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1.
Markus Gerber Magnus Lindwall Agneta Lindegård Mats Börjesson Ingibjörg H. Jonsdottir 《Patient education and counseling》2013
Objective
To examine how cardiorespiratory fitness and self-perceived stress are associated with burnout and depression. To determine if any relationship between stress and burnout/depression is mitigated among participants with high fitness levels.Methods
197 participants (51% men, mean age = 39.2 years) took part in the study. The Åstrand bicycle test was used to assess cardorespiratory fitness. Burnout was measured with the Shirom–Melamed Burnout Questionnaire (SMBQ), depressive symptoms with the Hospital Anxiety and Depression Scale (HAD-D). A gender-matched stratified sample was used to ensure that participants with varying stress levels were equally represented.Results
Participants with moderate and high fitness reported fewer symptoms of burnout and depression than participants with low fitness. Individuals with high stress who also had moderate or high fitness levels reported lower scores on the SMBQ Tension subscale and the HAD-D than individuals with high stress, but low fitness levels.Conclusion
Better cardiovascular fitness seems to be associated with decreased symptoms of burnout and a better capacity to cope with stress.Practical implications
Promoting and measuring cardiorespiratory fitness can motivate employees to adopt a more physically active lifestyle and thus strengthen their ability to cope with stress exposure and stress-related disorders. 相似文献2.
Background
According to the effort–reward-imbalance (ERI) model, a lack of reciprocity between costs and gains at work increases the risk for adverse health outcomes. Inflammation has been shown to play a crucial role in a variety of stress-related diseases and alterations in immune system glucocorticoid sensitivity may help to explain the increased risk for cardiovascular disease (CVD) and depression related to chronic work stress.Methods
Changes in lipopolysaccharide (LPS)-induced interleukin (IL)-6 production and inhibition of IL-6 production by dexamethasone in reaction to the Trier Social Stress Test (TSST) were assessed in forty-six healthy school teachers to test whether chronic work stress is accompanied by alterations in inflammatory activity and glucocorticoid sensitivity of the innate immune system.Results
High ERI was associated with an increase in pro-inflammatory potential, reflected in elevated IL-6 production before and after stress and with a lower capacity of dexamethasone to suppress IL-6 production in vitro over all measurement time points. ERI was not associated with stress-related changes in GC sensitivity.Conclusion
The present findings suggest a less effective anti-inflammatory regulation by glucocorticoids in teachers suffering from chronic work stress. 相似文献3.
Objective
To examine children's knowledge, understanding and experience of stress from 4 to 11 years of age across four age groups (4–5, 6–7, 8–9, and 10–11 years old).Methods
A semi-structured interview format was used to elicit information from 50 children about their understanding and experience of stress.Results
Most children were able to define stress, with older children providing more complex responses. Many children had indirect and/or personal experience of stress. Younger children were more likely than older children to report that there was nothing people could do to stop stress; children reported using both adaptive and maladaptive coping strategies to deal with stress.Conclusion
Some young children have a basic understanding of stress and many have experience of stress; both understanding and experience develop with age.Practice Implications
The research has potential implications for provider-patient communication, particularly within preventative health education and clinically within the field of childhood post-traumatic stress disorder (PTSD). 相似文献4.
Magdalena Romanowicz Stephen S. O'Connor Kathryn M. Schak Cosima C. Swintak Timothy W. Lineberry 《Journal of affective disorders》2013
Background
Suicide is the third leading cause of death in the United States for youth 12–17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission.Methods
Study participants were 1153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24 h of admission. Additional information on suicide risk factors was obtained through medical chart abstraction.Results
Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR=1.59, SE=0.29; CI=1.12–2.26), report a family history of suicide (OR=2.02, SE=0.33; CI=1.47–2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR=1.33, SE=0.13; CI=1.10–1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups.Limitations
Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample.Conclusions
Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings. 相似文献5.
