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Yetim Şahin A, Kandemir I, Dağ H, Türkkan E, Tuğrul Aksakal M, Sahin M, Baş F, Karakaş Z. Assessing Psychological Disorders in Turkish Adolescents with Transfusion-Dependent Thalassemia. CHILDREN (BASEL, SWITZERLAND) 2024; 11:837. [PMID: 39062286 PMCID: PMC11275219 DOI: 10.3390/children11070837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024]
Abstract
We investigated depression and anxiety levels and related psychological disorders in adolescents with transfusion-dependent thalassemia (TDT) in this study. The study was conducted in two pediatric hematology outpatient clinics and included adolescents with TDT (14.8 ± 2.4 years, n = 40) in the study and compared them with the healthy age-matched control group (14.3 ± 2.3 years, n = 62). The Turkish version of the Revised Child Anxiety and Depression Scale (RCADS) was used to determine depression, anxiety, and related psychologic disorders (obsession, panic disorder, social phobia). Depression, anxiety, obsession, panic disorder, and social phobia scores were significantly higher in the patient group compared with the control (all p < 0.05). Ferritin levels were positively correlated with total depression, general anxiety, separation anxiety, and social phobia scores, but transfusion frequency and young age were the confounding factors. Patients in early adolescence and those who require more frequent blood transfusions are at higher risk of developing psychological disorders; routine screening for mood disorders should be warranted. Serum ferritin level may be a good warning indicator for early recognition of psychologic disorders in TDT patients.
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Affiliation(s)
- Aylin Yetim Şahin
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, Turkey; (A.Y.Ş.); (M.T.A.); (F.B.)
| | - Ibrahim Kandemir
- Department of Pediatrics, Faculty of Medicine, Biruni University, 34452 Istanbul, Turkey
| | - Hüseyin Dağ
- Department of Pediatrics, University of Health Sciences, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, 34452 Istanbul, Turkey;
| | - Emine Türkkan
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, 34452 Istanbul, Turkey;
| | - Melike Tuğrul Aksakal
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, Turkey; (A.Y.Ş.); (M.T.A.); (F.B.)
| | - Memduh Sahin
- Department of Internal Medicine, University of Health Sciences, Istanbul Basaksehir Cam and Sakura Hospital, 34452 Istanbul, Turkey;
| | - Firdevs Baş
- Department of Pediatrics, Division of Adolescent Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, Turkey; (A.Y.Ş.); (M.T.A.); (F.B.)
| | - Zeynep Karakaş
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Istanbul University, 34452 Istanbul, Turkey;
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Bizri M, Koleilat R, Akiki N, Dergham R, Mihailescu AM, Bou-Fakhredin R, Musallam KM, Taher AT. Quality of life, mood disorders, and cognitive impairment in adults with β-thalassemia. Blood Rev 2024; 65:101181. [PMID: 38341336 DOI: 10.1016/j.blre.2024.101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
Advances in understanding the disease process in β-thalassemia supported development of various treatment strategies that resulted in improved survival. Improved survival, however, allowed multiple morbidities to manifest and cemented the need for frequent, lifelong treatment. This has directly impacted patients' health-related quality of life and opened the door for various psychiatric and cognitive disorders to potentially develop. In this review, we summarize available evidence on quality of life, depression and anxiety, suicidality, and cognitive impairment in adult patients with β-thalassemia while sharing our personal insights from experience in treating patients with both transfusion-dependent and non-transfusion-dependent forms.
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Affiliation(s)
- Maya Bizri
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rawan Koleilat
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nathalie Akiki
- Department of Haematology, King's College Hospital, London, United Kingdom
| | - Reem Dergham
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Rayan Bou-Fakhredin
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Khaled M Musallam
- Center for Research on Rare Blood Disorders (CR-RBD), Burjeel Medical City, Abu Dhabi, United Arab Emirates
| | - Ali T Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Fianza PI, Rahmawati A, Wijaya I, Oehadian A, Prasetya D, Vidyaniati P, Harti GF, Fadjari TH, Panigoro R. Gender Disparities in Psychological Disturbances and Quality of Life Among Adolescent and Adult Patients with Thalassemia: A Review. J Multidiscip Healthc 2024; 17:1663-1669. [PMID: 38646018 PMCID: PMC11032664 DOI: 10.2147/jmdh.s444592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 04/23/2024] Open
Abstract
Thalassemia is a chronic disease caused by impaired globin chain synthesis, leading to ineffective erythropoiesis, hemolysis, and chronic anemia. The treatment of patients with thalassemia, including blood transfusion combined with chelation therapy has progressed and improved their survival and prognosis. However, thalassemia-related psychological problems and impaired health-related quality of life (QoL) challenges still exist. Gender is one of the factors that has been suggested, to contribute to the disparities in psychological outcomes. This review article examined the evidence for gender differences in psychological disturbances and QoL in adolescent and adult patients with thalassemia. A non-systematic search of the literature was conducted in PubMed and Google Scholar for English full-text available from 2013 to 2023. We identified 23 studies with a sample size ≥ 100 that examined gender disparities in anxiety, depression, and QoL in adolescent and adult patients with thalassemia (mean prevalence of female = 53.1%; mean age = 28 years). Our review shows that there are gender disparities in psychological distress and QoL in adolescent and adult patients with thalassemia. Statistically significant gender differences were demonstrated in 62% of the psychological and QoL outcomes from 16 studies. Female patients had a higher prevalence of anxiety, depression, and poorer QoL in some studies. However, further studies with sufficient power and design are necessary to confirm the existence of gender disparities in psychological disturbances and QoL outcomes.
