategies. Need for more online support groups was also highlighted.Conclusion:Psychological distress is present amongst community residing older adults in urban India. A change in attitude towards tele mental health must be leveraged to provide support for adults experiencing psychological distress.

Persistence of psychological distress and correlated factors among patients with head and neck cancer

2015 ◽  
Vol 14 (1) ◽  
pp. 42-51 ◽  
Author(s):  
Kanako Ichikura ◽  
Aya Yamashita ◽  
Taro Sugimoto ◽  
Seiji Kishimoto ◽  
Eisuke Matsushima
Keyword(s):  
Head And Neck Cancer ◽  
Psychological Distress ◽  
Head And Neck ◽  
Neck Cancer ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Tokyo Medical ◽  
Correlated Factors

ABSTRACTObjective:Many patients with head and neck cancer (HNC) suffer from psychological distress associated with dysfunction and/or disfigurement. Our aim was to evaluate the ratio of patients with persistence of psychological distress during hospitalization and identify the predictors of persistence or change in psychological distress among HNC patients.Method:We conducted a single-center longitudinal study with self-completed questionnaires. We evaluated psychological distress (the Hospital Anxiety and Depression Scale; HADS) and functional level (the Functional Assessment of Cancer Therapy–Head and Neck Scale; FACT–H&N) among patients during hospitalization at the Medical Hospital of Tokyo Medical and Dental University.Results:Of 160 patients, 117 (73.1%) completed the questionnaire at both admission and discharge. Some 42 (52.5%) patients reported persistent psychological distress. The physical well-being of patients with continued distress was significantly lower than that of other patients (21.7 ± 4.7, 19.4 ± 6.1, 19.5 ± 5.4;p< 0.01), and the emotional well-being of patients with continued distress was significantly lower than that in patients with no distress and reduced distress (22.3 ± 3.5, 20.5 ± 2.5; p < 0.01).Significant of results:Impaired physical and emotional function appears to be associated with persistent psychological distress among HNC patients. Psychological interventions focused on relaxation, cognition, or behavior may be efficacious in preventing such persistent distress.

scholarly journals Associations between stress, anxiety, depression, and emotional intelligence among osteopathic medical students

2021 ◽  
Vol 121 (2) ◽  
pp. 125-133
Author(s):  
Nicole A. Doyle ◽  
Robert E. Davis ◽  
Syed Siraj A. Quadri ◽  
Joshua R. Mann ◽  
Manoj Sharma ◽  
...  
Keyword(s):  
Emotional Intelligence ◽  
Psychological Distress ◽  
Medical Students ◽  
Protective Factor ◽  
Well Being ◽  
The United States ◽  
Anxiety And Depression ◽  
Convenience Sample ◽  
Significant Difference ◽  
Anxiety Depression

Abstract Context Stress, anxiety, and depression affect medical student populations at rates disproportionate to those of general student populations. Emotional intelligence (EI) has been suggested as a protective factor in association with psychological distress. Objective To explore the relationships between EI and stress, anxiety, and depression among a sample of US osteopathic medical students. Methods From February to March 2020, a convenience sample of medical students enrolled at an osteopathic medical school in the southeastern region of the United States were invited to complete a voluntary and anonymous 54-item online questionnaire that included sociodemographic items as well as validated and reliable scales assessing perceived stress, anxiety, depression, and EI. Univariate statistics were calculated to describe the participant characteristics and the study variables of interest. Pearson’s product-moment correlations were used to examine relationships between EI and study variables. Three multiple regression models were fitted to examine the relationship between EI and stress, anxiety, and depression, adjusting for sociodemographic factors exhibiting significant bivariate relationships with outcome variables. Dichotomous variables were created that were indicative of positive screens for potential depressive disorder or anxiety disorder. Independent-sample t-tests were used to determine the presence of a statistically significant difference in EI scores between positive screeners for depression and anxiety and their respective counterparts; an alpha level of 0.05 was set a priori to indicate statistical significance. Results In all, 268 medical students participated in this study, for a response rate of approximately 27%. Importantly, EI exhibited significant negative correlations with stress, anxiety, and depression (r=−0.384, p<0.001; r=−0.308, p<0.001; r=−0.286, p<0.001), respectively). Thus, high levels of stress, anxiety, and depression were observed in the sample. Significant relationships remained following covariate adjustment. Established cutoffs for anxiety and depression were used to classify positive and negative screens for these morbidities. Using these classifications, individuals screening positive for potential anxiety and depression exhibited significantly lower levels of EI than their counterparts showing subclinical symptoms (t=5.14, p<0.001 and t=3.58, p<0.001, respectively). Conclusion Our findings support the notion that higher levels of EI may potentially lead to increased well-being, limit psychological distress, improve patient care, and facilitate an ability to thrive in the medical field. We encourage continued study on the efficacy of EI training through intervention, measurement of EI in both academic and clinical settings as an indicator of those at risk for programmatic dropout or psychological distress, and consideration of EI training as an adjunct to the educational program curriculum.

