Patients with physical disease and their family caregivers experience various types of stress in the course of treatment. These patients and their families require long-term psychological support that begins at diagnosis and covers the duration of treatment as well as the time after treatment. When providing emotional care to patients and their families, it is important to provide care while understanding the characteristics of each disease, including disease pathology, physical symptoms, type of treatment, and disease progression. In this study, we focused on representative diseases, including cancer, cardiovascular disease, diabetes, and rheumatoid arthritis. We clarified the stress/psychological characteristics unique to each disease and considered methods of support. In order to clarify the stressors unique to each disease, the physical symptoms and treatments (including side effects) of each must be understood. Moreover, for each disease, patients and their families are likely to feel anxiety about various uncertainties in their future, and each disease likely has some stressors in common with other diseases. In order to reduce stress in patients/families, the unique stressors of each disease should be understood, as well as the stressors common to all diseases. Moreover, multidisciplinary support that applies the expertise of different specialties is highly desired.
Cancer affects psychological well-being of both patients and family caregivers. Patients and family caregivers frequently experience anxiety which is specific to each of the following phases of cancer trajectory: upon diagnosis, during cancer treatments, during survivorship, upon and after cancer recurrence, and end-of-life period. Approximately a third of patients develop depression, including major depressive disorder and adjustment disorder. Inclusive criteria, which includes somatic symptoms regardless of whether or not they come from physical causes, is recommended as the diagnostic criteria of major depressive disorder in cancer patients. Both psychotherapies (e.g. supportive psychotherapy, problem-solving therapy, and cognitive-behavioral therapy) and pharmacological treatments are effective for major depressive disorder in cancer patients. Psychological distress of family caregivers has been reported as high as or even higher than that of patients themselves. Psychosocial interventions targeted to patients and family caregivers jointly can enhance caregivers’ coping resources, increase self-efficacy, thereby, reduce their burden and anxiety.
This paper discusses the stress of patients with cardiovascular disease and their families/caregivers. There are several types of stress that cardiac patients have such as anxiety/depression, anger/hostility/aggression and Type D personality, and these types of psychological stress can lead to cardiovascular disease. Furthermore, these stresses can negatively affect life prognosis in cardiac patients even after the onset of cardiovascular disease. Psychological stress intervention for cardiac patients is therefore important.
On the other hand, stress in family members/caregivers who provide care to cardiac patients can increase their physical and psychological fatigue due to the medical treatment life for cardiac patients. To make matters worse, families/caregivers’ stress can become more serious as the medical treatment life especially in patients with heart failure tends to continue for an extended period. Acceptance of emotional stress of families/caregivers and listening to their emotional side based on counseling is important as a psychological support for them.
In diabetes care, patients with diabetes are required to perform a range of self-care behaviors on their own in order to maintain glycemic control. Consequently, they are likely to have emotional burden. Similarly, family caregivers also experience higher levels of psychological stress as they are compelled to help such patients perform self-care behaviors. Psychological stress specific to patients with diabetes or their family caregivers has been widely investigated as “diabetes distress/diabetes-related emotional distress.” Diabetes distress is clearly distinct from general emotional symptoms, including depression and anxiety. As diabetes distress in patients with diabetes and their family caregivers causes various problems such as poor glycemic control, it is necessary to assess it accurately and provide adequate treatment in diabetes care. This article discusses the features of diabetes distress in patients with diabetes and their family caregivers and the instruments for measuring diabetes distress. In addition, we identify the key differences between the distress characteristics in adolescent and adult patients with diabetes.
Depression and anxiety are highly prevalent in rheumatoid arthritis (RA) patients and associated with their pain, fatigue and disease activity. Various psychological managements are developed to treat with psychological distress. Some management intervenes in the cognitive negative aspects of RA patients. In order to reach the target of treatment (T2T) with RA, medical team including medical doctor, nurse, pharmacist, occupational therapist and clinical psychologist etc. should be established. Team approaches have a possibility to cover psychological problems of patients and their families.