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Affiliation(s)
- Pandji Irani Fianza
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Anita Rahmawati
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Indra Wijaya
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Amaylia Oehadian
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Dimmy Prasetya
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Putri Vidyaniati
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Gusti Fungani Harti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Trinugroho Heri Fadjari
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Ramdan Panigoro
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Farzan R, Ghorbani Vajargah P, Mollaei A, Karkhah S, Samidoust P, Takasi P, Falakdami A, Firooz M, Hosseini SJ, Parvizi A, Haddadi S. A systematic review of social support and related factors among burns patients. Int Wound J 2023; 20:3349-3361. [PMID: 36960557 PMCID: PMC10502254 DOI: 10.1111/iwj.14166] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
Burn injuries, as a major public health problem, can lead to high morbidity and mortality. Burns is considered as one of the most devastating injuries globally and the fourth most common injury after traffic accidents, falls and interpersonal violence. Burn injuries can affect human life, such as physical and mental health, functional skills, and performance. Changes in appearance, social isolation, stress, anxiety, depression, low self-esteem, unemployment, financial burden and family problems can occur in these patients. These burn complications can be exacerbated without adequate social support. This systematic review evaluated burn patients' social support and related factors. A systematic search was performed on the international electronic databases such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Burns', 'Social support', 'Perceived social support' and 'Social care' from the earliest to 30 April 2022. The quality of the included studies in this review was assessed using the appraisal tool for cross-sectional studies (AXIS tool). A total of 1677 burn patients were included in this review from 12 studies. Mean score of social support in burn patients based on multidimensional scale of perceived social support, Phillips's social support questionnaire, social support questionnaire, social support scale and Norbeck social support questionnaire were 5.04 (SD = 1.59) of 7, 22.06 (SD = 3.05), 78.20 (SD = 15.00) of 95, 82.24 (SD = 13.70) and 4.14 (SD = 0.99), respectively. Factors such as income, educational attainment, burn surface area, reconstructive surgery, quality of life, self-esteem, socialisation, posttraumatic growth, spirituality, and ego resilience had a significant positive relationship with social support of burns patients. Social support in patients with burn had a significant negative relationship with factors such as psychological distress, having children, life satisfaction, neuroticism and post-traumatic stress disorder. Overall, patients with burns had moderate levels of social support. Therefore, it is recommended that health policymakers and managers make it easier for burn patients to adapt to burns by providing psychological intervention programs and the social support needed by burn patients.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic and Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Pirouz Samidoust
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Atefeh Falakdami
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | - Arman Parvizi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
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Muacevic A, Adler JR. Concomitant Pre- and Post-splenectomy Physiotherapy Rehabilitation in a 17-Year-Old Patient With Beta Thalassemia Major: A Case Report. Cureus 2022; 14:e29999. [PMID: 36381798 PMCID: PMC9637436 DOI: 10.7759/cureus.29999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/06/2022] [Indexed: 01/25/2023] Open
Abstract
Thalassemia is a group of disorders having hematological origin. It is hereditary in nature, characterized by a defect in the synthesis of alpha or beta chains of hemoglobin leading to alpha or beta thalassemia, respectively. Based on the severity, beta thalassemia can be minor, intermittent, or major. Patients with thalassemia major require frequent blood transfusions, which come with various complications, of which hepatosplenomegaly is the most common. A 17-year-old male patient had a chief complaint of stomach ache and fever for the last five days. He was on a monthly blood transfusion. USG impression revealed hepatosplenomegaly and cholelithiasis. Splenectomy along with cholecystectomy was done as a part of surgical management after which a comprehensive pre- and postoperative physiotherapeutic rehabilitation program has been inculcated incorporating various respiratory techniques, strength training, and home exercise program, hence helping the patient to return to his routine daily activities efficiently. The Numeric Pain Rating Scale, Fatigue Severity Scale, and Beck Anxiety Inventory were used as outcome measures over four weeks to demonstrate the efficacy of the treatment. In this case study, a well-planned comprehensive physiotherapy rehabilitation protocol has proven helpful in improving quality of life, maximizing functional capacity, and reducing anxiety and depression in the patient.
