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Shang B, Chen R, Luo C, Lv F, Wu J, Shao X, Li Q. The relationship between alexithymia, depression, anxiety, and stress in elderly with multiple chronic conditions in China: a network analysis. Front Psychiatry 2023; 14:1209936. [PMID: 37529068 PMCID: PMC10389667 DOI: 10.3389/fpsyt.2023.1209936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Objective This study aimed to construct a network structure to investigate the connections between alexithymia, depression, anxiety, and stress in Chinese older adults with multiple chronic conditions (MCC), identifying core and bridge symptoms, and comparing the network structure across different levels of alexithymia. Methods This study used a cross-sectional survey design and convenience sampling to recruit participants from six cities in Jiangsu Province. The study assessed the levels of alexithymia, depression, anxiety, and stress in older adults with MCC using the Toronto Alexithymia Scale (TAS-20) and the Depression Anxiety and Stress Scale-21 (DASS-21). Network analysis was performed using R language to identify core and bridge symptoms in the network and compare the network structure across different levels of alexithymia. Results A total of 662 participants were included in the analysis, including 395 men and 267 women. The mean age was 70.37 ± 6.92 years. The finding revealed that the "Difficulty Identifying Feelings" (DIF) node had the highest strength centrality (strength = 2.49) and predictability (rp = 0.76) in the network. The next highest strength centrality was observed for "Meaningless" (strength = 1.50), "Agitated" (strength = 1.47), "Scared" (strength = 1.42), and "No look forward" (strength = 0.75). They were identified as core symptoms. The bridge strength analysis identified "Panic," "Scared," "No wind down," "No initiative," and "No positive" as the bridge symptoms. There were notable differences in the overall network structure and specific connections between the groups with and without alexithymia (p < 0.05). Conclusion "DIF" is a core node in the network of older adults with MCC, indicating its significance as a potential target for psychological interventions in clinical practice. Preventing and mitigating bridge symptoms such as "panic," "Scared," "No wind down," "No initiative," and "No positive" can effectively impede the spread of symptom activation, thereby interrupting or severing the connections among comorbidities in older adults. Additionally, compared to non-alexithymia individuals, the psychological issues of older adults with alexithymia require prioritized intervention from healthcare professionals.
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Affiliation(s)
- Bin Shang
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Ruirui Chen
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Caifeng Luo
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Fei Lv
- Department of Nursing, Jingjiang College, Jiangsu University, Zhenjiang, China
| | - Jing Wu
- University Hospital, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Xiao Shao
- Endoscopy Center, Suqian First People’s Hospital, Suqian, China
| | - Qian Li
- Department of Neurology, Suzhou Xiangcheng People’s Hospital, Suzhou, China
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Bernstein MT, Reynolds KA, Jakobson LS, Stoesz BM, Alcolado GM, Furer P. Examining Anxiety Treatment Information Needs: Web-Based Survey Study. JMIR Form Res 2022; 6:e31338. [PMID: 35551056 PMCID: PMC9136655 DOI: 10.2196/31338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 02/21/2022] [Accepted: 03/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Several treatments for anxiety are available, which can make treatment decisions difficult. Resources are often produced with limited knowledge of what information is of interest to consumers. This is a problem because there is limited understanding of what people want to know when considering help for anxiety. OBJECTIVE This study aimed to examine the information needs and preferences concerning treatment options for anxiety by assessing the following: what information people consider to be important when they are considering treatment options for anxiety, what information people have received on psychological and medication treatment in the past, how they received this information in the past, and whether there are any differences in information needs between specific samples and demographic groups. METHODS Using a web-based survey, we recruited participants from a peer-support association website (n=288) and clinic samples (psychology, n=113; psychiatry, n=64). RESULTS Participants in all samples wanted information on a broad range of topics pertaining to anxiety treatment. However, they reported that they did not receive the desired amount of information. Participants in the clinic samples rated the importance of information topics higher than did those in the self-help sample. When considering the anxiety treatment information received in the past, most respondents indicated receiving information from informational websites, family doctors, and mental health practitioners. In terms of what respondents want to learn about, high ratings of importance were given to topics concerning treatment effectiveness, how it works, advantages and disadvantages, what happens when it stops, and common side effects. CONCLUSIONS It is challenging for individuals to obtain anxiety-related information on the range of topics they desire through currently available information sources. It is also difficult to provide comprehensive information during typical clinical visits. Providing evidence-based information on the web and in a brochure format may help consumers make informed choices and support the advice provided by health professionals.
