Aims: This study aimed to construct a standardized health risk assessment index system (HRAIS) under the guidance of general health and facilitate the family doctors to carry out chronic disease management. Methods: Available chronic disease surveillance systems and indexes were reviewed to identify potential indexes. The Delphi method was performed to establish the HRAIS, and the analytic hierarchy process was used to calculate the index weight. Results: HRAIS included four first-level indexes and 38 second-level indexes. The authority coefficient was 0.86. The Kendall’s W for the two rounds of Delphi consultation were 0.202 and 0.210 ( p < 0.001). The weights of the first-level indexes from high to low were physiological health (0.409), psychosocial health (0.290), health-related behaviors (0.205), and environment (0.097). Thus, HRAIS is a multi-dimension and multi-index tool, which can be used as a guideline for family doctors in early screening, early intervention, and classified management of main chronic diseases.
ObjectiveDemoralisation is a common psychological issue in patients with cancer and aggravates depression, reduces the quality of life and even causes suicidal ideation. There is a lack of knowledge about illness uncertainty, coping style and demoralisation in patients with breast cancer. The current study explored the relationship between illness uncertainty and demoralisation among those patients, as well as the potential mediating role of coping style.DesignA cross-sectional study.SettingParticipants were recruited from the Breast Tumor Center in a tertiary hospital in Shijiazhuang, Hebei province.ParticipantsA total of 211 patients with breast cancer completed the survey.Outcome measuresA total of 211 patients with breast cancer completed the Mishel’s Uncertainty in Illness Scale, Trait Coping Style Questionnaire and the Mandarin version of Demoralization Scale (DS-MV).ResultsOf the patients, 47.40% exhibited symptoms of demoralisation (DS-MV>30), and the mean of demoralisation score was (29.55±13.21). The results demonstrated that illness uncertainty and negative coping styles were positively related to demoralisation (p<0.001), while active coping styles were negatively related to demoralisation (p<0.001). Importantly, coping styles could partially mediate the relationship between illness uncertainty and demoralisation (p<0.01).ConclusionOur study illustrated that illness uncertainty was associated with demoralisation in patients with breast cancer, and coping style acted as a mediator in this relationship. The findings highlighted the critical role of reducing negative coping styles to the early prevention and efficient treatment of demoralisation among those patients.
ObjectiveThis study aimed to assess the quality of the clinical practice guidelines on psychological distress among cancer patients and provide users with recommendations for coping with psychological distress.MethodsA systematic search of relevant clinical practice guidelines was undertaken to identify and select the clinical practice guidelines related to psychological distress among cancer patients. Literature databases were searched in PubMed, Web of Science, Excerpta Medica Database, the Cumulative Index to Nursing & Allied Health Literature, China Biology Medicine, China National Knowledge Infrastructure, WanFang and Weipu Journal Database. The guideline databases include Yimaitong Guidelines Network, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, American Society of Clinical Oncology (ASCO), New Zealand Guidelines Group, Scottish Intercollegiate GuidelinesNetwork, American Psychological Association, Registered Nurses’ Association of Ontario and Cancer Care Ontario (CCO). Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.ResultsSix clinical practice guidelines were included and assessed for critical evaluation. The median score for the scope and purpose domain was 71.5% (IQR 64%-77.25%), the stakeholder involvement domain was 65% (IQR 47.5%-74.5%), the rigour of the development domain was 61.5% (IQR 45.5%-85.25%), the clarity of the presentation domain was 91% (IQR 72.25%-94.5%), the applicability domain was 70% (IQR 33%-78.75%), and the editorial independence domain was 48.84% (IQR 61.75%-95%). Four guidelines (ASCO, 2014; Canadian Association of Psychosocial Oncology, 2015; NCCN, 2020, and CCO, 2016) were classified as “recommended,” and the remaining (European Palliative Care Research Collaborative and Chinese Psychosocial Oncology Society) were “recommended with modifications,” especially in the domains of Stakeholder involvement, rigour of development, and applicability. The inter-rater consistency of each domain showed moderate level (0.52–0.90) analyzing by intraclass correlation.ConclusionsThe clinical practice guidelines on psychological distress among cancer patients varied in quality, and there were discrepancies in terms of the recommendations and recommendation grades. These findings could contribute to improving the quality of clinical practice guidelines on psychological distress, and enable the development and implementation of evidence-based guidelines for cancer patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD42020209204.
IntroductionAnxiety not only harms employees’ work efficiency and satisfaction but also presents as a hazard to their mental health. This study aimed to investigate the prevalence of anxiety among Chinese employees, identify their personality profiles and explore the anxiety-related factors in different personality profiles.MethodsThis national investigation adopted the multistage random sampling method to recruit employees. A total of 3,875 employees were enrolled in this study, and 39.1% (1,515/3,875) of them were experiencing anxiety at the time of the study. Latent profile analysis (LPA) was conducted to identify personality subgroups among Chinese employees based on their BFI-10 scores.ResultsLPA identified a three-profile solution among Chinese employees: average, resilient, and introverted. Employees in the resilient profile had the lowest anxiety rate (16.1%, 132/822), and those in the average profile had the highest rate (46.8%, 1,166/2,494). Multivariate analysis results showed that for all personality profiles, self-efficacy was positively associated with anxiety, and work-family conflict was negatively associated with anxiety. High levels of perceived social support and self-efficacy reduced the risk of anxiety and higher work-family conflict and no partner increased the odds of anxiety in the average profile. For the introverted profile, female gender, and living in a city increased the chances of suffering from anxiety.DiscussionThis study identified that each personality profile of Chinese employees had its own set of factors associated with anxiety, which could facilitate employers to provide targeted interventions to alleviate employees’ anxiety.
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