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Zhang C, Xiao S, Lin H, Shi L, Zheng X, Xue Y, Dong F, Zhang J, Xue B. The association between sleep quality and psychological distress among older Chinese adults: a moderated mediation model. BMC Geriatr 2022; 22:35. [PMID: 35012479 PMCID: PMC8744230 DOI: 10.1186/s12877-021-02711-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/10/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Previous research has found a link between sleep quality and psychological distress. However, the underlying mechanisms of this connection have still not been well explored. The aim of this study was to examine the roles of activities of daily living (ADL), physical activity, and perceived social support in the link between sleep quality and psychological distress among older adults. METHODS Three thousand two hundred fifty valid individuals (aged 60 years or above) participated in face-to-face questionnaire-based surveys. Older individuals were assessed using the Pittsburgh Sleep Quality Index, Barthel Index, International Physical Activity Questionnaire, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. The PROCESS macro developed by Hayes was used to conduct moderated mediation analysis. RESULTS In older adults, sleep quality had a substantial direct influence on psychological distress. ADL mediated the association between sleep quality and psychological distress. Physical activity significantly reduced ADL's mediating influence on the relationship between sleep quality and psychological distress. Furthermore, perceived social support moderated the direct relationship between sleep quality and psychological distress, as well as the second half of the mediating effect of the ADL. Moreover, physical activity and perceived social support were preventive factors that might successfully mitigate the detrimental effects of poor sleep quality on ADL and psychological distress. CONCLUSIONS The findings contribute to existing understanding by clarifying the fundamental mechanisms that link sleep quality and psychological distress. These results may provide a valuable reference to the Chinese government for improving mental health in older individuals.
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Affiliation(s)
- Chichen Zhang
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China. .,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Huang Lin
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China.,Shool of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Fang Dong
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, No.1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, China
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Depression symptoms and associated factors among thalassemia patients in the Palestinian Territories: a cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-021-00166-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Background
Thalassemia is a condition that causes the human body to destroy red blood cells faster than they can be made. It causes physical symptomology as well as psychological distress. The current study aimed to identify the prevalence of depression symptoms among individuals with moderate to severe thalassemia. A quantitative descriptive cross-sectional design was applied utilizing the Beck Depression Inventory to assess the level of depression in the sample.
Results
Some significant relationships were demonstrated in the sample: males reporting severe depression symptoms than females by 6.0 times (95% CI 0.07–0.62, p 0.014), and reporting moderate depression symptoms (95% CI 0.00–0.47, p 0.05). Additionally, income was found to be a predictor of level of depression symptoms with low income reported higher incidence of severe depression symptoms than those whose monthly income was > 400$ by 18.4 times (95% CI 0.38–1.03, p ≤ 0.001), but not reporting a significant association between moderate depressive symptoms and monthly income (95% CI − 012–1.47, P 0.225). A significant association was found between the educational attainment and level of depression symptoms with lower levels of education predicting higher levels of severe depression symptoms (95% CI 0.069–0.89, p 0.022), but no significant association was reported between moderate depression symptoms and educational attainment (95% CI − 0.49–0.01, p 0.81).
Related to disease characteristics a relationship was confirmed between severe depressive symptoms and medication level such as the individual needing tablets or pumps (95% CI 0.189–1.05, p 0.005 and 95% CI 0.52–1.44, p 0.001) respectively. Other disease related variables showed no significant correlation with depressive symptom levels.
Additional significant relationships were found in environment whereas increased moderate depressive symptoms were experienced by individuals residing in rural areas as opposed to those living in IDP camps or cities by 4 times (95% CI − 0.30–0.01, p 0.04), but no significant association was found between severe depression and the place of residence. The other independent variables had no significant correlation with severe or moderate depressive symptoms.
Conclusion
In light of these findings addressing symptoms of depression directly and supporting patients with thalassemia with basic life needs unrelated to their disease maybe mitigating depressive symptoms which may negatively affect recovery.
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Eziefula C, Shah FT, Anie KA. Promoting Adherence to Iron Chelation Treatment in Beta-Thalassemia Patients. Patient Prefer Adherence 2022; 16:1423-1437. [PMID: 35698633 PMCID: PMC9188463 DOI: 10.2147/ppa.s269352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/29/2022] [Indexed: 01/19/2023] Open
Abstract
Thalassaemia is one of the commonest inherited genetic disorders world-wide with around 25,000 births of the most severely affected transfusion dependent children annually. Patients with transfusion dependent thalassaemia require regular blood transfusions to maintain life but because of this will develop iron overload. To remove the excess iron, patients are required to take iron chelation therapy (ICT). ICT requires lifelong adherence to treatment to prevent end organ damage from developing. Many of these preventable complications make adherence to therapy more complex for patients. In this review, we focus on two commonly encountered patient scenarios and discuss how different psychological models and a relational theory can be used to understand and support adherence to treatment.
