Factors Related to Self-Care Ability in Patients With Severe Mental Disorders： Based on Community Patients Investigation in Beijing, China (Preprint)

UNSTRUCTURED Background: Severe Mental Disorders (SMD) have become a topic of increasing interest in research due to their serious consequences for the quality of life and functioning. In the pages that follow, it will be argued that the self-care ability and its influencing factors among SMD patients in Beijing, according to the questionnaire survey in 2019. Methods: The present study aimed to explore the factors influencing the self-care ability of SMD patients. Multi-stage sampling and proportioning sampling were used to take samples. The demographic characteristics of patients were obtained by questionnaires, and the self-care ability was measured by self-made scales. Multiple linear regression was used to analyze the influencing factors. Results: We surveyed 662 people and found that the deficiency of self-care ability is common in SMD patients. Significant relations were found between self-care ability and age, educated levels, guardian care, course of disease and physical disease (P<0.05). From a dimensional perspective, the daily basic activity was associated with educated levels and physical disease (P<0.05); the housework ability was associated with gender, educated levels, source of income, physical disease and medication adherence (P＜0.05); the social function was associated with age, educated levels, source of income, guardian care course of disease, physical disease and medication adherence (P＜0.05). Conclusion: The self-care ability of SMD patients is affected by many factors, including patient characteristics and social factors. Therefore, targeted interventions are needed to help patients restore their self-care ability, which requires the joint efforts of the government and the whole society.

The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis

Background Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are part of recommended treatment; however, no systematic review has evaluated the effects of depression self-management interventions for this population. The primary objective was to examine the effect of self-management interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). Methods Studies comparing depression self-management interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary ‘snowball’ search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. Results Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n = 7) or diabetes (n = 4). From baseline to < 6-months (T1), the pooled mean effect size was − 0.47 [95% CI −0.73, − 0.21] as compared to control groups for the primary outcome of depression and − 0.53 [95% CI −0.91, − 0.15] at ≥ 6-months (T2). Results were also significant for anxiety (T1) and glycemic control (T2). Self-management skills of decision-making and taking action were significant moderators of depression at T1. Conclusion Self-management interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future Self-management interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components.

The Influencing Factors of Citizens’ Attitude to Physical and Internet Hospitals

COVID-19 is driving the development of Internet hospitals. However, due to the short development time of Internet hospitals, they cannot meet the different needs of patients. This paper conducted the survey experiment and provided evidence: Participants were significantly less likely to go to the hospital when the risk of privacy disclosure was higher. There was no difference in the selection of Internet hospitals and physical hospitals when citizens suspected they were suffering from depression. However, citizens tended to choose physical hospitals when they suspected they were suffering from physical disease.

Fear of COVID-19 Among Elderly Patients with a Chronic Physical or Mental Disease

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9.According to the results, older chronic disease patients showed higher levels of fear, whereas anxiety and depressive symptoms were present mainly in the group of older psychiatric patients. Suicidality was reported from a subtotal of 25.4% that was composed of 7.8% chronic disease patients and 17.6% psychiatric patients. Chronic physical disease and higher anxiety predicted more severe COVID-19-related fear.

Psychological Distress in Patients with COVID-19 During Hospitalization

To determine the changes in psychological distress levels of patients hospitalized with the diagnosis of COVID-19 and the characteristics of patients at risk. This longitudinal study included 76 patients. The psychological distress was evaluated using the Hospital Anxiety and Depression Scale thrice (on the 1st day of hospitalization and isolation ( t0), sixth day ( t1), and when the discharge decision was made). The prevalence of anxiety was 22.4%, 14.5%, and 9.2%, whereas the prevalence of depression was 36.8%, 42.1%, and 43.4% at t0, t1, and t2, respectively. The patients’ anxiety level decreased, whereas the depression level increased during hospitalization ( p < .001). Increasing age, a chronic physical disease, and at least one COVID-19-positive relative increased the risk of psychological distress ( p < .05). The assessment and intervention of psychological distress should not be neglected in patients with COVID-19, particularly the group determined to be at a risk.

