Psychosocial Distress in Parents with Children Awaiting Surgery during the COVID-19 Pandemic

Due to resource restrictions related to the COVID-19 pandemic, many pediatric patients are facing substantial delays for surgery, potentially resulting in additional distress for caregivers. We aimed to assess the experiences and psychosocial distress of parents during COVID-19 as they relate to the pandemic, waiting for surgery, and the combined effects of both events. The was a cross-sectional qualitative study. Parents with children who faced treatment delays during the initial wave of the COVID-19 pandemic for elective, non-emergent procedures across a variety of surgical specialties were recruited. Semi-structured telephone interviews and thematic analysis were utilized. Thematic saturation was reached with eighteen participants. Four themes were identified: coping with COVID-19, distress levels, quality and nature of communication with the surgical team, and the experience of COVID-19 related hospital restrictions. Participants reported varying levels of distress due to the delay in surgery, such as the fear of developmental delay or disease progression for their child. They also indicated their own physical and mental health had been impacted by emotional distress related to both COVID-19 and delays in treatment. Most participants experienced the COVID-19-related hospital restrictions as distressing. This related predominantly to limiting in-hospital caregivers to only one caregiver. Participants were found to have substantial levels of psychosocial distress. Targeted social and emotional support may be helpful in reducing parental distress as the pandemic timeframe continues. Within the limits of individual health systems, reducing restrictions to the number of allowed care givers may help allay distress felt by parents.

Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.

Conceptualizing religious asylum: Security, religiosity, and subjective well-being of Christian asylum-seekers in Hong Kong

This article proposes the concept of religious asylum to examine how Christian asylum-seekers utilize religion to cope with their emotional experiences, induced by a sense of insecurity, during prolonged displacement. Drawing from interviews and ethnographic observations of people seeking asylum in Hong Kong, this research determines that asylum-seekers use religion to redefine their positive sense of self beyond their current situation, which is central to the construct of well-being. While religion supports asylum-seekers going through psychosocial distress and suffering, this discussion on religious asylum shows how asylum-seekers utilize the religiously inflected space to make the experience of prolonged displacement meaningful.

Predictors of adolescents’ response to Young Person’s Face IT: A web-based intervention to improve psychosocial adjustment to having an appearance-affecting condition (Preprint)

BACKGROUND Adolescents with a condition affecting their appearance that results in a visible difference can be at risk of psychosocial distress and impaired adjustment. Evidence for the effectiveness of existing interventions in improving psychosocial outcomes is limited and relevant treatment can be difficult to access. Young Person’s Face IT (YPF), a novel self-guided web-based intervention, has demonstrated potential in reducing social anxiety in adolescents with visible differences. However, more knowledge is needed regarding factors that contribute to variations in intervention effects in order to identify which adolescents may benefit most from YPF. OBJECTIVE This study aimed to identify predictors related to overall intervention effects following adolescents’ use of YPF. METHODS N=71 adolescents (61% girls; mean age 13.98, range 11–18 years) with a wide range of visible differences completed primary (body esteem and social anxiety symptoms) and secondary (perceived stigmatization, life disengagement, and self-rated health) outcome measures, at baseline and post-intervention. Predictor variables were demographic (age and gender), psychosocial (frequency of teasing experiences related to aspects of body and appearance, and depressive and/or anxiety symptoms), and intervention-related (time spent on YPF) factors. RESULTS Backward multiple regression revealed that higher intervention effects were predicted by gender, baseline frequency of teasing experiences, levels of depressive and/or anxiety symptoms, and time spent on YPF. However, the results were limited by low proportion of explained post-intervention variance, ranging from 1.6 to 24.1%. CONCLUSIONS This study suggests that adolescent boys, adolescents who experience higher levels of psychosocial distress related to their visible difference, and adolescents that spend sufficient time on YPF, may obtain better overall intervention effects. CLINICALTRIAL NCT03165331

Mediating Effects of Emotional Self-Efficacy on Food Consumption and Dietary Quality Before and During the COVID-19 Pandemic: A Web-Based Survey on Chinese Individuals (Preprint)

BACKGROUND The prevalence of psychosocial distress is increasing worldwide, which impacts people’s dietary behaviors and habits. Preparing and cooking food may facilitate the mitigation of psychosocial distress during epidemic-related quarantines. Emotional self-efficacy (ESE) measures various aspects of perceiving and understanding emotions and helping others modulate their emotions. ESE affects dietary behaviors and habits and mediates the relationship between socioeconomic status (SES) and diet-related behavior. OBJECTIVE This study attempts to identify whether the predictor variable, socioeconomic status, and the criterion variable, dietary quality, form a linear relationship. The statistical association between SES and dietary quality may be higher when considering ESE than when it is not considered. METHODS A questionnaire survey was designed to evaluate the impact of ESE on food-related behavior and that of SES on dietary quality. Adults from Mainland China participated in a web-based survey from April to June 2020. Factor analysis was used to report the survey results and item reliability. Multiple linear regression was performed to identify the association between ESE and dietary behavior, and further analytics analyzed how socioeconomic factors affected the dietary quality of those who were influenced by food advertising promotion (FAP). RESULTS The data derived from 441 responses showed that the ESE scale exhibited satisfactory internal consistency and predictive validity for Chinese individuals. The COVID-19 pandemic significantly decreased the food-consumption level, particularly in the case of salty snacks and alcoholic beverages. The respondents who reported a higher SES tended to have a higher ESE level than those with a lower SES. ESE mediated the relationship between SES and dietary quality (β=-.019, P<.001). When considering the influence of ESE, the direct association between SES and dietary quality was stronger than when ESE was not considered (β=.094, P<.05). Furthermore, this direct relationship was stronger for those who were influenced by FAP (β=-.317, P<.05). CONCLUSIONS The relationship between SES and food consumption with regard to dietary quality is stronger for people who encounter environmental influences. ESE is a well-established tool for evaluating how people cope with negative emotions. The findings support the mediating impact of ESE on the conditional process linking SES to dietary quality, which provides further insights about the dynamic process of psychological constructs in behavioral outcomes. This study highlights that the lockdown imposed to contain an infectious agent affected people’s dietary behaviors and habits and advocates for organized nutritional support during future epidemic-related quarantines.

