Factors affecting self-perceived participation and autonomy among patients with burns: A follow-up study

Demoralization syndrome in burn patients: A cross-sectional study

AIMS

To investigate the status of demoralization syndrome and the factors affecting demoralization in burn patients.

METHODS

This study employed a cross-sectional research design and utilized a face-to-face questionnaire to gather data from adult burn patients with burn depths classified as second-degree or higher. The Demoralization Scale Mandarin Version, the Perceived Social Support Scale, the Herth Hope Index, and the Medical Coping Method Questionnaire were used to assess the level of demoralization, perceived social support, sense of hope, and coping strategies, respectively. General information, including socio-demographic data and disease characteristics, were collected. The patients' level of demoralization was categorized as the mean ± 1 standard deviation of the DS-MV scores. The data was analyzed using IBM SPSS 26.0 software to explore the relationship between the variables.

RESULTS

This study included 381 burn patients with a mean DS-MV score of 34.62 ± 18.319. Of these, 66 (17.3%) had mild demoralization, 241 (63.3%) had moderate demoralization, and 74 (19.4%) had severe demoralization. Cause of burn, total burn area, average monthly income of the individual, occupation, sense of hope, perceived social support, and medical coping strategies were the important factors associated with the severity of demoralization in burn patients.

CONCLUSIONS

Patients with burn injuries exhibit a notable prevalence and severity of demoralization indicating focused attention. By considering associated risk factors, healthcare professionals can devise and execute tailored intervention strategies aimed at mitigating the occurrence and intensity of demoralization in burn patients.

Assessing perceived participation among older adults total hip arthroplasty and total knee arthroplasty patients six months post-surgery: a cross-sectional study

Aims

This research sought to assess the perceived levels of participation and autonomy in senior patients who had received total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Hangzhou, China. Furthermore, the study aimed to identify the factors linked to these outcomes.

Study design

This investigation will utilize a cross-sectional study design to assess perceived participation and autonomy among older adults total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. The research was conducted in Hangzhou, China, at a tertiary hospital.

Methods

Convenient sampling was utilized to select 139 patients who underwent THA or TKA between March 2022 and March 2023 and met the inclusion criteria at a tertiary hospital in Hangzhou. The Impact on Participation and Autonomy Questionnaire, Hip/Knee Injury and Osteoarthritis Outcome Score (HOOS/KOOS), 5-Item Geriatric Depression Scale, Multidimensional Scale of Perceived Social Support, and Elders Health Empowerment Scale were used to assess perceived participation, hip/knee-related symptoms and functional restrictions, depression symptoms, social support, and health empowerment.

Results

The mean score for perceived participation and autonomy was 22.554 (SD: 13.042). The mean scores for participation in indoor autonomy, outdoor autonomy, family roles, and social relations were 0.654 (SD: 0.608), 1.324 (SD: 0.792), 1.053 (SD: 0.657), and 0.664 (SD: 0.542), respectively. Negative correlations were observed between perceived participation/autonomy scores and HOOS/KOOS, social support, and health empowerment scores. Conversely, a positive correlation was found between perceived participation/autonomy scores and depression scores. The detrimental effect of HOOS/KOOS, social support, and health empowerment scores on perceived participation and autonomy was notable, while the impact of depressive symptoms was comparatively minor.

Conclusion

Older Chinese patients, at first six months post THA/TKA surgery, reported higher levels of perceived participation compared to individuals with other conditions, such as stroke patients. Functional limitations resulting from hip/knee-related symptoms, as well as social support and health empowerment, emerged as significant influencing factors for perceived participation and autonomy. This research enhances our comprehension of the elements influencing perceived participation among older adults individuals who have undergone THA/TKA procedures.

Social participation and acceptance of disability in young and middle-aged breast cancer patients after surgery: A 6-month follow-up study

Objective

To describe the social participation and acceptance of disability (AOD) in young and middle-aged patients with breast cancer after surgery and their dynamic trajectories and to explore the critical factors associated with social participation.

Methods

212 young and middle-aged patients with breast cancer after surgery were recruited for a 6-month follow-up study, and 158 of whom completed four surveys. Participants were asked to complete questionnaires including a general information questionnaire, Social Dysfunction Screening Scale, and Adaptation of Disability Scale Revised at baseline, and at 1, 3, and 6 months. T-test and chi-square test were used to analyze the difference in baseline data. Linear generalized estimating equations were used to analyze the dynamic trend and influencing factors. The Cochran-Armitage trend test was used to analyze the trend of the incidence of social function defects.

