scholarly journals A Cross-Sectional Study of Stress and the Perceived Style of Decision-Making in Clinicians and Patients With Cancer

2019 ◽  
Vol 6 ◽  
pp. 233339281985539
Author(s):  
Elaina Vivian ◽  
Hellen Oduor ◽  
Laurie Lundberg ◽  
Allison Vo ◽  
Parvez S Mantry

Background and Aims: Perceived stress and mindfulness can impact medical decision-making in both patients and clinicians. The aim of this study was to conduct a cross-sectional evaluation of the relationships between stress, mindfulness, self-regulation, perceptions of treatment conversations, and decision-making preferences among clinicians. Also, perceptions of treatment conversations and decision-making preferences among patients with cancer were evaluated. Methodology: Survey instruments were developed for clinicians and patients incorporating previously published questions and validated instruments. Institutional review board approval was obtained. Patients, physicians, and advanced practice providers from a tertiary referral center were asked to complete surveys. Continuous variables were evaluated for normality and then bivariate relationships between variables were evaluated using χ2, Fisher's exact test, Cochran-Mantel-Haenszel (CMH) row mean scores differ statistic, or Kruskal-Wallis tests, where appropriate. Significance was defined at P < .05. All tests were conducted using SAS v.9.4. Results: 77 patients and 86 clinicians (60.1% and 43% response rates, respectively) participated in the surveys. More clinicians who reported feeling “great/good” said they always/sometimes had enough time to spend with patients (66.1%) compared to those that hardly ever/never had enough time (26.3%), χ2(1, N = 75) = 6.62, P = .0101; CMH row mean scores differ statistic). Interestingly, 40.3% of patients preferred a paternalistic style of decision-making compared to 6.3% of clinicians, χ2(2, N = 146) = 27.46, P < .0001; χ2 test. Higher levels of dispositional mindfulness (Mindful Attention Awareness Scale) were found among clinicians who reported they felt “great/good” (median = 4.5) as compared to those who reported that they were “definitely stressed/stressed out” (3.3), χ2(2, N = 80) = 10.32, P = .0057; Kruskal-Wallis test. Higher levels of emotional self-regulation (Emotional Regulation Questionnaire—Cognitive Reappraisal facet) were found among clinicians who reported they felt “great/good” (median = 31.0) compared to those who reported that they were “definitely stressed/stressed out” (20.0), χ2(2, N = 79) = 8.88, P = .0118; Kruskal-Wallis test. Conclusion: In order to have meaningful conversations about treatment planning, an understanding of mental well-being and its relationship to decision-making preferences is crucial for both oncology patients and clinicians. Our results show that for clinicians, lower perceived stress was associated with higher levels of mindfulness (experiencing the present moment), emotional self-regulation, and spending more time with patients. Larger prospective studies are needed to validate these findings.

2019 ◽  
Vol 5 ◽  
pp. 237796081982747
Author(s):  
Elaina Vivian ◽  
Hellen Oduor ◽  
Sharina R. Arceneaux ◽  
Jasmine A. Flores ◽  
Allison Vo ◽  
...  

Introduction Workplace stress and burnout may influence nurses’ physical and emotional well-being, which can impact the quality of care patients receive and their overall satisfaction with their hospitalization. Objectives The objectives of the study were to evaluate whether there are significant statistical relationships between nurses’ perceived stress, frequency of stressors, mindfulness, emotional self-regulation, self-care habits, and patient satisfaction scores. Methods The study took place over the course of 4 weeks. In this study, 340 nurse participants were surveyed using cross-sectional voluntary sampling design. The survey included previously developed and validated instruments. SAS v. 9.4 was used for statistical analysis. Results Significant differences were noted in average patient satisfaction scores by perceived stress; major nursing units in the Death and Dying, Conflict with Physicians, Lack of Support, and Work Load subscales of the Nursing Stress Scale; and major nursing units and dispositional mindfulness. Conclusions Hospital administrators can use this information in their organizations and set priorities and tailor mindfulness-based stress-reduction interventions for nursing professionals.


2021 ◽  
pp. 1-9
Author(s):  
Hamid Sharif Nia ◽  
Mobin Mohammadinezhad ◽  
Kelly A. Allen ◽  
Christopher Boyle ◽  
Saeed Pahlevan Sharif ◽  
...  

Abstract Objective The spiritual well-being scale (SWBS) is a widely used clinical scale which should be evaluated for Iranian patients with cancer. The aim of this study is to evaluate the psychometric properties of the Persian version of the SWBS in Iranian patients with cancer. Method This cross-sectional, methodological study was conducted among Iranian patients with cancer (n = 400). The participants were recruited using convenience sampling. The content, construct, convergent and discriminant validity, and reliability of the Persian version of the SWBS were evaluated. Results A two-factor structure for the scale was indicated with the factors being: connecting with God and meaningless life that explained 54.18% of the total variance of the concept of spiritual well-being. The results demonstrated the model had a good fit. Cronbach's alpha, McDonald's omega, and the inter-item correlation values of the factors indicated good internal consistency of the scale. Significance of results These results suggest that the Persian version of the SWBS is a reliable and valid measure to assess the spiritual well-being of patients with cancer through 16 items related to connecting with God and meaningless life.


