Search

Abstract Background This study aimed to investigate quality of life (QoL) in middle-aged adults living alone and identify comprehensive biological, psychological, interpersonal, and contextual factors related to QoL using the dynamic biopsychosocial model. As a secondary analysis, this study used data from the 2017 Korea Community Health Survey conducted by the Korea Disease Control and Prevention Agency. Methods Among the total 228,381 respondents, 10,639 middle-aged individuals aged 40–64 years from single-person households (5,036 men and 5,603 women) were included in the analysis. QoL was measured using the EuroQoL-5 Dimension (EQ-5D). The EQ-5D descriptive statistics were provided according to biological, psychological, interpersonal, and contextual factors. Considering the data structure of the multistage stratified cluster sampling method, a complex samples general linear model statistic was used to identify the predictors of QoL. Results QoL was lower in those who had undesirable psychological status (e.g., more depressive symptoms, poor subjective health, and higher perceived stress), less engagement in social networking (less frequent contact with friends and less frequent participation in social activities such as religious activities, friendship gathering, and leisure), and lower physical, behavioral, and socioeconomic factors. Conclusions This study’s findings indicate that psychological and interpersonal factors should be addressed and prioritized to improve the QoL of middle-aged adults living alone. By providing many opportunities for easily accessible social activities that meet the needs and interests of this demographic, their QoL can be improved through strengthening social support.

Background: Intimate partner violence is a serious global social problem. While intimate partner violence is highly prevalent, few studies have examined its negative outcomes among victims in South Korea. The aim was to clarify the mediating roles of interpersonal dependency and anger on the relationship between intimate partner violence victimization and suicidal ideation. Methods: In this descriptive, cross-sectional study, 301 participants (203 women and 98 men) aged 18–65 yr completed an online questionnaire on a social networking site. Data were collected between Feb and Mar 2017 in South Korea. Structural equation modeling was used to test the fitness of the conceptual model of this study. Results: We found significant correlations between intimate partner violence victimization, interpersonal dependency, state-trait anger, and suicidal ideation. Intimate partner violence victimization influenced anger and suicidal ideation only when the victims had high interpersonal dependency. Conclusion: It is necessary to develop programs for reducing interpersonal dependency and improving anger management that are specifically targeted at intimate partner violence victims to prevent suicidal ideation.

Abstract Background We conducted a systematic review and meta-analysis of randomized controlled trials examining the effect of psychosocial interventions on the quality of life of patients with colorectal cancer. Methods We searched the main health-related databases for relevant papers. Then, we examined the titles and abstracts of the retrieved papers, applying exclusion criteria to filter out irrelevant papers; a more in-depth filtering process was then conducted by reading the full texts. Eight studies remained at the end of this process. Next, we performed data extraction and assessed the methodological quality of the selected studies. This was followed by computation of effect sizes and the heterogeneity of the results, and then an assessment of the potential bias. Results The systematic review found that most of the interventions in these eight studies did not have a significant effect on quality of life. Meanwhile, the meta-analysis, the overall effect of psychosocial interventions at the post-intervention period was found to be statistically significant but small. Conclusions This meta-analysis provides evidence for the beneficial effect of face-to-face psychosocial interventions on the quality of life of colorectal cancer patients. It is, however, suggested that further studies be conducted on this topic to assess the roles of physical functioning and severity of symptoms before utilizing such face-to-face interventions.

Purpose: To identify parsimonious models for changes in depression in spouses of post myocardial infarction (MI) patients over 2 years based on the biopsychosocial model. Methods: A total of 442 community living patients who had experienced an MI and their spouses were included for analysis. Patients and spouses completed psychosocial assessments at baseline, 1 year, and 2 years after enrollment in the Patients' and Families' Psychological Response to Home Automated External Defibrillator Trial. Linear mixed models were used for testing hypotheses. Results: A total of 15.2% (baseline), 11.5% (1-year follow up), and 8.1% (2-year follow up) of spouses were depressed. Spouse biological factors did not influence changes in depression. Among all spouses, two groups of spouses showed increased depression over time: spouses with lower baseline depression scores (p

Objective: In this study, we evaluated the effectiveness of an environmental health training program for child care providers. Methods: We conducted a retrospective analysis to evaluate a 5-state training program using a 20-question pretest and posttest. We also examined the effects of state regulation on knowledge scores. Analyses included descriptive statistics, dependent samples t-tests, and linear mixed models. Results: Posttest scores significantly improved following the training program (overall pretest = 13.78 of 20, posttest = 17.92 of 20, p < .001). Pretest scores were not associated with the degree of regulatory oversight. Conclusions: The training program improved the knowledge of environmental exposures and pretest knowledge was not associated with state policy. More research is needed to determine if knowledge persists, is shared, and decreases children's exposures. [ABSTRACT FROM AUTHOR]