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Affiliation(s)
| | | | - Lorna S Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Brenda M Stoesz
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.,Centre for the Advancement of Teaching and Learning, University of Manitoba, Winnipeg, MB, Canada
| | - Gillian M Alcolado
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Patricia Furer
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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Bernstein MT, Reynolds KA, Jakobson LS, Petty SK, Pryor TAM, Stoesz BM, Alcolado GM, Furer P. Do anxiety websites have the answers people are looking for? PATIENT EDUCATION AND COUNSELING 2022; 105:933-941. [PMID: 34404559 DOI: 10.1016/j.pec.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 07/09/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED OBJECTIVES AND METHODS: A wealth of online anxiety information exists but much of it is not evidence-based or well-balanced. This study evaluated anxiety websites (N = 20) on readability, quality, usability, visual design, and content. RESULTS Overall, websites were of reasonable quality but only half were considered understandable according to the PEMAT usability scale (70% cutoff value). The average reading level across websites was 11.2 (SMOG), which is higher than NIH recommended grade 6-7 level. Websites had variable design features and a trending association suggested websites with better design come up earlier in search results. The number of topics covered varied across websites and most did not adequately cover all topics of interest. Most websites included information about psychological and self-help treatments, how treatment works, and what treatment entails. The Top 5 websites were: (1) Anxiety BC, (2) ADAA, (3) Mind, (4) Beyond Blue, and (5) Web MD. CONCLUSIONS This is the first study to evaluate existing anxiety information websites based on the dimensions described above and their relationship to Google search results. PRACTICE IMPLICATIONS This study highlights the importance of considering several dimensions in developing mental health resources and provides direction for strategies to improve existing websites and/or develop new resources.
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Affiliation(s)
| | | | - Lorna S Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Sarah K Petty
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Teaghan A M Pryor
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Brenda M Stoesz
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada; Centre for the Advancement of Teaching and Learning, University of Manitoba, Winnipeg, MB, Canada
| | - Gillian M Alcolado
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Patricia Furer
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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Bernstein MT, Garber J, Faucher P, Reynolds KA, Restall G, Walker JR, Singh H. New Patient Education Video on Colonoscopy Preparation: Development and Evaluation Study. JMIR Hum Factors 2020; 7:e15353. [PMID: 33084594 PMCID: PMC7641787 DOI: 10.2196/15353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/20/2020] [Accepted: 09/11/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although several patient education materials on colonoscopy preparation exist, few studies have evaluated or compared them; hence, there is no professional consensus on recommended content or media to use. OBJECTIVE This study aims to address this need by developing and evaluating a new video on colonoscopy preparation. METHODS We developed a new video explaining split-dose bowel preparation for colonoscopy. Of similar content videos on the internet (n=20), the most favorably reviewed video among patient and physician advisers was used as the comparator for the study. A total of 232 individuals attending gastroenterology or urology clinics reviewed the new and comparator videos. The order of administration of the new and comparator videos was randomly counterbalanced to assess the impact of presentation order. Respondents rated each video on the following dimensions: information amount, clarity, trustworthiness, understandability, new or familiar information, reassurance, information learned, understanding from the patient's point of view, appeal, and the likelihood of recommending the video to others. RESULTS Overall, 71.6% (166/232) of the participants preferred the new video, 25.0% (58/232) preferred the comparator video, and 3.4% (8/232) were not sure. Furthermore, 64.0% (71/111) of those who viewed the new video first preferred it, whereas 77.7% (94/121) of the participants who viewed the new video second preferred it. Multivariable logistic regression analysis also demonstrated that participants were more likely to prefer the new video if they had viewed it second. Participants who preferred the new video rated it as clearer and more trustworthy than those who preferred the comparator video. CONCLUSIONS This study developed and assessed the strengths of a newly developed colonoscopy educational video.
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Affiliation(s)
| | - Jesse Garber
- IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada
| | - Patrick Faucher
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | | | - Gayle Restall
- Department of Occupational Therapy, University of Manitoba, Winnipeg, MB, Canada
| | - John R Walker
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Harminder Singh
- IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada
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Marrie RA, Walker JR, Graff LA, Patten SB, Bolton JM, Marriott JJ, Fisk JD, Hitchon C, Peschken C, Bernstein CN. Gender differences in information needs and preferences regarding depression among individuals with multiple sclerosis, inflammatory bowel disease and rheumatoid arthritis. PATIENT EDUCATION AND COUNSELING 2019; 102:1722-1729. [PMID: 30982700 DOI: 10.1016/j.pec.2019.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/07/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE We assessed the information needs of persons with any of three immune-mediated inflammatory diseases (multiple sclerosis [MS], inflammatory bowel disease [IBD] and rheumatoid arthritis [RA]) regarding depression, as a first step toward developing patient-relevant information resources, ultimately to facilitate self-management and appropriate care. We also compared information needs across genders. METHODS We surveyed participants with MS, IBD and RA regarding depression-related information needs including types of treatments, effectiveness, risks, benefits, and perceived helpfulness of treatments. We compared responses between groups using multivariate regression. RESULTS 328 participants provided complete responses (MS: 141, IBD: 114, RA: 73). Most of the topics queried were perceived as very important, and similarly important for all groups. Women placed higher importance than men on most topics. The most popular formats for receiving information were discussion with a counselor (very preferred: 67.4%) and written information (very preferred: 65.5%); this did not differ between groups. CONCLUSIONS Persons affected by MS, IBD and RA are interested in receiving information about multiple topics related to depression treatment, from multiple sources. Women desire more information than men. PRACTICE IMPLICATIONS These findings can be used to design information resources to meet information needs regarding depression in MS, IBD and RA.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - John R Walker
- Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lesley A Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott B Patten
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James M Bolton
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - James J Marriott
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - John D Fisk
- Nova Scotia Health Authority, Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada
| | - Carol Hitchon
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Christine Peschken
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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