scholarly journals Anxiety and Depression in Patients with Gastrointestinal Cancer: Does Knowledge of Cancer Diagnosis Matter?

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Dr. Hosamani Marilingappa
Keyword(s):  
Psychological Distress ◽  
Cancer Diagnosis ◽  
Gastrointestinal Cancer ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety Score ◽  
Cancer Site ◽  
Anxiety And Depression ◽  
The Mean ◽  
Knowledge Of Cancer

Background: Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. The present study examine the anxiety and depression in this group of patients and assess whether the knowledge of cancer diagnosis affect their psychological distress. Methods: This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute, Iran. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). Demographic and clinical data also were collected to examine anxiety and depression in the sub-group of patients especially in those who knew their cancer diagnosis and those who did not. Results: 142 patients were studied. The mean age of patients were 54.1 (SD = 14.8). 56% were Male. 52% did not know their cancer diagnosis and their diagnosis was related to esophagus (29%), stomach (30%), small intestine (3%), colon (22%) and rectum (16%). The mean anxiety score was 7.6 (SD = 4.5) and 8.4 (SD = 3.8) for depression. Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD) anxiety score: knew diagnosis 9.1 (4.2) vs. 6.3 (4.4) did not know diagnosis, P < 0.001; mean (SD) depression score: knew diagnosis 9.1 (4.1) vs. 7.9 (3.6) did not know diagnosis, P = 0.05]. logistic regression analysis indicated that those who knew their cancer diagnosis showed a significant higher risk of anxiety [OR: 2.7, 95% CI: 1.1–6.8] and depression [OR: 2.8, 95% CI: 1.1–7.2]. Conclusion: Psychological distress was higher in those who knew their cancer diagnosis. It seems that the cultural issues and the way we provide information for cancer patients play important role in their improved or decreased psychological well-being.

Experiences of Patients With Rheumatoid Arthritis: A Qualitative Study

2016 ◽  
Vol 26 (3) ◽  
pp. 373-393 ◽  
Author(s):  
Li Wen Poh ◽  
Hong-Gu He ◽  
Wai Chi Sally Chan ◽  
Ching Siang Cindy Lee ◽  
Manjari Lahiri ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Social Life ◽  
Well Being ◽  
Support Needs ◽  
Emotional Challenges ◽  
Psychosocial Challenges ◽  
Inflammatory Autoimmune Disease ◽  
Chronic Inflammatory Autoimmune Disease

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that greatly impacts one’s physical and psychosocial well-being. The purpose of this study was to explore the experiences and support needs of adult patients living with RA. A descriptive qualitative study was conducted, and 16 adults with RA were interviewed from October 2013 to January 2014. The transcribed data were analyzed using thematic analysis. Five themes were identified: altered physical capacity and well-being, psychological and emotional challenges, changes in social life, coping strategies, and support received and further support needs. This study provided insights into the experiences and support needs of patients with RA in Singapore. Physical and psychosocial challenges experienced by patients affected their daily and social activities. Patients’ needs for variety of support should be addressed.

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