PHYSICAL ACTIVITIES IN THE CORONA ERA ARE A BOON

The journey from forest to land and from soil to house has made a huge impact on the work efficiency and physical routine of man. In the modern era, the mechanical work has made the physical work of the human more relaxed. Due to which their physical defense system has been adversely affected. And man has been surrounded by many incurable diseases. The most severe attack on this plight of humans was done by the corona virus, a disease that emerged in 2019 China. Due to which millions of human beings lost their lives. And that person is becoming the easiest sufferer of this disease, their physical disease immune system is weak. Or they do not do physical work, exercise, yoga etc. to the person. Whether physical activities be it labor, exercise, yoga, the physical disease of man keeps the immune system healthy.

Psychoanalysis of the Doctrine of Acute Pneumonia

It is difficult to predict how the founder of psychoanalysis, Sigmund Freud, would react to an attempt to link his theory and the method of treating mental disorders based on it [1] with such a purely physical disease as acute pneumonia (AP). It is unlikely that such an innovation could cause full approval and support. However, in this context, we are not talking about psychoanalysis as a therapeutic method for AP. In this case, only the diagnostic features of this technique are of interest. The essence of psychoanalysis, which is based on the search for the causes of the so-called echoes of the past, as well as the connection between conscious and unconscious phenomena, can be useful in order to understand the causes of errors and paradoxes that exist in solving the problem of AP. In other words, we are not talking about the nuances of the disease itself, but about the peculiarities of its nature, since the interpretation of the essence of AP determines the principles of treatment and the final results.

Diagnostic and treatment barriers to persistent somatic symptoms in primary care – representative survey with physicians

Background Many patients consult their primary care physician with persistent somatic symptoms such as pain or sickness. Quite often these consultations and further diagnostic measures yield no medical explanation for the symptoms – patients and physicians are left in uncertainty. In fact, diagnostic and treatment barriers in primary care hinder timely health-care provision for patients suffering from persistent somatic symptoms (PSS). The significance of individual barriers is still unknown. We compare and quantify these barriers from the perspective of primary care physicians and identify subpopulations of primary care physicians who experience particular barriers as most severe. Methods We mailed a questionnaire to primary care physicians (PCP) in Germany and asked them which barriers they consider most important. We invited a random sample of 12,004 primary care physicians in eight federal states in Germany. Physicians provided anonymous mailed or online responses. We also mailed a postcard to announce the survey and a mail reminder. Main measures were Likert rating scales of items relating to barriers in the diagnosis and treatment of PSS in primary care. Information on demography and medical practice were also collected. Results We analyzed 1719 data sets from 1829 respondents. PCPs showed strongest agreement with statements regarding (1.) their lack of knowledge about treatment guidelines, (2.) their perceptions that patients with PSS would expect symptom relief, (3.) their concern to overlook physical disease in these patients, and (4.) their usage of psychotropic drugs with these patients. More experienced PCPs were better able to cope with the possibility of overlooking physical disease than those less experienced. Conclusions The PCPs in our survey answered that the obligation to rule out severe physical disease and the demand to relieve patients from symptoms belong to the most severe barriers for adequate treatment and diagnosis. Moreover, many physicians admitted to not knowing the appropriate treatment guidelines for these patients. Based on our results, raising awareness of guidelines and improving knowledge about the management of persistent somatic symptoms appear to be promising approaches for overcoming the barriers to diagnosis and treatment of persistent somatic symptoms in primary care. Trial registration German Clinical Trials Register (Deutschen Register Klinischer Studien, DRKS) https://www.drks.de/drks_web/setLocale_EN.do The date the study was registered: October 2nd 2017 The date the first participant was enrolled: February 9th 2018 DRKS-ID: DRKS00012942

The Effects of Self-Management Interventions on Depressive Symptoms In Adults With Chronic Physical Disease(S) Experiencing Depressive Symptomatology: A Systematic Review And Meta-Analysis

Background: Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management (SM), are part of recommended treatment; however, no systematic review has evaluated the effects of depression SM interventions for this population. Objectives: The primary objective was to examine the effect of SM interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). Methods: Studies comparing depression SM interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary ‘snowball’ search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. Results: Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n = 7) or diabetes (n = 4). From baseline to < 6 months (T1), the pooled mean effect size was -0.47 [95% CI -0.73, -0.21] as compared to control groups for the primary outcome of depression and -0.53 [95% CI -0.91, -0.15] at ≥ 6-months (T2). Results were also significant for anxiety (T1 and T2) and glycemic control (T2). SM skills of decision-making and taking action were significant moderators of depression at T1. Conclusion: SM interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future SM interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components. Prospero registration: CRD42019132215