Uncertainty in illness and the coping styles of severe patients with COVID-19: Current status and correlation

Correlation Between Illness Uncertainty in Caregivers of Patients with Liver Cancer, Their Coping Styles, and Quality of Life

Objective

This study explores the correlation between coping style, quality of life, and illness uncertainty in the family caregivers of patients with liver cancer.

Methods

Employing convenience sampling, 210 family caregivers of patients with liver cancer who met the admission criteria were selected from a grade A infectious disease hospital in Beijing between January and December 2022. A cross-sectional survey was conducted using the Simplified Coping Style Questionnaire, Caregiver Quality of Life, and the Mishel Uncertainty in Illness Scale for Family Members. This study analysed the correlations between coping styles, quality of life, and illness uncertainty in these caregivers.

Results

The study found that family caregivers of patients with liver cancer had average scores for illness uncertainty (83.44 ± 11.86), coping style (33.19 ± 9.79; both positive [23.02 ± 6.81] and negative [10.17 ± 5.05]), and quality of life (169.53 ± 32.46). A negative association was observed between illness uncertainty in these caregivers and positive coping style (r = -0.207, p = 0.003), physical status (r = -0.182, p = 0.008), psychological status (r = -0.200, p = 0.004), and social adaptation (r = -0.229, p = 0.001).

Conclusion

The study concludes that illness uncertainty in family caregivers of patients with liver cancer is at a moderate level. Furthermore, there is a notable correlation between illness uncertainty, coping style, and quality of life in these caregivers.

Perceived Stress and Level of Uncertainty Among Hospitalized COVID-19 Patients

Introduction

Disease uncertainty refers to the inability to assign meaning to events related to the illness. Uncertainty of the disease can affect various aspects of human life such as psychological aspects.

Objectives

This study aims to examine the relationship between disease uncertainty and perceived stress in COVID-19 patients.

Methods

An analytical cross-sectional study was conducted on 212 hospitalized COVID-19 patients who were initially admitted to the intensive care units (ICUs) and later transferred to general wards within the same hospitals. Three instruments were utilized to collect data for this study. The Demographic Information Questionnaire, Mishel Uncertainty in Illness Scale (MUIS) for disease uncertainty, and Perceived Stress Questionnaire. For data analysis, both descriptive and inferential statistics were employed using IBM SPSS Statistics version 25.

Results

The Pearson correlation coefficient matrix results showed a positive and significant relationship between uncertainty about the illness (P < .001, r = 0.829), ambiguity (P < .001, r = 0.795), complexity (P < .001, r = 0.835), inconsistency or instability (P < .001, r = 0.787), and unpredictability (P < .001, r = 0.776) with perceived stress in COVID-19 patients transferred from the intensive care units.

Conclusion

Based on the findings of the current study, both uncertainty and perceived stress are elevated among COVID-19 patients, and a significant and direct relationship exists between these two variables. Healthcare providers, particularly nurses, should address the uncertainties surrounding emerging diseases, both at the hospital and community levels.

A Study on the Relationship between Sense of Disease Uncertainty and Family Strength and Mental Resilience in Guardians of Children with Inflammatory Bowel Disease

Background

Inflammatory bowel disease is difficult to cure, which seriously affects the physical and mental health of children and brings negative psychological stress to guardians. Uncertainty in illness of guardians reduces the ability of care and is not conducive to the treatment and recovery of children. Therefore, it is of great significance to explore the related factors of uncertainty in illness.

Objective

The aim of this study is to explore the relationship between sense of disease uncertainty and family strength and mental resilience in guardians of children with inflammatory bowel disease (IBD).

Method

A total of 146 guardians of 88 children with inflammatory bowel disease were investigated. The guardians' sense of disease uncertainty, family strength, and mental resilience were evaluated by Mishel uncertainty in illness scale-family member (MUIS-FM), family hardiness index (FHI), and Connor-Davidson resilience sca1e (CD-RISC), respectively. Spearman correlation was used for analyzing the correlation between the guardian's sense of disease uncertainty and family resilience.

