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Zhong Sheng Goh, Konstadina Griva Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore Abstract: Psychiatric disorders commonly co-exist with the diagnosis of chronic kidney disease (CKD). Research on depression and CKD has increased to a great extent. Multiple studies have demonstrated that depression is more prevalent in CKD and that end-stage renal disease is a robust risk factor for adverse outcomes such as hospitalization and mortality, yet these are often underdiagnosed or untreated. This review provides a selective overview on the prevalence rates of depression and anxiety in patients with CKD and across renal replacement therapies, the factors most consistently associated with symptoms of distress and their clinical implications. Finally, treatment and management strategies from relevant literature are appraised and discussed. Keywords: psychological, difficulties, symptoms, chronic kidney disease

Aim: Diabetes in young adulthood has been associated with poor outcomes. Self‐management is fundamental to good diabetes care, and self‐management interventions have been found to improve outcomes in older adults. We performed a systematic review and meta‐analysis to assess the effectiveness of self‐management interventions in young adults (aged 15–39 years) with type 1 or type 2 diabetes. Methods: We searched five databases and two clinical trial registries from 2003 to February 2019, without language restrictions. We included randomized controlled trials (RCTs) comparing the effectiveness of self‐management interventions with usual care or enhanced usual care in young adults. Outcomes of interest included clinical outcomes, psychological health, self‐care behaviours, diabetes knowledge and self‐efficacy. Pairwise meta‐analysis was conducted using a random effects model and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria. We followed Cochrane gold standard systematic review methodology and reported this systematic review according to PRISMA guidelines. The protocol was registered with PROSEPRO (CRD42018110868). Results: In total, 13 studies (1002 participants) were included. Meta‐analysis showed no difference between self‐management interventions and controls in post‐intervention HbA1c levels, BMI, depression, diabetes‐related distress, overall self‐care, diabetes knowledge and self‐efficacy. Quality of evidence ranged from very low to moderate due to study limitations, inconsistency and imprecision. Conclusions: Current self‐management interventions did not improve outcomes in young adults with diabetes. Our findings, which contrast with those from systematic reviews in older adults, highlight the need for the development of more effective interventions for young adults with diabetes. What's new?: Previous systematic reviews and meta‐analyses on self‐management interventions in type 1 and type 2 diabetes have been conducted in adults of a wide age range and have found improved glycaemic control.No systematic review and meta‐analysis has been conducted in young adults with diabetes.Our meta‐analysis found that existing self‐management interventions did not improve glycaemic control, self‐care behaviours, psychological well‐being, self‐efficacy or diabetes knowledge in young adults with type 1 or type 2 diabetes when compared with controls.There is an urgent need for more effective self‐management interventions for young adults with type 1 and type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective. This study explores (1) the motivations and challenges facing family caregiving for cancer in Singapore and (2) suggests a possible framework to guide culturally sensitive future work on caregivers. Design. Twenty caregivers of patients being treated for cancer at a public hospital in Singapore were interviewed. A semi-structured interview format and inductive thematic analysis were used to analyse the data. Caregivers were asked about their motivations for caregiving and the challenges they faced. Results. Caregivers’ motivations grouped into three categories: personal value and fulfilment, giving care because of societal expectations such as filial piety, and practical need. Challenges were grouped into interpersonal challenges, disclosure and finding balance. Caregivers with different primary motivations varied in their responses to these challenges. More autonomous caregivers cited learning points and reprioritised more effectively than less autonomous caregivers, who reported more internal conflict and less control over their situation. Conclusions. In Singapore and Asia, sociocultural values of family caregiving are not uniformly experienced as positive, and may be burdensome for caregivers who give care primarily for extrinsic motivations. As family caregiving needs increase, targeted psychosocial support for caregivers with less autonomous behavioural orientations may pre-empt caregiver burnout and burden. [ABSTRACT FROM PUBLISHER]