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Affiliation(s)
- Chinea Eziefula
- Camden & Islington NHS Foundation Trust, London, UK
- Psychology Services, Whittington Health NHS Trust, London, UK
| | - Farrukh T Shah
- Department of Haematology, Whittington Health NHS Trust, London, UK
- Medical Director for Transfusion, NHSBT, London, UK
- Correspondence: Farrukh T Shah, Department of Haematology, Whittington Health, Magdala Avenue, London, N19 5NF, Tel +44 0207 288 5144, Email
| | - Kofi A Anie
- London North West University Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
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Zafar M. Common mental disorders and its associated factors among thalassemic patients. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_44_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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10
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Jaafari Z, Sadidi N, Abdolahinia Z, Shahesmaeili A. Prevalence of Depression among Iranian Patients with Beta-Thalassemia Major: A Systematic Review and Meta-analysis. IRANIAN JOURNAL OF MEDICAL SCIENCES 2022; 47:15-24. [PMID: 35017773 PMCID: PMC8743376 DOI: 10.30476/ijms.2020.85941.1557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Patients with beta-thalassemia (BT) are susceptible to psychological disorders such as depression. The present study was conducted to estimate the pooled prevalence of depression among patients with BT in Iran. METHODS Domestic and international databases were searched for relevant articles published from 1991 until June 2019. We searched international databases such as Scopus, ISI, and Embase; Iranian databases such as SID, Magiran, and IranDoc; and Google Scholar and PubMed search engines. The MeSH keywords used were "depression", "mental health", "depressive disorder", "thalassemia", "beta-thalassemia major", "prevalence", "epidemiology", and "Iran". Relevant cross-sectional or cohort studies were included in the analysis. Cochran's Q test and the I2 index were used to assess heterogeneity. The pooled prevalence and its 95% confidence interval (CI) were calculated using "metaprop" commands in Stata 14. In cases, where the I2 statistic was greater than 50%, the random-effects model was used. RESULTS Eighteen eligible studies were included. The pooled prevalence of depression was 42% (95% CI: 33% to 52%), whereas the pooled prevalence of mild, moderate, severe, and extremely severe depression was 16% (95% CI: 11% to 22%), 13% (95% CI: 9% to 18%), 13% (95% CI: 9% to 17%), and 3% (95% CI: 0% to 8%), respectively. The pooled prevalence of depression in moderate- and high-quality studies was 45% (95% CI: 29% to 61%), and 39% (95% CI: 27% to 51%), respectively. CONCLUSION The high prevalence of depression highlights the urgent need for the establishment of interventions for the prevention, early detection, and treatment of depression among Iranian patients with BT.
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Affiliation(s)
- Zahra Jaafari
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Nasrin Sadidi
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Abdolahinia
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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11
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The survey on the relationship between frustration and social relationships among patients with Thalassemia major in Tehran, Iran. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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12
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Rikos N, Giannadaki GK, Spontidaki A, Tzagkaraki M, Linardakis M. Health status, anxiety, depression, and quality of life of patients with thalassemia. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01241-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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13
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Etemad K, Mohseni P, Aghighi M, Bahadorimonfared A, Hantooshzadeh R, Taherpour N, Piri N, Sotoodeh Ghorbani S, Malek F, Kheiry F, Khodami A, Valadbeigi T, Hajipour M. Quality of Life and Related Factors in β-Thalassemia Patients. Hemoglobin 2021; 45:245-249. [PMID: 34409903 DOI: 10.1080/03630269.2021.1965617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The β-thalassemias are a group of genetic disorders defined by decreased levels of functional hemoglobin (Hb). In light of pivotal improvements in patient survival, the load of consistent treatment harms patients' quality of life (QOL). This study aimed to determine the QOL in patients with β-thalassemia (β-thal) in Iran and identify associated factors. This cross-sectional study was conducted among 1240 patients with β-thal. Data for this study were obtained from the General, the TranQol (Transfusion-dependent QoL) Standard, and the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires. The univariate and multivariable linear regression was used in STATA version 14 to identify factors related to QOL. Overall, the QOL score was 103 ± 21.96, and adults had a higher score than children under 15 years old. Emotional health had the highest score (39.96 ± 11.54), and sexual activity in adults (1.87 ± 2.08) and activities related to education in children (10.43 ± 7.46) had the lowest. The multivariable linear regression analysis showed that the age, gender, age of blood transfusion initiation, Hb level, number of underlying diseases, and social support level by family and community significantly impact QOL. In exchange for an increase in comorbidities, patients' QOL decreased by 86.0% [odds ratio (OR) = 0.14, 95% confidence interval (95% CI): 0.04-0.45]. Many factors affecting the QOL can be controlled, so social support, increased Hb levels, regular and timely blood transfusions, and treatment can improve the thalassemia patients' QOL.
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Affiliation(s)
- Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Mohseni
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Aghighi
- Management Center for Transplantation and Special Diseases, Ministry of Health, Tehran, Iran
| | - Ayad Bahadorimonfared
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Hantooshzadeh
- Thrombosis and Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloufar Taherpour
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negar Piri
- Health Network of Dehgolan, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sahar Sotoodeh Ghorbani
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Malek
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Childern's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Kheiry
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azimeh Khodami
- Health Education and Health Promotion, Public Health Department, School of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Tannaz Valadbeigi
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Hajipour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Phang YC, Kassim AM, Mangantig E. Concerns of Thalassemia Patients, Carriers, and their Caregivers in Malaysia: Text Mining Information Shared on Social Media. Healthc Inform Res 2021; 27:200-213. [PMID: 34384202 PMCID: PMC8369049 DOI: 10.4258/hir.2021.27.3.200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/05/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The main aim of this study was to use text mining on social media to analyze information and gain insight into the health-related concerns of thalassemia patients, thalassemia carriers, and their caregivers. Methods Posts from two Facebook groups whose members consisted of thalassemia patients, thalassemia carriers, and caregivers in Malaysia were extracted using the Data Miner tool. In this study, a new framework known as Malay-English social media text pre-processing was proposed for performing the steps of pre-processing the noisy mixed language (Malay-English language) of social media posts. Topic modeling was used to identify hidden topics within posts shared among members. Three different topic models-latent Dirichlet allocation (LDA) in GenSim, LDA in MALLET, and latent semantic analysis-were applied to the dataset with and without stemming using Python. RESULTS LDA in MALLET without stemming was found to be the best topic model for this dataset. Eight topics were identified within the posts shared by members. Of those eight topics, four were newly discovered by this study, and four others corresponded to the findings of previous studies that used an interview approach. Conclusions Topic 2 (the challenges faced by thalassemia patients) was found to be the topic with the highest attention and engagement. Healthcare practitioners and other concerned parties should make an effort to build a stronger support system related to this issue for those affected by thalassemia.