Background
Misdiagnosis of African–U.S. persons is argued to be a built-in characteristic of Western-based assessment requiring augmentation with culture-focused input where possible. Regarding depression, materialistic depression is explained as an African-centered African–U.S. culture-focused construct of masked depression. Materialistic depression symptomatology is presented. Materialism orientation is postulated to necessarily be associated with materialistic depression.Method
144 undergraduates, 37 male (25.7%) and 107 female (74.3%), average age of 21 completed the Zung Self-rating Depression Scale, the depression subscale of the Symptom Checklist 90-R, the materialism subscale of the Cultural Misorientation Scale, and the Materialistic Depression Quiz.Results
Contrasting high versus lower scoring MDQ groups on both depression scores produced reliable t-tests (p<.017). One-way ANOVA on materialism scores with high, medium, low MDQ groups was reliable (p<.017).Limitation
The sample precluded generalization to clinically depressed and non-college African–U.S. populations.Conclusions
Using the Materialistic Depression Quiz, high scorers versus medium and low scorers had greater depression scores on two depression measures and greater materialism scores. Materialistic depression appears a masked form of depression not to be overlooked. 相似文献6.
Ulrike Dinger Sigal Zilcha-Mano Kevin S. McCarthy Marna S. Barrett Jacques P. Barber 《Journal of affective disorders》2013
Background
Previous studies reported inconsistent findings regarding the association of interpersonal problems with therapy outcome. The current study investigates if interpersonal problems predict process and outcome of three different treatments for depression.Methods
The data originate from a randomized clinical trial comparing supportive–expressive psychotherapy, antidepressant medication and pill-placebo for treatment of depression. Interpersonal problems were used as predictors of alliance, symptomatic improvement and premature termination of treatment.Results
Interpersonal problems related to communion predicted better alliances, but slower symptomatic improvement. Low agency predicted slower symptomatic improvement in supportive–expressive psychotherapy, but not in the medication or placebo condition. Lower interpersonal distress was associated with an increased likelihood to terminate treatment prematurely.Limitations
The sample size did not allow the detection of small effects within the treatment groups.Conclusions
Interpersonal problems are influential for the treatment of depression, but parts of their effects depend on the type of treatment. 相似文献7.
Linnea Sjöberg Svante Östling Hanna Falk Valter Sundh Margda Waern Ingmar Skoog 《Journal of affective disorders》2013
Background
Rapid societal changes occurred in the Western world during the 20th century. It is not clear whether this has changed the relation between social factors and depression in older people.Methods
Representative samples of 70-year-olds from Gothenburg, Sweden, were examined with identical psychiatric examinations in 1971–72 (N=392; 226 women and 166 men) and 2000–01 (N=499; 270 women and 229 men). Follow-up studies were conducted after five years. Social factors were obtained by self-report and depression was diagnosed according to DSM-IV-TR.Results
Feelings of loneliness were related to both concurrent depression at baseline and new depression at follow-up in both birth cohorts. Visits with others than children and neighbours once per month or less, compared to having more visits, and the perception of having too little contact with others, were related to both concurrent and new depression in 70-year-olds examined 1971–72, but not in those examined 30 years later.Limitations
The response rate declined from 85.2% in 1971–72 to 65.8% in 2000–01. Participation bias may have resulted in an underestimation of depression in the later-born cohort.Conclusions
Social contacts with others were related to depression in 70-year-olds examined in the 1970s, but not in those examined in the 2000s. This may reflect period changes in the ways of socialising, communicating and entertaining, e.g. due to technological development and expansion of mass media. Findings may be useful when developing modern and effective programs for the prevention of mental ill-health in older people. 相似文献8.
Objectives
Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women.Methods
One hundred and sixteen women aged 45–55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health.Results
Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping.Conclusions
Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause. 相似文献9.