Results

The guardian's MUIS-FM score from lowest to highest was complexity, unpredictability, lack of information, and uncertainty. The average scores of FHI and CD-RISC were lower than the average score of CD-RISC of the general community in China 65.4 (t = -4.36, P < 0.05). The score of MUIS-FM was significantly correlated with the scores of FHI and CD-RISC (P < 0.05). Multiple linear regression analysis showed that the challenge score in the FHI scale and the fortitude score and the strength score in the CD-RISC scale were the main influencing factors of guardians' sense of disease uncertainty in children with IBD (P < 0.05).

Conclusion

The guardians of children with IBD had a more serious sense of disease uncertainty, which was related to family strength and mental resilience.

Predictors of psychological resilience trajectories in patients with knee arthroplasty: A longitudinal study

AIMS

To identify the different classes of total knee arthroplasty patients according to the heterogenous trajectories of psychological resilience and investigate the predictors for different patterns of resilience.

DESIGN

A prospective cohort study.

METHODS

A total of 210 patients with total knee arthroplasty from March to December 2021 were included. Baseline assessment (T0) data were collected before surgery and included demographic, biological (clinical characteristics), psychological (psychological resilience, self-efficacy, psychological distress, hope, medical coping mode) and social (social support) factors. Resilience measurements were repeated at 3 days after surgery (T1), the date of discharge (T2), and 1 month (T3) and 3 months (T4) after discharge. Latent growth mixture modelling was employed to define different resilience trajectories. Predictors of class membership were identified using multinomial logistic regression.

RESULTS

Data from 198 patients were analysed. Three latent classes were identified with similar patterns in different intercepts, showing a significant decrease in resilience from admission (T0) to 3 days after surgery (T1) followed by an increase from T1 to T4. The three trajectories of psychological resilience were named the stable-resilience class (65.66%), high-resilience class (17.68%), and low-resilience class (16.66%). Multinomial logistic regression showed that compared with the stable-resilience class, the high-resilience class was predicted by having a higher level of hope, having higher education, living in urban areas and having more children, while the low-resilience class was predicted by having lower levels of self-efficacy and hope, living in semirural areas, and having more children.

CONCLUSIONS

The three trajectories indicated that surgery was the major stressor influencing patients' psychological resilience and that patients in the low-resilience class needed to be intervened.

IMPACT

Predictors of patients in different classes provide evidence for the identification of vulnerable populations and lay a foundation for future research contributing to the development of targeted interventions for improving patients' psychological resilience. No patient or public contribution but the time points of investigation were decided based on our interviews with 12 total knee arthroplasty patients.

Pathways from self-disclosure to medical coping strategy among adolescents with moderate and major depression during the COVID-19 pandemic: A mediation of self-efficacy

BACKGROUND

The prevalence of adolescent depression in China during the COVID-19 pandemic is increasing. Self-disclosing depressive emotions could help release stress. Self-disclosure, which is a prerequisite for self-efficacy, can directly contribute to people's psychological health, and depression and the choice of coping strategy are determined by the level of self-efficacy perceived.

PURPOSE

We aimed to discuss the relationship between self-efficacy, self-disclosure, and medical coping strategy. Further, we explore the mediation effect of self-efficacy on the influence of self-disclosure on medical coping strategies in adolescents with depression.

METHODS

A total of 585 patients aged 11-24 years with moderate and major depression were recruited. All the assessments were completed on the second day after admission, including the General Self-Efficacy Scale (GSE), Distress Disclosure Index (DDI), and Medical Coping Modes Questionnaire (MCMQ). Pearson correlation was performed to explore the relationships of these variables. The bootstrap analysis was used to conduct to assess the mediation effects.

RESULTS

Both direct and indirect effects of self-disclosure on medical coping strategy were found. As predicted, self-efficacy partially mediated the relationship between self-disclosure and medical coping strategy (b = 0.0385, 95% CI: 0.0244-0.0538 for Confrontation; b = -0.0466, 95%CI: -0.0651 to -0.0296 for Resignation), respectively. The effect size for Confrontation and Resignation was 0.2659 and 0.2485, respectively.

CONCLUSION

Self-efficacy played a partial mediating role in the effect of self-disclosure on medical coping strategies for adolescent depression during the COVID-19 pandemic, and the use of a positive self-disclosure mechanism may be anticipated to promote improved self-efficacy and the use of active coping strategies.