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Affiliation(s)
- Yuen Chi Phang
- School of Computer Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Ernest Mangantig
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
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15
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Al-Hakeim HK, Najm AH, Moustafa SR, Maes M. Construction of an exposure-pathway-phenotype in children with depression due to transfusion-dependent thalassemia: Results of (un)supervised machine learning. J Affect Disord 2021; 282:644-655. [PMID: 33445087 DOI: 10.1016/j.jad.2020.12.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/05/2020] [Accepted: 12/22/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Transfusion dependent thalassemia (TDT) patients are treated with continued blood transfusions and show a higher prevalence of depression. TDT with consequent iron overload and inflammation is associated with increased severity of depressive symptoms in TDT children. AIM OF THE STUDY To construct a pathway-phenotype which combines iron overload and neuro-immune biomarkers with depressive symptom subdomains in TDT children. METHODS We measured iron status parameters (iron, ferritin, transferrin saturation percentage) and inflammatory (interleukin-1β and tumour necrosis factor-α) biomarkers in TDT (n=111) and healthy (n=53) children and analyzed the results using machine learning. RESULTS Cluster analysis separated TDT children with depression from those without depression and revealed two depressive subgroups one with low self-esteem and another with increased social-irritability scores. Exploratory factor analysis validated four depressive symptom dimensions as reliable constructs, namely key depressive, physiosomatic, lowered self-esteem and social-irritability dimensions. Partial Least Squares showed that 73.0% of the variance in a latent vector extracted from those four clinical subdomains, immune-inflammatory and iron overload biomarkers was explained by exposure variables including the number of blood transfusions and hospitalizations and use of deferoxamine. The exposure data, iron and immune biomarkers, and symptom subdomains are reflective manifestations of a single latent trait, which shows internal consistency reliability and predictive relevance. CONCLUSIONS The nomological network combining exposure, pathways and behavioral phenome manifestations provides an index of overall severity and disease risk and, therefore, constitutes a new drug target, indicating that iron overload and immune activation should be targeted to treat depression due to TDT.
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Affiliation(s)
| | | | - Shatha Rouf Moustafa
- Clinical Analysis Department, College of Pharmacy, Hawler Medical University, Havalan City, Erbil, Iraq.
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; IMPACT Strategic Research Centre, Deakin University, PO Box 281, Geelong, VIC, 3220, Australia.
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16
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Eren R, Karışmaz A, Aslan C, Doğu MH, Altındal Ş, Yokuş O, Suyanı E. Beta Thalassemia Minor: Patients Are Not Tired but Depressed and Anxious. Med Princ Pract 2021; 30:69-72. [PMID: 32460294 PMCID: PMC7923903 DOI: 10.1159/000508981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/27/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We aimed to investigate whether the severity of fatigue and the incidences of depression and anxiety of patients with beta thalassemia minor (BTm) are different from healthy individuals using the Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS). SUBJECTS AND METHODS BTm patients who were followed at the University of Health Sciences Istanbul Training and Research Hospital Hematology Clinic between 2016 and 2017 and who had normal biochemical parameters, thyroid function tests and C-reactive protein levels, and did not use any medications, consume alcohol or tobacco, have any chronic diseases or sleep disturbances were included in the study. Healthy control subjects who were matched with age, sex, marital status, educational status, and body mass index (BMI) were also included for comparison. RESULTS Thirty-nine BTm patients and 25 healthy controls were included in the study. The BTm and the control groups were comparable in terms of gender, age, BMI, educational status and marital status (p = 0.368, 0.755, 0.851, 0.785, and 0.709, respectively). FSS score was ≥4 in 23 (59.0%) BTm subjects and in 15 (60%) control subjects (p = 1.0). HADS anxiety score was ≥10 in 20 (51.3%) BTm subjects and in 5 (20.0%) control subjects (p = 0.018), and HADS depression score was ≥7 in 20 (51.3%) BTm subjects and in 6 (24.0%) healthy control subjects (p = 0.039).There was no correlation of hemoglobin with FSS score (p = 0.526, r = -0.105), HADS anxiety score (p = 0.703, r = -0.063), or HADS depression score (p = 0.718, r = -0.06) in the BTm group. CONCLUSION We found that both depression and anxiety were higher in BTm patients than in healthy individuals, but this difference was not feasible for fatigue.