Jaynie L. Gaskin Adam J. PulverKiswana Branch Ahmed KaboreTabiitha James Jian Zhang 《Journal of affective disorders》2013
Background
Failure to control for the confounding effects from body perceptions may contribute to the inconsistency of literature on the relationship between body weight and depression. The aim was to determine if perception mediates the associations between measured weight and depression.Methods
We analyzed the data of 13,548 adults age 18 or older, collected in the National Health and Nutrition Examination Survey, 2005–2008. Depression status was ascertained using the Patient Health Questionnaire; and the BMI was calculated from measured height and weight.Results
Among women, adjusting for perception weakened the relationship between measured weight and depression. The odds ratios (OR) of depression for being obese and overweight were 2.26 [95% confidence interval (1.50–3.40)] and 1.92 (1.29–2.85) before being adjusted for perception and 1.72 (1.01–2.92) and 1.62 (1.01–2.60) when perception was adjusted for. Independent from measured weight, women who perceived themselves as underweight [OR=2.95(1.47–5.14)] or overweight [1.73 (1.14–2.61)] had an increased odds of depression compared with women who perceived themselves as about the right weight. Among men, measured weight, neither overweight nor underweight, was associated with depression, perceiving oneself as underweight [OR=2.80 (1.42–5.54)] was associated with depression.Limitation
The inherent limitation of the study's cross-sectional design prevented the authors from investigating causality.Conclusion
Perception may be more important than measured weight in the relationship with depression. Independent from measured weight either perceived under or overweight among women, or underweight among men, appear to be significantly associated with depression. 相似文献10.
Streisand R Mackey ER Elliot BM Mednick L Slaughter IM Turek J Austin A 《Patient education and counseling》2008,73(2):333-338
Objective
To examine demographic and clinical characteristics, such as pediatric parenting stress and self-efficacy for diabetes care, of parents of children newly diagnosed with type 1 diabetes that are associated with parental anxiety and depression.Methods
102 parents reported on their levels of depression (CESD), state anxiety (STAI), pediatric parenting stress (PIP), and self-efficacy for diabetes care (SED) within 4 weeks of their child's diagnosis with type 1 diabetes. Data were analyzed using hierarchical multiple regression.Results
Parents’ scores in the clinical range for depression and anxiety were associated with increased frequency and difficulty of pediatric parenting stress, and there was a trend for depression to be related to lower self-efficacy for diabetes care. The association of female gender with anxiety and depression was partially mediated by more frequent pediatric parenting stress.Conclusion
Parents of children newly diagnosed with type 1 diabetes are at risk for experiencing anxiety and depression, related, in part, to their experiences of pediatric parenting stress.Practice implications
Providers and educators should be aware of the risk for depression and anxiety in parents and should work to decrease pediatric parenting stress, increase self-efficacy, and refer parents who are experiencing significant anxiety or depression following their child's diagnosis to a mental health specialist. 相似文献11.
Background
Little is known about depression in older people in sub-Saharan Africa, the associated impact of HIV, and the influence on health perceptions.Objectives
Examine the prevalence and correlates of depression; explore the relationship between depression and health perceptions in HIV-infected and -affected older people.Methods
In 2010, 422 HIV-infected and -affected participants aged 50+ were recruited into a cross-sectional study. Nurse professionals interviewed participants and a diagnosis of depressive episode was derived from the Composite International Diagnostic Interview (Depression module) using the International Classification of Diseases diagnostic criteria and categorised as major (MDE) or brief (BDE).Results
Overall, 42.4% (n=179) had a depressive episode (MDE: 22.7%, n=96; BDE: 19.7%, n=83). Prevalence of MDE was significantly higher in HIV-affected (30.1%, 95% CI 24.0–36.2%) than HIV-infected (14.8%, 95% CI 9.9–19.7%) participants; BDE was higher in HIV-infected (24.6%, 95% CI 18.7–30.6%) than in HIV-affected (15.1%, 95% CI 10.3–19.8%) participants. Being female (aOR 3.04, 95% CI 1.73–5.36), receiving a government grant (aOR 0.34, 95% CI 0.15–0.75), urban residency (aOR 1.86, 95% CI 1.16–2.96) and adult care-giving (aOR 2.37, 95% CI 1.37–4.12) were significantly associated with any depressive episode. Participants with a depressive episode were 2–3 times more likely to report poor health perceptions.Limitations
Study limitations include the cross-sectional design, limited sample size and possible selection biases.Conclusions
Prevalence of depressive episodes was high. Major depressive episodes were higher in HIV-affected than HIV-infected participants. Psycho-social support similar to that of HIV treatment programmes around HIV-affected older people may be useful in reducing their vulnerability to depression. 相似文献12.
