Relationships between depression, family function, physical symptoms, and illness uncertainty in female patients with chronic kidney disease

Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit

BACKGROUND

Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients.

METHODS

The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel's Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty.

RESULTS

According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients.

CONCLUSIONS

Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.

Gut microbiome and tissue metabolomics reveal the compatibility effects of Xiaoyaosan on depression based on "gut-liver-kidney" axis

BACKGROUND

Depression affects not only the central nervous system, but also the peripheral system. Xiaoyaosan (XYS), a classical traditional Chinese medicine (TCM) prescription, exhibits definite anti-depression effects demonstrated both clinically and experimentally. However, its compatibility has not been entirely revealed due partly to the complex compositions of herbs contained.

AIM

Based on the strategy of "Efficacy Group", this study aimed to reveal the compatibility of XYS from the perspective of "gut-liver-kidney" axis.

METHODS

Firstly, XYS was divided into two efficacy groups, i.e. Shugan (SG) and Jianpi (JP) groups. Classic behaviors of rats were measured to confirm the anti-depression effects of XYS and its two efficacy groups. On top of this, gut microbiota analysis and kidney metabolomics were performed by 16S rRNA sequencing and ¹H NMR, respectively.

RESULTS

We found that XYS and its efficacy groups significantly regulated the abnormalities of behaviors and kidney metabolism of depressed rats, as well as intestinal disorders, but to different degrees. The regulatory effects of XYS and its efficacy groups on behaviors and kidney metabolomics of depressed rats had the same order, i.e. XYS > SG > JP, while the order of regulating gut microbiota was XYS > JP > SG. Both XYS and its efficacy groups significantly ameliorated gut microbiota disturbed, especially significant modulation of Peptostreptococcaceae. XYS significantly regulated nine kidney metabolites, while SG and JP regulated four and five differential metabolites, respectively, indicating that the two efficacy groups synergistically exhibited anti-depression effects, consequently contributing to the overall anti-depression effects of XYS.

CONCLUSION

The current findings not only innovatively demonstrate the anti-depression effects and compatibility of XYS from the perspective of "gut-liver-kidney" axis, comprehensively using "Efficacy Group" strategy, macro behavioristics, metabolome and microbiome, and also provide a new perspective, strategy, and methodology for studying complex diseases and the compatibility of TCMs.

Correlations between uncertainty in illness and anxiety, depression and quality of life in patients receiving maintenance haemodialysis: A cross-sectional study

Aim

To investigate the uncertainty in illness, anxiety, depression and quality of life in patients receiving maintenance haemodialysis and confirm the correlations between these variables.

Design

A cross‐sectional study was conducted among 396 patients receiving maintenance haemodialysis in four tertiary hospitals in China.

Methods

Uncertainty in illness was measured by Mishel's uncertainty in illness scale. The scores of self‐rating anxiety scale, self‐rating depression scale and medical outcomes study short form 36 were collected and compared with available norms. The Pearson correlation coefficient was calculated to investigate the correlation between uncertainties in illness with these vital variables.

Results

The mean score of uncertainty in illness was 78.16 out of 160. Compared with the norm, patients receiving maintenance haemodialysis had a statistically significantly lower score of depression and higher scores of most domains of quality of life. Uncertainty in illness is corrected with anxiety, depression positively and with quality of life negatively.

Illness uncertainty among patients with COVID-19 in the Mobile Cabin Hospital

Aims

To investigate the status and influencing factors of illness uncertainty among patients with coronavirus disease 2019 (COVID‐19) in the mobile cabin hospital.

Design

A cross‐sectional study.

Methods

114 patients with COVID‐19 admitted to a mobile cabin hospital in Wuhan, Hubei Province, in February 2020 were enrolled by a convenience sampling method. The Chinese version of the Mishel Illness Uncertainty Scale (MUIS) was used to assess patients’ degree of illness uncertainty, and multiple regression analysis was used to explore the influencing factors.

Results

The average total score of MUIS (Chinese version) was 52.22 ± 12.51, indicating a moderate level of illness uncertainty. The dimension unpredictability turned out to have the highest mean score: 2.88 ± 0.90. The multiple stepwise regression analysis showed that female (t = 2.462, p = .015), monthly family income not less than RMB 10,000 (t = −2.095, p = .039), and disease duration of 28 days or more (t = 2.249, p = .027) were independent influencing factors of illness uncertainty.

Conclusion

Patients with COVID‐19 are at a moderate level of illness uncertainty. Medical staffs should pay more attention to female patients, patients with lower monthly family income, patients with the prolonged disease, and take targeted interventions to help them reduce illness uncertainty.

Impact

Facing the brand new and unknown infectious disease, patients confirmed of COVID‐19 suffer from immense physical and psychological stress, where illness uncertainty is a major stressor that troubles patients. The present study surveys illness uncertainty among patients with COVID‐19 in the mobile cabin hospital with results revealing a moderate level. Study results will benefit nurses in any setting where care for patients with COVID‐19 is provided, public policymakers and future researchers.