INTRODUCTION

Caring for persons with diabetes involves a holistic approach. Addressing diabetes distress is crucial to achieve optimal health outcomes for persons with diabetes. This study aims to validate a Filipino version of the diabetes distress scale (DDS).

We conducted forward and backward translations to construct a Filipino version from the validated English questionnaire. We performed statistical analysis to check internal consistency and validation and to correlate diabetes distress with glycemic control based on the subjects’ HbA1c levels.

We included one hundred and seventy patients (170) seen at the Outpatient Diabetes Clinic in the analysis. Of the participants, 13 (7.6%) have Type 1 Diabetes Mellitus (T1DM), while the rest have Type 2 (T2DM). We found physician distress (PD) to be significantly associated with having T1DM. All domains in the Filipino DDS showed good internal consistency, ranging from 0.81 to 0.85. We used factor analysis to extract four factors similar to the original diabetes distress scale. We did not find any significant correlation between diabetes distress and HbA1c level.

The Filipino DDS showed good internal reliability and had consistent results similar to the original diabetes distress scale. However, we did not find a significant correlation between diabetes-related distress and the HbA1c level.

BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

BACKGROUND: Growing up with a sibling with a chronic health problem or a disability requiring assistance can affect the lives of the family members in various ways. Previous studies documented health problems among siblings of children with a chronic health problem or a disability. However, these studies are limited in that they tend to rely on small convenience samples of children with specific illnesses/disabilities. This study aims to investigate mental health and self-rated health status of siblings of such children using data from a population study in Japan. METHODS: We used data from the 2016 wave of Japan's Comprehensive Survey of Living Conditions. The analytic sample included 16,510 adolescents aged 15-19 years who were living with a sibling with or without care needs. The outcomes were psychological distress as defined by K6 score of 13 or higher and poor self-rated health. We examined these health outcomes of adolescents who have a sibling with care needs to relative to adolescents with a sibling without such needs via logistic regression. RESULTS: Adolescents who live with a sibling with care needs were more likely to have psychological distress (Odds Ratio (OR) 2.47; 95% Confidence Interval (CI), 1.46-4.17) and poor self-rated health (OR 2.21; 95% CI, 1.30-3.75). These associations were more pronounced in post-high school age (18-19 years old) group than in high school age (15-18 years old) group. CONCLUSION The presence of a child with care needs in the household was associated with spillover psychological distress and poorer subjective health among siblings. Providing support for children/adolescents with care needs may have additional benefits in terms of well-being of their siblings.
Humans ; Adolescent ; Male ; Female ; Siblings/psychology* ; Young Adult ; Psychological Distress ; Japan/epidemiology* ; Health Status

Objectives: This study aimed to compare the levels of depression, anxiety, and stress, and the coping styles among physicians and nurses in a COVID-19 referral hospital in Manila from June to July 2020. Methods: A cross-sectional study among medical residents and nurses selected via convenience sampling was employed. Data were obtained through COVID Stressors and Stress Reduction Questionnaire, Depression, Anxiety, and Stress Scale-21, and Filipino Coping Strategies Scale. Descriptive and inferential analysis of data was done. Results: Five hundred seventy-one (571) healthcare workers (total population: 1,650 nurses and physicians) participated in the study, representing 81.6% of the computed sample size of 700 respondents. Among the participants, 60.6 %, 69.0%, 48.9% reported symptoms of depression, anxiety, and stress, respectively. Nineteen percent (19%) of nurses reported severe to extremely severe depression, and 42.0% reported severe to extremely severe anxiety. In contrast, 30.8% of residents reported severe to extremely severe depression, and 28.4% conveyed severe to extremely severe anxiety. There was no association observed between perceived levels of stress between the two healthcare professions. There were more mildly to extremely severe anxious healthcare workers in the COVID areas (74.6%) compared to the non-COVID areas (61.2%). Differences in coping styles were observed among the participants’ clinico-demographic characteristics. Top healthcare worker stressors include being negligent and endangering co-workers (88.6%), frequent modification of infection control procedures (87.0%), and discomfort from protective equipment (81.4%). Top stress-reducing factors include provision of food and vitamins (86.7%), sufficient rest (84.2%), and support from higher-ranking colleagues (73.7%). Conclusion This study has shown that more than half of the healthcare workers reported mild to extreme levels of depression and anxiety, while a little less than half reported mild to extreme levels of stress. The development and implementation of hospital interventions and programs based on the sources of distress and stress-reducing factors is recommended to mitigate the impact of sustained psychological distress on mental health and physical wellbeing of hospital healthcare workers.
Psychological Distress