Mark A. McEvoy Peter Schofield Wayne Smith Kingsley Agho Arduino A Mangoni Roy L Soiza Roseanne Peel Stephen Hancock Brian Kelly Kerry Inder Ciriaco Carru Angelo Zinellu John Attia 《Journal of affective disorders》2013
Background
Methylarginines are endogenous nitric oxide synthase inhibitors that have been implicated in depression. This study measured serum concentrations of l-arginine, asymmetric (ADMA) and symmetric (SDMA) dimethylarginine in a representative sample of older community-dwelling adults and determined their association with incident depression over 6-years of follow-up.Methods
Data on clinical, lifestyle, and demographic characteristics, methylated arginines, and l-arginine (measured using LC–MS/MS) were collected from a population-based sample of older Australian adults (Median age=64 years; IQR=60–70) from the Hunter Community Study. Clinical depression was defined as a Centre for Epidemiological Studies Depression Scale (CES-D) score ≥16 or use of antidepressant medications.Results
In adjusted analyses ADMA (Q3), SDMA (Q2), l-arginine (Q2), gender, and asthma remained statistically significant predictors of incident depression at follow-up. Quartile 3 of ADMA concentration was associated with 3.5 times the odds of developing depression compared with Q1 (OR=3.54; 95% CI: 1.25–9.99).Limitations
Limitations of our study include the use of a subjective self-reported questionnaire tool using a dichotomous cut-off, together with use of antidepressant medications, as proxies for clinical depression. Moreover, similarly to most population studies on methylated arginines, the measurement of ADMA and SDMA from blood does not necessarily reflect intracellular concentrations of these compounds. Finally, there were no measures of nitric oxide metabolites to determine if these levels were altered in the presence of elevated methylarginines and depression.Conclusions
After adjusting for clinical, demographic, biochemical, and pharmacological confounders, higher serum ADMA was independently associated with incident depression at 6-years follow-up. 相似文献13.
Roos Y. Arends Christina Bode Erik Taal Mart A.F.J. Van de Laar 《Patient education and counseling》2013
Objective
Persons with polyarthritis often experience difficulties in attaining personal goals due to disease symptoms such as pain, fatigue and reduced mobility. This study examines the relationship of goal management strategies – goal maintenance, goal adjustment, goal disengagement, goal reengagement – with indicators of adaptation to polyarthritis, namely, depression, anxiety, purpose in life, positive affect, participation, and work participation.Methods
305 patients diagnosed with polyarthritis participated in a questionnaire study (62% female, 29% employed, mean age: 62 years). Hierarchical multiple-regression-analyses were conducted to examine the relative importance of the goal management strategies for adaptation. Self-efficacy in relation to goal management was also studied.Results
For all adaptation indicators, the goal management strategies added substantial explained variance to the models (R2: .07–.27). Goal maintenance and goal adjustment were significant predictors of adaptation to polyarthritis. Self-efficacy partly mediated the influence of goal management strategies.Conclusion
Goal management strategies were found to be important predictors of successful adaptation to polyarthritis. Overall, adjusting goals to personal ability and circumstances and striving for goals proved to be the most beneficial strategies.Practice implications
Designing interventions that focus on the effective management of goals may help people to adapt to polyarthritis. 相似文献14.