Author(s):  
Daniela Di Santo ◽  
Calogero Lo Destro ◽  
Conrad Baldner ◽  
Alessandra Talamo ◽  
Cristina Cabras ◽  
...  

AbstractPositivity (i.e., the individual tendency to positively approach life experiences) has proven to be an effective construct applied in positive psychology. However, individuals’ self-regulation may have contrasting effects on positivity. We specifically examined whether positivity could be partially explained through two aspects of motivation concerned with self-regulation: locomotion (i.e., a motivational orientation concerned with movement) and assessment (i.e., a motivational orientation concerned with comparison and evaluation). Furthermore, based on previous literature that found a link between these aspects and narcissism, we examined whether “adaptive” and “maladaptive” dimensions of narcissism could mediate the effects of locomotion and assessment on increased or decreased positivity. Narcissism was defined by previous research as adaptive or maladaptive insofar as it leads or does not lead to increased psychological well-being. We estimated a mediation model with multiple independent variables and multiple mediators in a cross-sectional study with self-reported data from 190 university students. We found that both locomotion and assessment were associated with adaptive narcissism, which in turn was positively associated with positivity. However, assessment was also associated with maladaptive narcissism, which in turn was negatively associated with positivity. Relationships between aspects of self-regulation, narcissism, and positivity can have significant implications which will be discussed.


Author(s):  
Maria Kaczmarek ◽  
Sylwia Trambacz-Oleszak

Higher stress reactivity during adolescence is a vulnerability marker of exposure to various environmental stressors. This study aimed to investigate the association between a high level of perceived stress experienced by adolescents and stressful stimuli induced from school environment, peer, and parental relationships. The data used were from a cross-sectional, observational study conducted in a stratified sample of 1846 adolescents (13–18 years) in the Wielkopolska province, Poland. Data were collected through self-administered questionnaires and anthropometric measurements. Perceived stress was assessed using the Perceived Stress Scale (PSS-10). The association of a high level of perceived stress with school-induced exposures was determined using multivariate logistic regression after adjusting for gender, age, height and weight status and interpersonal relationships (STATISTICA 13.1). It was found that girls were over three times more likely than boys to experience a high level of perceived stress. Moreover, girls appeared to be more vulnerable than boys to school-related stressors and weight status, while boys to stressors that can arise from interpersonal relationships. School environment was the only predictor factor of high perceived stress level with a large effect size in both boys (OR = 4.45; 95% CI: 3.11–6.36) and girls (OR = 6.22; 95% CI: 4.18–7.59). Given the findings of the present study, preventive programs are critical to mitigate the effect of stress from school on adolescents’ health and well-being.


2020 ◽  
Author(s):  
Richard Huan Xu ◽  
Ling-Ming Zhou ◽  
Eliza Lai-Yi Wong ◽  
Dong Wang

BACKGROUND Although previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being. OBJECTIVE This study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being. METHODS The data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics. RESULTS A total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM<sub>≥61 years</sub>=88.6 vs SSDM<sub>16-30 years</sub>=84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM (<i>β</i>=.22; <i>P</i>&lt;.001) and well-being (<i>β</i>=.26; <i>P</i>&lt;.001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables. CONCLUSIONS This study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM. CLINICALTRIAL


2020 ◽  
Author(s):  
Ming-Jye Wang ◽  
Hung-Ming Lin ◽  
Li-Chen Hung ◽  
Yi-Ting Lo

Abstract Background: The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making.Methods: A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via self-administered questionnaires. Partial least squares structural equation modeling was used for analysis.Results: Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making. Conclusions: Health literacy is a critical factor in improving self-care behaviors in patients with type 2 diabetes, and the effect of health literacy on self-efficacy was more significant in the shared decision-making than in the physician decision-making. Therefore, developing an effective health strategy to strengthen health literacy awareness and designing friendly, diverse health literacy materials, and application tools is the most important factor to facilitate self-care behaviors in this population.


2019 ◽  
Vol 56 (9) ◽  
pp. 1220-1229
Author(s):  
Francesca Wogden ◽  
Alyson Norman ◽  
Louise Dibben

Objective: Limited research has studied the involvement of children in medical decision-making. The aim of the study was to understand the involvement of adolescents with cleft lip and/or palate (CL/P) in decisions about elective surgeries and treatments. Design: Parents and professionals completed mixed-methods questionnaires about the degree to which children had been involved in choices about elective treatments. Data were analyzed using content analysis. Young people aged 12 to 25 years were asked to take part in semistructured interviews. The data were analyzed using inductive thematic analysis. Setting: Questionnaire data collection took place online, and interview data were collected via messenger or telephone-based interviews. Participants: The study employed 30 participants; 11 young people (3 male, 8 female), 17 parents (13 mothers, 4 fathers), and 5 professionals (2 surgeons, 2 speech and language therapists, and 1 pediatric dentist). Results: Five main themes were identified. These reflected participants feeling that with increasing age should come increased involvement in decision-making and that it was important for adolescents to “have a voice” during decision-making. Parents, peers, and health professionals were identified as influencing decisions. Most adolescents reported overall satisfaction with their involvement in decision-making but sometimes felt “left in the dark” by professionals or under pressure from parents. A desire to improve speech and/or appearance was as an area where adolescents wanted to be more involved in decision-making. Conclusions: Shared decision-making is an important factor for psychological well-being by promoting autonomy and self-esteem among adolescents with CL/P.


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