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Affiliation(s)
- Rafet Eren
- Department of Hematology, University of Health Sciences, Okmeydanı Training and Research Hospital, Istanbul, Turkey,
| | - Abdülkadir Karışmaz
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ceyda Aslan
- Department of Hematology, University of Health Sciences, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Mehmet Hilmi Doğu
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Şermin Altındal
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Osman Yokuş
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Elif Suyanı
- Department of Hematology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
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17
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Zolaly MA, Zolaly FM, Al Belowi L, Shuqdar R, Al Belowi MA, Alwasaidi TA, Albadrani M. Depression, Anxiety, and Stress Symptoms in Patients With Beta Thalassemia Major in Almadinah Almunawwarah, Saudi Arabia. Cureus 2020; 12:e11367. [PMID: 33304700 PMCID: PMC7721071 DOI: 10.7759/cureus.11367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introduction Beta thalassemia major (BTM) is a chronic hereditary blood disorder. Patients are dependent on blood transfusion and are prone to multiple comorbidities. Depression, anxiety, and stress (DAS) can complicate their condition. No reports from Saudi Arabia to measure DAS in BTM patients. We report the prevalence of DAS symptoms in our BTM patients using the DASS-21 (Depression, Anxiety, and Stress Scale - 21 Items) test. Methods A cross-sectional study including adolescents and adults aged 14 years and above with BTM treated in Almadinah Almunawwarah and excluding patients who had bone marrow transplant or with central nervous system insults were performed. Results A total of 31 male and 31 female patients were enrolled, with a mean age of 24.32 ± 7.05 years. Depression symptoms were detected in 60 % of patients, anxiety symptoms were detected in half of the studied group, and stress symptoms were detected in 38.7% of patients. We found a significant positive correlation between DAS and DASS total score. Age below or above 18, parent’s employment, patient’s educational level, and status of satisfaction about medical care were statistically significant in having positive effects on scores of DAS symptoms. Conclusions BTM patients are prone to develop psychological disorders, which can affect the course of the disease. Our results are comparable to international and Arab population studies, which have the highest reported prevalence. It is important to not ignore the psychological evaluation of patients with BTM and to refer them for proper evaluation and management.
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18
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Ahmadi M, Gheibizadeh M, Rassouli M, Ebadi A, Asadizaker M, Jahanifar M. Experience of Uncertainty in Patients with Thalassemia Major: A Qualitative Study. Int J Hematol Oncol Stem Cell Res 2020; 14:237-247. [PMID: 33603985 PMCID: PMC7876423 DOI: 10.18502/ijhoscr.v14i4.4479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major. Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software. Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'. Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.
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Affiliation(s)
- Mehrnaz Ahmadi
- Department of Nursing, Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Marziyeh Asadizaker
- Nursing Care Research Center in Chronic Diseases, Jundishapur University of Medical Sciences, Ahvaz, Iran
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Yüksel A, Bahadir-Yilmaz E. The effect of sociodemographic factors on anxiety, depression, and perceived social support in patients with internal medicine and surgical problems. Perspect Psychiatr Care 2020; 56:837-843. [PMID: 32176328 DOI: 10.1111/ppc.12499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to determine the effect of sociodemographic factors on anxiety, depression, and perceived social support in patients with internal medicine and surgical problems. DESIGN AND METHODS The study comprised 522 patients who were hospitalized at the internal medicine and surgical clinics of the training and research hospital of a university. FINDINGS Of all the patients, 27% were at the risk of anxiety and 51.7% at the risk of depression. Sociodemographic characteristics, health-related issues, and disease characteristics, besides hospitalization-related matters, affected anxiety, depression, and social support levels of patients. PRACTICE IMPLICATIONS It was determined that more than half of the patients were at the risk of depression. Perceived social support is essential to reduce the risk of anxiety and depression.
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Affiliation(s)
- Arzu Yüksel
- Faculty of Health Sciences, Department of Psychiatric Nursing, Aksaray University, Aksaray, Turkey
| | - Emel Bahadir-Yilmaz
- Faculty of Health Sciences, Department of Psychiatric Nursing, Giresun University, Giresun, Turkey
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20
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Pasyar N, Rambod M, Behrouzi Z. The Predictor Role of Perceived Social Support and Spiritual Intelligence in Hope Among Thalassemia Patients. Malays J Med Sci 2020; 27:75-83. [PMID: 32684808 PMCID: PMC7337945 DOI: 10.21315/mjms2020.27.3.8] [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: 09/06/2019] [Accepted: 05/12/2020] [Indexed: 11/12/2022] Open
Abstract
Background Thalassemia is a prevalent chronic blood disorder, which is accompanied with a wide range of challenges. This study aimed to determine the predictor role of perceived social support and spiritual intelligence in hope among thalassemia patients. Methods This cross-sectional study was conducted on 300 thalassemia patients. The data were collected using Miller hope scale, spiritual intelligence scale, and personal resource questionnaire. The data were analysed using Pearson’s correlation coefficient and multiple regression analysis. Results The results indicated that the mean score of hope was 173.38 (standard deviation [SD] = 24.6). Besides, 86.7% of the patients showed high levels of hope. The mean score of spiritual intelligence was 134.66 (SD = 18.07). In addition, 91.7% of the patients showed moderate levels of spiritual intelligence. The mean score of social support was 127.87 (SD = 20.19) and the patients showed high social support levels. The results revealed a significant association between hope and perceived social support (r = 0.65, P < 0.001) as well as between hope and spiritual intelligence (r = 0.63, P < 0.001). Moreover, perceived social support (b = 0.43, P < 0.001) and spiritual intelligence (b = 0.37, P < 0.001) were the predictors of hope among thalassemia patients. Conclusion Considering the study results, in addition to common treatments for thalassemia, policymakers’ are recommended to pay attention to spiritual intelligence and more importantly social support to enhance thalassemia patients’ hope.