Sarah Dewing Mark Tomlinson Ingrid M. le Roux Mickey Chopra Alexander C. Tsai 《Journal of affective disorders》2013
Background
Although the public health impacts of food insecurity and depression on both maternal and child health are extensive, no studies have investigated the associations between food insecurity and postnatal depression or suicidality.Methods
We interviewed 249 women three months after they had given birth and assessed food insecurity, postnatal depression symptom severity, suicide risk, and hazardous drinking. Multivariable Poisson regression models with robust standard errors were used to estimate the impact of food insecurity on psychosocial outcomes.Results
Food insecurity, probable depression, and hazardous drinking were highly prevalent and co-occurring. More than half of the women (149 [59.8%]) were severely food insecure, 79 (31.7%) women met screening criteria for probable depression, and 39 (15.7%) women met screening criteria for hazardous drinking. Nineteen (7.6%) women had significant suicidality, of whom 7 (2.8%) were classified as high risk. Each additional point on the food insecurity scale was associated with increased risks of probable depression (adjusted risk ratio [ARR], 1.05; 95% CI, 1.02–1.07), hazardous drinking (ARR, 1.04; 95% CI, 1.00–1.09), and suicidality (ARR, 1.12; 95% CI, 1.02–1.23). Evaluated at the means of the covariates, these estimated associations were large in magnitude.Limitations
The study is limited by lack of data on formal DSM-IV diagnoses of major depressive disorder, potential sample selection bias, and inability to assess the causal impact of food insecurity.Conclusion
Food insecurity is strongly associated with postnatal depression, hazardous drinking, and suicidality. Programmes promoting food security for new may enhance overall psychological well-being in addition to improving nutritional status. 相似文献15.
A. Koukopoulos D. Reginaldi L. Tondo C. Visioli R.J. Baldessarini 《Journal of affective disorders》2013
Background
Inferior response to lithium treatment has been reported in bipolar disorder (BD) patients with mania or hypomania following episodes of major depression (DMI) versus preceding depression (MDI), with intervening euthymic periods. However, additional characteristics of BD course-patterns require further assessment.Methods
We reviewed computerized clinical records and life-charts of 855 DSM-IV-TR BD-I or -II patients assessed and followed at mood-disorder centers in Cagliari or Rome to characterize their predominant course-sequences.Results
Morbidity over an average of 9.5 cycles in 18 years was characterized for sequencing of illness-episodes and euthymic intervals. Prevalent sequences included: major depression–hypomania (15.0%), mania–major depression (14.6%), major depression–mania (11.6%), and rapid-cycling (9.6%). Among subjects grouped by course-sequences (based on mania, mixed-states, or hypomania and major or minor depression), depression-before-[hypo]mania (DMI) cases were more likely to be women, diagnosed BD-II, have first-episodes of depressive or anxiety disorder, spend more time ill in depression, and benefit less with long-term mood-stabilizing treatments than with the opposite pattern (MDI). MDI patients were more likely to have substance-abuse and receive long-term mood-stabilizer treatments. Meta-analysis of 5 previous reports plus present findings found inferior treatment-response in DMI vs. MDI cases at a pooled risk-difference of 29% [CI: 18–40%] (p<0.0001).Limitations
Some data were retrospective and subject to recall bias, and treatment was clinical (non-randomized).Conclusions
The DMI course was strongly associated with first-episode depression or anxiety, excess depressive morbidity, and inferior treatment response, especially for depression. 相似文献16.
Angelo Alonzo Grace Chan Donel Martin Philip B. Mitchell Colleen Loo 《Journal of affective disorders》2013
Background
There is growing evidence that transcranial direct current stimulation (tDCS) may be an effective treatment for depression. However, no study to date has profiled the antidepressant effects of tDCS using items or factors on depression symptom severity rating scales. This could potentially provide information about the mechanisms by which tDCS achieves its antidepressant effects and also identify clinical predictors of response.Methods
The present study analysed scores on the Montgomery–Åsberg depression rating scale (MADRS) from a randomised, sham-controlled trial of tDCS (Loo et al., 2012. British Journal of Psychiatry. 200, 52–59) using a three-factor model of MADRS items (Suzuki et al., 2005. Depression and Anxiety. 21, 95–97) encompassing dysphoria, retardation and vegetative symptoms.Results
Participants in the active tDCS treatment group showed significant improvement in dysphoria while participants in the sham treatment group did not. While both groups showed improvement in retardation symptoms, improvement was significantly greater in the active tDCS group. Both groups also showed improvement in vegetative symptoms but there were no between-group differences.Limitations
Further studies with larger sample sizes are warranted to investigate the generalisability of results and whether the MADRS factor structure may change as a result of the specific treatment used.Conclusions
tDCS appears to be particularly effective in treating dysphoria and retardation, but not vegetative symptoms of depression. This may have implications for selection of types of depression most likely to respond to this treatment. 相似文献17.