The purpose of this study was to examine whether perceived stress and Sense of Coherence (SOC) were associated with Mibyou (presymptomatic disease) from Oriental medicine among community-dwelling Japanese. Participants were 651 men and 1,183women aged 30 to 79 years who participated in the Toon Health Study, which was conducted in Toon city, Ehime prefecture, from 2011 to 2015. Mibyou was assessed using the Oriental Medicine Health Questionnaire 57 (OHQ57); a total score of ≥ 29 points on the OHQ57 indicated presence of Mibyou. Perceived stress was assessed using a self-administered questionnaire. SOC was assessed using a 13-item Japanese version of the SOC scale. Gender and age group-specific analyses were performed using logistic regression model. The prevalence of Mibyou was positively associated with the perceived stress (p < .01), and negatively associated with SOC (trend p < .01) among men and women. Age-adjusted odds ratio (95% confidence intervals) of Mibyou for participants with perceived stress and low-median score of SOC was 8.35 (5.20-13.41) for men and 9.25 (6.39-13.41) for women, compared with those without perceived stress and with high SOC. Our findings suggested that the measure for Mibyou was important especially for people with perceived stress and low SOC.
The purpose of the present study was to examine depression and social disability among Japanese high school students who experienced the Great East Japan Earthquake and tested if cognitive behavioral factors were related to depression and social disability. Two hundred and five students (160 female, M age = 16.2 years, SD = 0.4) who experienced the Great East Japan Earthquake were administered the Impact of Event Scale–Revised, Center for Epidemiologic Studies Depression scale, Sheehan Disability Scale, Automatic Thoughts Questionnaire–Revised, Behavioral Activation for Depression Scale, and Environmental Reward Observation Scale(EROS). More participants had depression than post-traumatic stress disorder(PTSD) symptoms. Partial correlation analysis found that depression was positively correlated with social disability. Multiple regression analysis found that, regarding cognitive factors, “negative evaluation of the future” was positively correlated with depression and social disability, whereas “positive thinking” was negatively correlated with depression. Regarding behavioral factors, “avoidance/rumination” and “social impairment” were positively correlated with depression, “school impairment” was positively correlated with social disability, whereas EROS was negatively correlated with depression and social disability. These findings suggest that interventions to reduce depression are necessary after natural disasters. Specifically, interventions should target cognitive behavioral factors to reduce depression and improvement of social disability.
This study examined the relaxing effects of a hot spring bath as part of climatotherapy on the elderly based on psychological stress and sympathetic/parasympathetic nervous system activity. As indices of these items, salivary CgA and amylase activity levels were measured, and assessment was conducted using a short form of the Profile of Mood States (POMS) questionnaire, involving 5 males and 5 females with a mean age of 71.4 (SD = 5.4), all of whom lived in the Kansai area. After the hot spring bath, a sense of refreshment was developed, supporting the effectiveness of this method to reduce stress. Although fatigue was also observed after it, this was likely unrelated to stress. Furthermore, for the elderly aged 65-74, the hot spring bath as part of climatotherapy was also suggested to be psychologically effective.
This study investigated the mental health in four years and six to eight months after the Great East Japan earthquake among junior high school students living in the coast of Fukushima Prefecture, who were affected by the accident at the Fukushima Daiichi Nuclear Power Plant. Three hundred nine students living there completed the questionnaire to assess post-traumatic stress responses, positive emotions, social support, positive events, and well-being. As the results, the scores of post-traumatic stress responses and mother support in first-year students were significantly higher than those in third-year students. The scores of post-traumatic stress responses and peer support in girls were significantly higher than those in boys. Furthermore, structural equation modeling revealed that the experiences of positive events enriched social support and positive emotions, which reduced post-traumatic stress responses and enhanced well-being.
Despite the fact that induced discovery is considered to be an essential element of cognitive behavioral therapy, fundamental study of it is still uncommon. Through an empirical examination of this point, the paper notes how some previous studies have incorporated the perspective of “Total conviction” which is a core element of induced discovery. However, the factors promoting “Total conviction” are yet to be examined. Therefore, in this study, in order to model and investigate the hypothesis that an “impasse” in everyday problem-solving situations can serve to promote “Total conviction” toward problem-solving strategies, as well as inspire a sense of willingness toward a problem, we conducted a questionnaire survey of 368 university students. This resulted in a model showing a series of associations whereby the mediation of “Total conviction” by the intensity of an “impasse” exerted a positive effect on willingness to engage with a problem. This study suggests the possibility that an everyday “impasse” may be a driving factor in bringing about problem-solving behavior.