The rate of and factors influencing colorectal cancer screening differs by gender. We aimed to determine the behaviors for and predict the factors influencing self-reported colorectal cancer screening in Korean adults. Secondary analysis was performed with data from the crosssectional 2012 Community Health Survey. We examined the relationship between gender and self-reported screening using data for 115 045 adults aged ≥50 years; 62.4% of men and 65.5% of women underwent colorectal cancer screening. In the multivariate logistic regression analysis, men with private insurance and who attended regular health checkups were more likely to undergo screening; men who were employed, ate salty food, were older, or smoked were less likely. Women with private insurance, who lived with a spouse, were more educated, were housewives, or attended regular health checkups were more likely, and older women were less likely to undergo screening. Therefore, gender-specific interventions are needed to encourage colorectal cancer screening. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is a progressive and lifelong condition with multiple medical comorbidities. Patients with CKD experience frailty more frequently and have lower health-related quality of life than do those with other chronic diseases. The purpose of this study was to examine the prevalence of frailty and investigate the contribution of frailty to quality of life in pre-dialysis CKD patients in Korea. Methods: Using a cross-sectional survey design, data were collected at an outpatient CKD clinic in a general hospital in Korea. The frailty criterion was modified from previous studies. The Short Form-36 Health Survey version 2 was used to measure physical and mental component summary scores. Data were analyzed using chi-square, t-tests, and hierarchical linear regression. Results: Of the 168 CKD patients, 63 (37.5 %) were frail. Frail patients were significantly older and had lower physical and mental quality of life than those who were non-frail. In hierarchical regression evaluating the influence of frailty on physical and mental quality of life, the initial model was significantly improved when frailty was included. Frail patients had lower physical and mental quality of life. Conclusions: Frailty affected both physical and mental quality of life in pre-dialysis patients with CKD. More attention should be paid to the potential role of early detection and prevention of frailty to improve patients' quality of life. [ABSTRACT FROM AUTHOR]

Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. The purpose of this article is to illustrate the similarities of the underlying pathophysiology of heart failure, depression, and anxiety by using the Biopsychosocial Holistic Model of Cardiovascular Health. Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) is a major health problem in the United States, affecting 5.7 million American adults. Psychosocial distress, in particular depression, contributes to morbidity and mortality in patients with HF. Little is known about the interrelationship among disease severity, social support, and depression. Objective: The aim of this study was to examine the contributions of social support and disease severity to longitudinal changes in depression and anxiety of outpatients with HF. Methods: Patients (N = 108) enrolled in the Psychosocial Factors Outcome Study completed the Beck Depression Inventory-II, the State Trait Anxiety Inventory, and the Social Support Questionnaire-6 at study entry and every 6 months for up to 2 years. Results: At baseline, 30% of the patients were depressed and 42% were anxious. Social support amount contributed to changes in depression (P = .044) but not anxiety (P = .856). Depression increased over time for patients who had lower initial social support amount. Depression did not increase for those with higher initial social support amount. Neither New York Heart Association class nor treatment group (placebo or implantable cardioverter defibrillator) interacted with time to predict depression, which indicates that changes in depression were parallel for patients with New York Heart Association class II and class III HF and for those who received implantable cardioverter defibrillators and those who did not. Assessment of patients with HF should include depression and social support. Interventions to enhance social support among patients with HF who have low social support may help alleviate the development of depression. Conclusions: Reducing psychological distress and increasing social support may improve health outcomes among HF outpatients. It is important for studies of HF to include assessment of depression, anxiety, and social support and evaluate their contributions to health outcomes. [ABSTRACT FROM AUTHOR]