Objectives: This study examined the association between irrational beliefs and psychological distress among female office workers in Bali, and formulate general equation to predict psychological distress from the irrational belief scores. Methods: A cross-sectional study was conducted among 111 female office workers in Bali. The irrational beliefs were measured by the Smith Irrational Belief Inventory (SIBI) questionnaire and the psychological distress was assessed by a questionnaire quoted from the Brief Job Stress Questionnaire (BJSQ). Multivariable linear regression was performed to evaluate the role of irrational beliefs on psychological distress scores. Results: There was a moderate, positive correlation between irrational beliefs and psychological distress, which was statistically significant (r = 0.451, n = 111, p = 0.000). The R squared was 0.205, indicating that 20.5% of psychological distress variance can be explained by irrational beliefs. The F-ratio in the ANOVA test shows that the independent variables statistically significantly predict the dependent variable, F(3,107) = 9.187, p < 0.0005. The general form of the equation to predict psychological distress from irrational belief scores is: Predicted psychological distress (Y) = 17.909 + (0.392 x Irrational belief scores). Conclusion Irrational beliefs are significantly associated with psychological distress among female office workers in Gianyar, Bali. This finding suggests the need for strategies anticipating better health and productivity among female workers.
Psychological Distress ; Female

OBJECTIVES

This study aimed to compare the levels of depression, anxiety, and stress, and the coping styles among physicians and nurses in a COVID-19 referral hospital in Manila from June to July 2020.

A cross-sectional study among medical residents and nurses selected via convenience sampling was employed. Data were obtained through COVID Stressors and Stress Reduction Questionnaire, Depression, Anxiety, and Stress Scale-21, and Filipino Coping Strategies Scale. Descriptive and inferential analysis of data was done.

Five hundred seventy-one (571) healthcare workers (total population: 1,650 nurses and physicians) participated in the study, representing 81.6% of the computed sample size of 700 respondents. Among the participants, 60.6 %, 69.0%, 48.9% reported symptoms of depression, anxiety, and stress, respectively. Nineteen percent (19%) of nurses reported severe to extremely severe depression, and 42.0% reported severe to extremely severe anxiety. In contrast, 30.8% of residents reported severe to extremely severe depression, and 28.4% conveyed severe to extremely severe anxiety. There was no association observed between perceived levels of stress between the two healthcare professions. There were more mildly to extremely severe anxious healthcare workers in the COVID areas (74.6%) compared to the non-COVID areas (61.2%). Differences in coping styles were observed among the participants’ clinico-demographic characteristics. Top healthcare worker stressors include being negligent and endangering co-workers (88.6%), frequent modification of infection control procedures (87.0%), and discomfort from protective equipment (81.4%). Top stress-reducing factors include provision of food and vitamins (86.7%), sufficient rest (84.2%), and support from higher-ranking colleagues (73.7%).

This study has shown that more than half of the healthcare workers reported mild to extreme levels of depression and anxiety, while a little less than half reported mild to extreme levels of stress. The development and implementation of hospital interventions and programs based on the sources of distress and stress-reducing factors is recommended to mitigate the impact of sustained psychological distress on mental health and physical wellbeing of hospital healthcare workers.

This study aimed to explore the prevalence and risk factors of cardiovascular disease (CVD) and psychological distress among female scientists and technicians in China. Accordingly, we included scientists and technicians from representative research institutions, medical institutions, colleges, universities, and businesses in China, and the data were collected from July 1, 2019 to March 31, 2021 via online questionnaires. The parameters evaluated in this study included age, sex, marital status, educational background, monthly income, sleep hours, sleep problems, smoking, alcohol consumption, work-related stress, work burnout, cardiovascular symptoms, CVD, family history, and depressive and anxiety symptoms. A total of 14 530 scientists and technicians were included, comprising 7144 men and 7386 women. We found 34.9% men and 16.6% women with CVD, 35.1% men and 21.4% women with depressive symptoms, 28.7% men and 13.8% women with anxiety symptoms, and 22.0% men and 9.5% women with CVD combined with depressive or anxiety symptoms. This study focused on the details of women. Younger women (age≤35 years) had the highest prevalence of depressive symptoms (24.9%), anxiety symptoms (16.2%), and comorbidity (11.2%). It was established that, despite traditional risk factors, unmanageable work burnout, depressive symptoms, and anxiety symptoms were associated with a higher risk of CVD in women; insomnia, overwhelming work stress, unmanageable work burnout, and CVD were linked to a higher risk of depressive symptoms and anxiety; insomnia, overwhelming work stress, and unmanageable work burnout were related to CVD combined with depressive or anxiety symptoms. A bidirectional relationship was noted between CVD and depression or anxiety in female scientists and technicians, and insomnia and overwhelming work stress were positively associated with comorbidity. It is suggested that effective measures should be taken to protect female scientists and technicians from CVD and psychological distress.
Male ; Female ; Humans ; Adult ; Cardiovascular Diseases/epidemiology* ; Prevalence ; Depression/complications* ; Sleep Initiation and Maintenance Disorders/epidemiology* ; Anxiety/epidemiology* ; Risk Factors ; Psychological Distress ; Stress, Psychological/psychology*