Christian Gaden Jensen Peter Elsass Line Neustrup Tina Bihal Henrik Flyger Signe Maria Kay Sadia Khan Sivi Svenning Jensen Anne Pedersen Hanne Würtzen 《Patient education and counseling》2014
Objective
To analyze whether qualitative themes in breast cancer patients’ self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process.Methods
Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression scale (CES-D).Results
Among the qualitative themes, only the percentage of words spent on talking about ‘Acceptance-based psychological coping’ was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted less psychological distress and depression, respectively. A cross-validation including only the first few minutes of speech per patient confirmed these results and supported their practical utility in health consultations.Conclusion
Patients’ focus on acceptance-based coping significantly predicted decreased psychological distress and depression, respectively. No other qualitative themes predicted symptoms. Doctor–patient studies may benefit from combined qualitative–quantitative methods.Practice implications
While quantitative symptom assessment is important for a consultation, health care providers may improve their understanding of patients by attending to patients’ presentations of acceptance-based psychological coping. 相似文献18.
Soili M. Lehto Anu Ruusunen Tommi Tolmunen Sari Voutilainen Tomi-Pekka Tuomainen Jussi Kauhanen 《Journal of affective disorders》2013
Background
Zinc is an immunomodulatory trace element suggested to be beneficial in the augmentation of antidepressant therapy. Cross-sectional studies have also suggested an association between low dietary zinc and depression. This study examined the association between dietary zinc intake and depression in a prospective setting in initially depression-free men during a 20-year follow-up.Methods
The study formed a part of the population-based Kuopio Ischemic Heart Disease Risk Factor (KIHD) Study, and comprised 2317 Finnish men aged 42–61 years. Zinc intake was assessed at baseline by a 4-d food record. Baseline depression severity was recorded with the Human Population Laboratory Depression Scale. In the prospective setting, depression was defined as having received a hospital discharge diagnosis of unipolar depressive disorder. Individuals who at baseline had elevated depressive symptoms were excluded (n=283).Results
Altogether, 60 (2.7%) individuals received a hospital discharge diagnosis of depression during the 20-year follow-up. In Cox regression analysis adjusted for age, baseline depression severity, smoking, alcohol use, physical exercise and the use of dietary supplements, belonging to the lowest tertile of energy-adjusted zinc intake was not associated with an increased depression risk (RR 1.06, 95% CI 0.59–1.90).Limitations
These observations may not be generalizable to women, or to individuals with a depression level not warranting hospitalization.Conclusions
Our findings suggest that a low dietary zinc intake may not longitudinally precede depression in men. Dietary zinc intake may not have relevance for the prevention of depression in middle-aged men with a sufficient dietary zinc intake. 相似文献19.
Objective
This study explored the impact of breast cancer patients’ experiences of physician–patient communication and participation in decision making on patient depression and quality of life three and six months after primary treatment.Methods
Participants were 135 German breast cancer patients, recruited within a week after the beginning of treatment. Women were asked to complete a self-administered questionnaire at baseline and three and six months later.Results
Patients who rated their level of information at baseline as high were less depressed after three (p = .010) and six months (p < .001) and experienced higher quality of life after three (p < .001) and six months (p = .049). Patients who participated as much as they had wanted were more satisfied with the decision making process (p < .001) and had lower depression scores three months later (p = .005). The level of participation itself (passive, collaborative, active) and the treatment type had no impact.Conclusion
The findings reveal the significance of physician–patient communication and stress the meaning of baseline depression for later adjustment.Practice implications
A high level of information and tailoring the involvement in decision making to patients’ desired level can help patients to better cope with their illness. Physicians should assess and treat depression early in cancer treatment. 相似文献20.
Debajyoti Bhowmik Rajender R. Aparasu Suja S. Rajan Jeffrey T. Sherer Melissa Ochoa-Perez Hua Chen 《Journal of affective disorders》2013