As the population ages the number of older adults living with hypertension (HTN) is rising dramatically. Uncontrolled HTN increases cardiovascular and renal mortality. Ambulatory (A) blood pressure (BP) is a better predictor of HTN-related morbidity and mortality than office BP. Lower BP is the most important therapeutic goal in treating HTN. Any reduction in BP has significant benefits for older adults. The current study was designed to evaluate the impact of the presence of pet dogs and cats on ABP during the daily lives of independently living, older pet owners with pre- to mild HTN. A repeated measures observational study of ABP of 32 pet owners (21 dogs, 8 cats, 3 cat and dog; 29 women) aged 50-83 years with BP 120-150/80-100 mmHg or < 150/100 with anti-hypertensive medication was conducted. Owner's ABPs were recorded every 20 minutes for one day during waking hours at study entry, one month, and three months. Activity monitors and diaries were used to obtain information about activity, mood, and whether the pet and/or another person was present in the room (indoors) or in close proximity (outdoors) with the owner at each assessment. Generalized estimating equation (GEE) analyses for hierarchical data (unstructured correlations) were performed for systolic and diastolic ABP. Mean ABPs were significantly (systolic BP/diastolic BP: dog p = 0.008/p = 0.002; cat p < 0.009/p < 0.001 ) different (systolic BP/diastolic BP mmHg: dog 3.1/1.5; cat -3.0/2.2) when pets were present after controlling for participant's mood (p > 0.05/p < 0.001), activity intensity (p = 0.026/p = 0.441), location (p = 0.013/p = 0.004), and the presence of other people (p = 0.947/p = 0.723). The presence of a dog was associated with lower systolic and diastolic BP and of a cat was associated with lower diastolic BP and higher systolic BP during their owners' normal daily lives. This finding suggests that pets, especially dogs, may be effective as an adjunctive intervention to slow the development or progression of HTN in older adults. Comparison of ABPs of pet owners with non-owners during their daily lives is warranted and underway. [ABSTRACT FROM AUTHOR]

Objective To compare the long-term effects of cardiopulmonary resuscitation (CPR) training and CPR/ automatic external defibrillator (AED) training on anxiety and depression of patients who were medically stable after myocardial infarction (MI) and of their spouses/companions. Design Longitudinal. Participants Post-MI patients (N=460) and their spouses/companions from the Home Automatic External Defibrillator Trial. Main outcome measures Depression (Beck Depression Inventory-II scores) and anxiety (State Trait Anxiety Inventory scores). Results At study entry, 25% of the patients and 15% of their spouses were depressed and 21% of the patients and 19% of the spouses were anxious. The prevalence of depression and anxiety did not change over time in the patients or their spouses. Average depression and anxiety decreased for patients but not for spouses. An intervention group did not contribute significantly to these changes. Psychological distress, indicated by depression or anxiety of the spouse or the patient, occurred in 191 couples. Among psychologically distressed patients (N=128), depression and anxiety decreased over time; the intervention group did not contribute to these changes. The reduction in anxiety among male patients was greater than in female patients (p=0.012, 95% CI 0.002 to 0.018). Among psychologically distressed spouses (N=118), depression decreased over time independently of the intervention. Changes in spouse anxiety depended on the intervention group (p=0.012, 95% CI 0.001 to 0.012); anxiety decreased significantly in the CPR and remained high in the CPR/AED group. Conclusion There was no evidence that home AEDs caused psychological distress among patients. Even among those who were psychologically distressed when they were assigned to receive either CPR training or CPR/ AEDs, home AEDs did not influence changes in patients' depression or anxiety or spouses' depression in comparison with CPR training. Among psychologically distressed spouses, AEDs may keep anxiety higher than it would be otherwise. Interventions to reduce anxiety of spouses who are psychologically distressed may be indicated when their partners receive an AED. [ABSTRACT FROM AUTHOR]

Background: Delirium is associated with increased mortality, morbidity, hospital costs, and postdischarge cognitive dysfunction. Most research focuses on nontrauma patients receiving mechanical ventilation in the intensive care unit., Objectives: To determine the prevalence and predictors of delirium in trauma patients residing in intensive and intermediate care units of an academic medical center., Methods: Trauma patients were screened for delirium by using the Confusion Assessment Method for the Intensive Care Unit. Exclusion criteria included documented brain injury, history of psychosis or cognitive impairment, not speaking English, and hearing or vision loss., Results: Of the 215 study patients, 24% were positive for delirium; 36% of patients in the intensive care unit and 11% of patients in the intermediate care unit. Delirium-positive patients were older (mean age, 53.4 years) than patients who were not (mean age, 44 years; P = .004). Although mechanical ventilation (odds ratio, 4.73, P = .004) was the strongest independent risk factor for delirium, 12% of delirium-positive patients were not receiving mechanical ventilation. Other predictors of delirium were use of antipsychotic medications, higher scores on the Acute Physiology and Chronic Health Evaluation III, and lower scores on the Richmond Agitation-Sedation Scale., Conclusions: Patients in both the intermediate and intensive care units, whether mechanical ventilation was used or not, were positive for delirium. Delirium prevention protocols may benefit trauma patients regardless of their inpatient location., (©2017 American Association of Critical-Care Nurses.)