Objective: To explore the dynamic changes of Distress Thermometer scores and the relationship between psychological distress and quality of life in Chinese early breast cancer patients during chemotherapy. Methods: This prospective study enrolled 110 Chinese postoperative early breast cancer patients between March 2019 and December 2019. The psychological distress and quality of life (QOL) of patients were assessed by using the psychological distress management screening tool and the patient quality of life scale. Logistic regression model was used to analyze the influencing factors of psychological distress degree. The correlation between distress thermometer (DT) score changes and quality of life was analyzed by Pearson correlation analysis. Results: In total, 96 valid cases were analyzed. Before chemotherapy, 47 cases (49.0%) had DT score ≥4 points. After 2 cycles of chemotherapy, 40 cases (41.7%) had DT score ≥4 points. Thirty-four patients (35.4%) had DT score ≥4 points after chemotherapy. The DT score after chemotherapy was lower than that before chemotherapy and after 2 cycles of chemotherapy. Univariate analysis showed that income level and pathological stage were still significant related to the detection of DT score ≥4 points after chemotherapy (P<0.05). The changes of DT scores before and after chemotherapy were negatively correlated with the changes of quality of life ( r=-0.298, P=0.003). Conclusions: The detection rate of psychological distress in patients with early breast cancer during chemotherapy showed a decreasing trend. Income level and tumor stage are significant factors affecting the psychological distress of patients. There is a significant correlation between the psychological distress and the quality of life during chemotherapy. We should pay attention to the evaluation and monitoring state of psychological distress of patients during chemotherapy.
Humans ; Female ; Quality of Life/psychology* ; Breast Neoplasms/psychology* ; Stress, Psychological/psychology* ; Prospective Studies ; Psychological Distress ; China ; Neoplasms ; Surveys and Questionnaires

OBJECTIVE: To analyze the changes in psychological distress and quality of life of patients with advanced liver cancer after transformation therapy. METHODS: This study was conducted among 60 patients with advanced liver cancer undergoing transformation therapy from July, 2019 to March, 2022. Before and after 2-10 cycles of treatment, the patients were assessed for psychological distress and quality of life using a psychological stress thermometer and the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). RESULTS: The patients showed significantly lowered scores for psychological distress after transformation therapy (P < 0.01) with decreased psychological stress, emotional factors, tension, worry, sleep problems, memory decline and inattention, physical factors, pain, fatigue, eating problems and dyspepsia (P < 0.05). The total score of quality of life and the scores for physical status, social and family status, emotional status, functional status and hepatobiliary-specific items were all significantly lowered after the treatment (P < 0.05). CONCLUSION In patients with advanced liver cancer, the psychological distress involves mainly the emotional factors and physical factors. Transformation therapy can significantly relieve psychological distress of the patients and improve their quality of life.
Humans ; Quality of Life/psychology* ; Surveys and Questionnaires ; Psychological Distress ; Fatigue/psychology* ; Stress, Psychological ; Neoplasms ; Liver Neoplasms

The psychological impact of the diagnosis of congenital anomalies is an area with limited research; and more limited still when such congenital anomalies are not very obvious. MayerRokitansky-Kuster-Hauser (MRKH) syndrome can be one of those less apparent congenital anomalies. Owing to their inability to bear children, women confronted with the diagnosis of MRKH can be left stressed, or worse, traumatized by the fact that they can no longer function in their traditional gender roles. This may leave any individual wanting to deny the diagnosis or even withhold such information. And the experience is a fertile ground for the development of any mental illness. MRKH occurs in every 1 out of 4000-5000 females. Although the psychological impact of stress is a well –established fact, there are fewer literature on the possible genetic link of MRKH and mental illness, the psychodynamic underpinnings and the similarities to trauma of the diagnosis of MRKH, in particular. We present here a case of MRKH syndrome with an initial presentation of major depression and psychosis; with the diagnosis of MRKH initially withheld from the resident psychiatrist. We would also want to highlight a trauma perspective of the case presented as well as to emphasize the need for more research congenital anomalies are accompanied by co-morbid psychiatric illnesses.
Depression ; Psychotic Disorders ; Psychological Distress