Results

The status of social participation in patients after breast cancer surgery was poor, and 77.9%, 59.3%, 45.9%, and 29.1% had social function defects, respectively. The AOD was at a moderate level. Both social participation and AOD showed a trend of dynamic improvement. Age (P ​= ​0.044), residence (P ​= ​0.007), surgery type (P ​= ​0.043), postoperative chemotherapy (P ​= ​0.003), and AOD (P < 0.001) were the key factors associated with social participation.

Conclusions

Medical staff should focus on elderly patients, who lived outside the provincial capital city, received total mastectomy, or modified radical mastectomy and postoperative chemotherapy. AOD might be an important potential avenue for improving the social participation level of young and middle-aged patients with breast cancer after surgery.

Wound Pain as a Determinant of Function in Patients Hospitalised for Burns

Burn wounds most often occur on visible parts of the body. They therefore cause fear of disfigurement and rejection by those around them. In addition, they cause pain. The main aim of this study was to analyse factors affecting the functioning of patients hospitalised for burns. The study included 57 patients hospitalised for burns. Each person was surveyed twice: on day seven after admission and on the day of discharge from the hospital. The following research tools were used: a personal questionnaire to collect clinical data and the scales of the Katz Activities of Daily Living (ADL), the short-form McGill Pain Questionnaire (SF-MPQ), the Beck Depression Inventory (BDI) and the Satisfaction with Appearance Scale (SWAP). On the discharge day, compared to day 7, there was an improvement in the patient's level of functioning in all areas analysed. Pain intensity (p < 0.0001), depression (p < 0.0001) and dissatisfaction with appearance (p = 0.0239) decreased significantly. Improvements in daily functioning were also obtained (p < 0.0001). Multiple regression was performed to estimate the effect of selected variables on patients' level of functioning. Burn area (p = 0.0126), pain level (questionnaire part B: p = 0.0004 and questionnaire part C: p = 0.0208) and gender (p = 0.0413) had a significant impact on the level of daily functioning. Pain complaints are the most crucial predictor affecting the functional status and depression levels in burn wound patients. Increased levels of depression promote dissatisfaction with one's appearance.

Perceived participation and autonomy structural relationships among related factors in patients with stroke and hypertension in China: A ISM model approach

Aims

To explore the structural relationship between perceived participation and autonomy among older adults with stroke and hypertension in home and community-based services (HCBSs) in the eastern coastal region of China.

Design

An explorative cross-sectional study.

Methods

From July to September 2021, a total of 714 respondents were reported to have stroke and hypertension, and their information was used in the analysis of this study. A multiple linear regression analysis was used to explore the factors influencing factors older adults' perceived participation and autonomy. Using the ISM model, we analyzed the factors affecting social participation in patients with stroke and hypertension and explained the logical relationships and hierarchy among the factors.

Results

The mean score of perceived participation was 58.34 ± 27.57. Age, marital status, health insurance, living status, number of children, chronic diseases, sleep time, frequency of outings, and health utility value were significant factors affecting perceived participation and autonomy with stroke and hypertension patients. Among them, health insurance is the direct factor on the surface, age, number of children, chronic diseases, sleep time, frequency of outings, and health utility value are the intermediate indirect factors, and marital status and living status are the deep-rooted factors.

Conclusion

By the study that the hierarchical structure provides a visualization of interrelationships and interdependences among the influencing factors of perceived participation and autonomy. It also may be a significant complement to traditional variable-entered approaches and construct an optimized multidimensional perspective of participation and autonomy. Future research should focus on optimizing the living environment of older adults with stroke and hypertension to explore the model of rehabilitative intervention and help patients successfully reintegrate into their families/societies.

Associations among resilience, hope, social support, stress, and anxiety severity in Chinese women with abnormal cervical cancer screening results

This study was to explore the resilience level and its potential correlates and further to evaluate the influence of these resilience-centred variables on anxiety severity among Chinese women with abnormal cervical cancer screening results. One hundred and seventy-five subjects completed self-administered questionnaires to collect relevant variables. The level of resilience of our sample is moderate (70.57 ± 12.14). The data identified hope (β = 0.218), social support (β = 0.247) and perceived stress (β = -0.320) as independent associates for resilience. Finally, among variables, only perceived stress is found to have a direct and positive influence on anxiety severity. Interventions on these variables can be effective for resilience promotion in this population. In addition, anxiety should be preferentially intervened in through the alleviation of perceived stress.