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Affiliation(s)
- Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Behrouzi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Zhang H, Tang L, Ye Z, Zou P, Shao J, Wu M, Zhang Q, Qiao G, Mu S. The role of social support and emotional exhaustion in the association between work-family conflict and anxiety symptoms among female medical staff: a moderated mediation model. BMC Psychiatry 2020; 20:266. [PMID: 32471440 PMCID: PMC7260826 DOI: 10.1186/s12888-020-02673-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Limited work has been done to explain how work-family conflict is related to anxiety symptoms and the roles of emotional exhaustion and social support may play. METHODS Based on a sample of 764 female nurses and physicians, a model was tested in which emotional exhaustion served as a mediator and social support was regarded as a moderator between work-family conflict and anxiety symptoms. RESULTS This current study supported a moderated mediation model where the relationship between work-family conflict and anxiety symptoms via emotional exhaustion was weakest for female medical staff who reported high levels of social support. CONCLUSIONS This study contribute to providing an understanding of how and when work-family conflict affects anxiety symptoms. The results implicate a wide range of interventions aimed at promoting mental wellbeing among female medical staff for policymakers and individuals.
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Affiliation(s)
- Hui Zhang
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Leiwen Tang
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - ZhiHong Ye
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016, Zhejiang, China.
| | - Ping Zou
- grid.260989.c0000 0000 8588 8547School of Nursing, Nipissing University, Toronto, Ontario Canada
| | - Jing Shao
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Man Wu
- grid.459540.90000 0004 1791 4503Department of cardiology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou China
| | - Qi Zhang
- grid.13402.340000 0004 1759 700XZhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016 Zhejiang China
| | - Guojin Qiao
- grid.452244.1The affiliated hospital of Guizhou Medical University, Guiyang, Guizhou China
| | - Shaoyu Mu
- grid.203458.80000 0000 8653 0555Nursing College of Chongqing Medical University, Chongqing, China
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22
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Tartaglione I, Manara R, Caiazza M, Carafa PA, Caserta V, Ferrantino T, Granato I, Ippolito N, Maietta C, Oliveto T, Casale M, Di Concilio R, Ciancio A, De Michele E, Russo C, Elefante A, Ponticorvo S, Russo AG, Femina G, Canna A, Ermani M, Cirillo M, Esposito F, Centanni A, Gritti P, Perrotta S. Brain functional impairment in beta-thalassaemia: the cognitive profile in Italian neurologically asymptomatic adult patients in comparison to the reported literature. Br J Haematol 2019; 186:592-607. [PMID: 31106405 DOI: 10.1111/bjh.15959] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/19/2019] [Indexed: 01/19/2023]
Abstract
Cognitive involvement in beta-thalassaemia is strikingly controversial and poorly studied in adulthood. This multicentre prospective study investigated 74 adult neurologically-asymptomatic beta-thalassaemia patients (mean-age 34·5 ± 10·3 years; 53 transfusion-dependent [TDT], 21 non-transfusion dependent [NTDT]) and 45 healthy volunteers (mean-age 33·9 ± 10·7 years). Participants underwent testing with Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), Brief Psychiatric Rating Scale (BPRS) and multiparametric brain 3T-magnetic resonance imaging (MRI) for parenchymal, vascular and iron content evaluation. Patients had lower Full-Scale Intelligence Quotient (FSIQ) than controls (75·5 ± 17·9 vs. 97·4 ± 18·1, P < 0·0001) even after correction for education level. Compared to TDT, NTDT showed a trend of higher FSIQ (P = 0·08) but a similar cognitive profile at WAIS-subtests. FSIQ correlated with total and indirect bilirubin (P < 0·0001 and P = 0·002, respectively); no correlation was found with splenectomy, intracranial MRI/magnetic resonance-angiography findings, brain tissue iron content or other disease-related clinical/laboratory/treatment data. FSIQ did not correlate with BPRS scores, although the latter were higher among patients (28·74 ± 3·1 vs. 27·29 ± 4·8, P = 0·01) mainly because of increased depression and anxiety levels. Occupation rate was higher among controls (84·4% vs. 64·9%, P = 0·004) and correlated with higher FSIQ (P = 0·001) and education level (P = 0·001). In conclusion, Italian adult beta-thalassaemia patients seem to present a characteristic cognitive profile impairment and an increased rate of psychological disorders with possible profound long-term socio-economic consequences.