COVID-19-Related Psychological and Psychosocial Distress Among Parents and Youth With Physical Illness: A Longitudinal Study

Despite the initial thrust of research aimed at understanding the impact of the COVID-19 pandemic on youth with physical illness and their parents, knowledge gaps in the literature remain, providing the impetus for additional investigation. This study described changes in psychological distress from prior to during the COVID-19 pandemic for parents and youth with physical illness, compared parent-proxy and youth self-reported perceptions of COVID-19-related psychosocial health, and modeled factors associated with psychological and psychosocial distress. There were 147 parent–youth dyads (2–16 years) from MY LIFE—a longitudinal study of youth with physical illness. The Kessler-6 (K6) measured psychological distress for the time before the COVID-19 lockdown (December 19 to March 20) and during the pandemic (December 20 to March 21) among parents and youth. COVID-19-related psychosocial health was measured using the CRISIS. Parents and youth reported increases in K6 scores (d = 0.62 and 0.38). Parent-proxy reports on the K6 were lower vs. youth self-reports prior to and during the pandemic (d = 0.63 for both). In contrast, parents reported lower proxy CRISIS scores for worries (d = 0.38) and effects of social restrictions (d = 0.52). Pandemic parent K6 scores were associated with age, combined in-person and online schooling for youth, COVID-19-related worries, and effects of social restrictions. For youth, only COVID-19-related worries and effects of social restrictions were associated with K6 scores. Parent worries were associated with youth sex, parental stress, family functioning, online and combination learning, and social restrictions. Parental depression and worries were associated with effects of social restrictions. Youth worries were associated with online and combination learning, and social restrictions. Youth disability, online learning, and worries were associated with effects of social restrictions. Few clinical factors are associated with COVID-19-related psychological and psychosocial distress. Instead, parent/family factors and youth learning environment have prominent roles in predicting outcomes and have implications for the health, education, and social services systems.

Disparity of perception of quality of life between head and neck cancer patients and caregivers

Background Caregivers are invaluable sources of support for individuals recovering from head and neck cancer (HNC). Accordingly, minimizing caregiver distress is essential to promote the well-being of both caregivers and their patients. This study assessed if psychosocial distress (i.e., anxiety and depression) among HNC caregivers is associated with a difference in how caregivers and their patients perceive patients’ quality of life (QOL) after treatment completion. Methods Caregivers’ and patients’ perceptions of patient QOL were assessed using the University of Washington QOL Questionaire (UWQOL), a validated HNC-specific health-related QOL questionnaire. The survey is interpreted in terms of its two composite scores: a physical QOL score and a social-emotional QOL score with higher scores indicating better QOL. Caregiver anxiety was assessed using the Generalized Anxiety Questionaire-7 (GAD-7) and caregiver depression was assessed using the Patient Health Questionaire 8 (PHQ-8). Patients completed the UWQOL as part of clinic intake while caregivers were asked to complete the UWQOL for their patients in addition to the PHQ-8 and GAD-7 in private. Linear regression was used to analyze the association between differences in caregivers’ and patients’ QOL scores (both social-emotional and physical QOL subscale scores) and GAD-7 and PHQ-8 scores. Results Of 47 caregivers recruited, 42.6% (n = 20) viewed patients’ social-emotional QOL more negatively than patients themselves, while 31.9% viewed patients’ physical QOL more negatively. After controlling for covariates, differences in perception of social-emotional QOL (p = .01) and differences in perception of physical QOL (p = .007) were significantly associated with caregiver depression, but not anxiety. Caregivers who disagreed with patients regarding patients’ social-emotional QOL scored 6.80 points higher on the PHQ8 than agreeing caregivers. Caregivers who disagreed regarding patients’ physical QOL scored 6.09 points higher. Conclusion Caregivers commonly view patients’ QOL more negatively than patients themselves. These caregivers tend to have greater psychosocial distress than caregivers who agree with their patients. Interventions designed to identify and aid at-risk caregivers are critically needed. We propose screening for differences in perception of patient QOL as a way of identifying distressed caregivers as well as provider-facilitated communication between patients and caregivers as possible interventions that should be examined in future research.