Analysis of the resilience level and associated factors among patients with lumbar disc herniation

This study aims to determine the resilience level and its influence on anxiety among Chinese lumbar disc herniation (LDH) patients, and to determine the critical psychological and non-psychological predictors of resilience among LDH patients. Twenty hundred and fifty LDH patients from a tertiary hospital in Jinzhou, China were included in this survey to answer the Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10). The mean resilience level of LDH patients was 61.96 ± 12.37. Resilience was negatively correlated with anxiety (χ² = 32.603, p < 0.001), accompanied by a significant linear trend (χ² = 28.567, p < 0.001). Hope, stress, social support, and medical payment type accounted for 48.7% resilience variance. This study reveals that Chinese LDH patients had low resilience level, and that lower level of resilience was closely associated with higher anxiety level. The predictors for resilience among LDH patients include hope, stress, social support, as well as medical payment types. These findings provide local government and related health-care professionals with a basis for development of targeted mental health management of Chinese LDH patients, and will also help to devise appropriate health intervention strategies for promoting the mental health status of LDH patients.

Acceptance of disability predicts quality of life in patients with epilepsy

BACKGROUND

Acceptance of disability (AOD) is a key concept in rehabilitation psychology that enhances psychosocial adjustment of individuals with disability. However, the impact of AOD on well-being has never been examined for patients with epilepsy. The present study investigated whether AOD affects quality of life (QOL) in patients with epilepsy in the presence of other multiple aspects of epilepsy based on the biopsychosocial model.

METHODS

We retrospectively reviewed 151 consecutive patients with epilepsy (77 men, aged 18-74 years) who underwent comprehensive assessment including long-term video-EEG monitoring, neuroimaging studies, and neuropsychological and psychosocial assessment in our epilepsy monitoring unit. Data were obtained from medical records and self-reported questionnaires. The outcome variable was QOL. Predictive variables included demographic characteristics, seizure-related variables (i.e., duration of epilepsy, seizure frequency, and number of antiepileptic drugs), psychological factors (i.e., AOD, depression, and self-stigma), and social factors (i.e., social support and education level). Acceptance of disability was measured by the Adaptation of Disability Scale-Revised (ADS-R), which we translated into Japanese with the original author's approval, and examined its internal consistency reliability. Data were analyzed using four hierarchical multiple regression analysis models.

RESULTS

The mean ADS-R score was 80 (range 45-115). The predictors accounted for 42% of the variance in QOL (R² = 0.45, ΔR² = 0.42, F[8, 141] = 14.47, p = 0.00). Higher AOD (p < 0.01), higher social support (p < 0.01), and lower depression scores (p = 0.02) were found to contribute significantly to higher overall QOL.

CONCLUSION

The present study revealed AOD as an important psychological concept, in addition to social support and depression as previously reported, to improve the QOL of patients with epilepsy. Acceptance of disability should be incorporated in the intervention to increase QOL of patients with epilepsy.

Perceived participation and autonomy post-stroke and associated factors: An explorative cross-sectional study

AIMS

To explore the level and associated factors of perceived participation and autonomy among stroke survivors in Shanghai, China.

DESIGN

Cross-sectional explorative study.

METHODS

From January to December 2018, 431 patients presenting at the neurology departments of three hospitals with a confirmed diagnosis of stroke were recruited. Impact on Participation and Autonomy Questionnaire, modified Rankin Scale, Self-efficacy for Managing Chronic Disease six-item Scale, Medical Coping Modes Questionnaire and Multidimensional Scale of Perceived Social Support were applied to measure their participation, physical function, self-efficacy, coping styles, and social support.

RESULTS

The average score of perceived participation and autonomy was 41.30 (SD 21.22); and 54.3%, 46.9%, 21.6%, and 7.7% of the participants reported poor participation in social relations, family role, autonomy indoors, and autonomy outdoors. Age, physical function, self-efficacy, friend support, and knowledge of stroke were predictors of post-stroke participation. Physical function and self-efficacy were the most relevant factors of nearly all domains of participation except autonomy outdoors, while predictors of autonomy outdoors were social support, resignation coping style, and knowledge of stroke.

CONCLUSION

The stroke patients experienced insufficient participation compared with previous studies in western countries. Patients' physical function and self-efficacy were particularly important and contributed to their participation, while the patient's age, perceived social support, coping styles, and knowledge of stroke also played a role in formulating participation.

IMPACT

The results may be used to provide nurses with a better understanding of the participation among stroke patients and assist them in promoting the post-stroke participation. Nurses should pay special attention to those with older age, worse physical function, lower self-efficacy, less support, little stroke-related knowledge, or who applied resignation coping style since those patients might experience lower participation in their daily life. It needs further studies to explore the causal effects of self-efficacy, coping styles, and social support on post-stroke participation.