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Affiliation(s)
- Immacolata Tartaglione
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Renzo Manara
- Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
| | - Martina Caiazza
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | | | - Violetta Caserta
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Teresa Ferrantino
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Ilaria Granato
- Ambulatorio di Psicologia, Ospedale "Umberto I", Nocera Inferiore, Italy
| | - Noemi Ippolito
- Ambulatorio di Psicologia, Ospedale "Umberto I", Nocera Inferiore, Italy
| | - Caterina Maietta
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Tiziana Oliveto
- Ambulatorio di Psicologia, Ospedale "Umberto I", Nocera Inferiore, Italy
| | - Maddalena Casale
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | | | - Angela Ciancio
- Unità Operativa Ematologia - Day Hospital di Talassemia, Ospedale "Madonna delle Grazie", Matera, Italy
| | - Elisa De Michele
- Medicina Trasfusionale AUO "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Camilla Russo
- Neuroradiologia, Università degli Studi di Napoli "Federico II", Napoli, Italy
| | - Andrea Elefante
- Neuroradiologia, Università degli Studi di Napoli "Federico II", Napoli, Italy
| | - Sara Ponticorvo
- Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
| | - Andrea Gerardo Russo
- Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
| | - Gianluca Femina
- Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
| | - Antonietta Canna
- Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
| | - Mario Ermani
- Dipartimento di Neuroscienze (DNS), Unità di Statistica e di Informatica, Scuola di Medicina, Università di Padova, Padova, Italy
| | - Mario Cirillo
- Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Università della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Fabrizio Esposito
- Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
| | - Antonella Centanni
- Ambulatorio di Psicologia, Ospedale "Umberto I", Nocera Inferiore, Italy
| | - Paolo Gritti
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Silverio Perrotta
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania "Luigi Vanvitelli", Napoli, Italy
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Mohamadian F, Bagheri M, Hashemi MS, Komeili Sani H. The Effects of Cognitive Behavioral Therapy on Depression and Anxiety among Patients with Thalassemia: a Randomized Controlled Trial. J Caring Sci 2018; 7:219-224. [PMID: 30607363 PMCID: PMC6311627 DOI: 10.15171/jcs.2018.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 06/17/2018] [Indexed: 01/19/2023] Open
Abstract
Introduction: Thalassemia is a chronic hereditary anemia
which can be associated with different psychological, emotional, and behavioral problems
such as depression and anxiety. This study aimed to evaluate the effects of cognitive
behavioral therapy on depression and anxiety of patients with thalassemia. Methods: This was a randomized controlled trial study. A
total of 76 patients were randomly allocated to an experimental (n=38) and a control group
(n=38). Patients in the experimental group were provided with cognitive behavioral therapy
while their counterparts in the control group received routine care services. Depression
and anxiety assessments were performed four weeks before the intervention as well as four
and six weeks after that. Between-group and within-group comparisons were performed
through the independent-sample t-tests and the paired sample t-test, respectively Results: The post-test mean score of anxiety in the
experimental group was significantly lower than that for the control group, while there
was no significant difference between the groups regarding the post-test mean score of
depression. The mean score of depression in both study groups decreased significantly. The
rate of decrease in the experimental group was significantly greater than that in the
control group. Conclusion: Cognitive behavioral therapy can be used to
prevent or alleviate depression and anxiety among patients.
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Affiliation(s)
- Fateme Mohamadian
- Department of Psychological Nursing, School of Nursing and Midwifery, Abadan University of Medical Sciences, Abadan, Iran
| | - Maryam Bagheri
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Sadat Hashemi
- Department of Critical Care, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Komeili Sani
- Department of Psychological Nursing, School of Nursing and Midwifery, Education development center, Ahvaz, Jundishapour University of Medical Sciences, Ahvaz, Iran
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24
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The burden of psychiatric illnesses in adult patients with beta-thalassemia: a 5-year nationwide inpatient evaluation in the United States. Ann Hematol 2018; 98:851-860. [PMID: 30488326 DOI: 10.1007/s00277-018-3557-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
Beta-thalassemia (ß-thalassemia) is a frequently inherited monogenic disorder worldwide with severe physical and mental health comorbidities. The aim of this study is to evaluate the burden of psychiatric disorders in adult patients hospitalized with ß-thalassemia in the United States (US). We utilized the discharge data from the National Inpatient Sample (NIS) from 2010 through 2014 to identify hospitalized ß-thalassemia patients who are 18 years and older. We assessed categorical and continuous variables using chi-square test and Student's t test respectively. The burden of psychiatric disorders was assessed using descriptive statistics and represented in terms of frequency (n) and percentage (%). A p value threshold of < 0.05 was considered clinically significant. All statistical analyses were performed using SPSS version 22.0 (IBM Corp., Armonk, NY, USA). Of the 10,046 ß-thalassemia patients studied, 24.4% (n = 2448) reported psychiatric disorders. Mood disorders (15.2%; inclusive of 10.3% depression), followed by anxiety (9.4%), and substance abuse disorder (6.5%; 4.3% drug abuse, 2.2% alcohol abuse) were most prevalent. Comorbid mental illnesses increased the length of stay by 44.6% and total costs by 23.4%. All-cause mortality rate was reported at 1.9% in overall ß-thalassemia patients. This study highlights higher rates of psychiatric disorders such as depression and anxiety and correlated increases in length of stay and cost in hospitalized ß-thalassemia patients. To improve medical outcomes and curtail unnecessary health-care costs, implementation of an integrated care model can be considered.
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