The current study aims to investigate the relationship between the components of the Karasek model and burnout, somatic complaints and job satisfaction in teachers. Questionnaires were collected from 166 teachers from six secondary schools in the greater London area. The European reference group consisted of 2017 teachers from 10 other countries who participated in the EUROTEACH Project.Regression analyses show that of the Karasek components, job demands was the most consistent predictor for the study outcomes, whereas control and social support appeared to have less predictive power. The inclusion of other job aspects (e.g. physical exertion, environmental risks, and job meaningfulness) significantly added varying degrees to the explained variance of the outcomes. The addition of coping strategies marginally adds to overall explained variances of the burnout components.The UK teachers were considerably worse off than their European colleagues on all outcome measures, and the majority of the predictor variables. They appear to use different coping strategies, work under worse conditions and report lower levels of psychological and physical well-being. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore in depth the lived experience and quality of life outcomes in patients receiving automated peritoneal dialysis (APD) treatment., Methods: The study adhered to the standards of the Consolidated Criteria for Reporting Qualitative Research. A total of 19 APD patients were recruited and assessed using in-depth semi-structured interviews on various aspects of life with respect to APD modality. The interviews were transcribed verbatim and analyzed using Interpretive Phenomenological Analysis., Results: Study findings generated five superordinate themes: (a) treatment-free daily routine, (b) sleep disturbances, (c) remote care, (d) limitations of peritoneal dialysis, and (e) the dimension of chronic disease. Further analysis of the material revealed the relationship of these themes with individual patient characteristics., Conclusions: Overall, our findings suggest that APD characteristics contribute to the perceptions of quality of life in patients under dialysis considerably., (© 2024 The Author(s). Therapeutic Apheresis and Dialysis published by John Wiley & Sons Australia, Ltd on behalf of International Society for Apheresis and Japanese Society for Apheresis.)

Background: Initiation onto hemodialysis marks a critical transition with intense psychosocial demands. Interventions using cognitive-behavioral therapy to improve distress have been variably effective but require trained staff and are typically delivered only to those who screen positive for clinically significant distress. Interventions guided by positive psychology are lacking., Purpose: To investigate the effectiveness of a brief positive-skills RCT in improving psychological adjustment in new hemodialysis patients., Methods: Using a parallel (2:1) design, blinded cluster-randomized controlled trial (cRCT) design, incident patients (<6 months at NKF dialysis centers) undergoing hemodialysis were randomized to intervention or usual care (UC). HED-Start intervention comprised four group sessions delivered by healthcare staff on positive emotions, acceptance, and life-orientated goal setting. Measures were taken at baseline (pre-randomization) and at 12 weeks: distress/mood (HADS; SPANE); quality of life (KDQOL-SF, WHOQOL-BREF); benefit-finding (BFS, BIPQ); life-oriented skills (HEIQ, CD-RISC-2); self-efficacy (CD-SES)., Results: A total of 147 participants enrolled in the trial (response rate, 51.0%; retention [assessment], 90.5%). Study arms were comparable on all baseline and outcome variables except for age, diabetic nephropathy, and hypertensive nephrosclerosis which were subsequently controlled for. Repeated measures ANCOVAs (intention to treat) were used. HED-Start yielded significant reductions over time in depression, and increased quality of life, self-efficacy, benefit finding, and skills relative to UC (moderate effect sizes). Rates of clinically significant depression significantly decreased in HED-Start (p < .001) and increased in UC (p = .002)., Conclusions: The significant positive effects of HED-Start, a low-intensity and cost intervention, on several adjustment indices, suggest that programs focusing on positive life skills can value add to existing renal care services., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Self-management is impacted by knowledge, self-efficacy, psychological health (general mental health and diabetes-related distress) and physical health (KSPP), and variations in KSPP contribute to heterogeneity in diabetes self-management education (DSME) program outcomes. This study aimed to identify unique KSPP profiles, and their associations with self-management behaviors., Methods: A cross-sectional survey was conducted in 518 participants with type 2 diabetes. Diabetes knowledge, self-efficacy, diabetes-related distress, mental and physical health, self-care, medication adherence and social support were assessed. A mixed-model latent profile analysis was conducted on eight KSPP variables, and sociodemographic, self-care (diet, physical activity, and medication adherence), and glycemic levels were compared across profiles., Results: Four unique KSPP profiles were identified: profile 1 (untroubled), profile 2 (distressed: diabetes-specific), profile 3 (distressed: global) and profile 4 (activated). Profile 3 was associated with the lowest self-care, highest glycemic and lowest social support levels. Profile 4 was associated with the highest self-care, lowest glycemic and highest social support levels., Conclusions: Our study identified novel KSPP profiles, which were associated with differential self-management behaviors and metabolic profiles., Practice Implications: Identifying KSPP profiles might improve self-management support through identifying clustering of care needs, and support more targeted DSME development., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)