Is fatigue associated with adolescents' mental health? A pre- vs. post-COVID-19 cross-sectional survey comparison.

Pneumoconiosis is the most severe occupational pulmonary disease worldwide, caused by inhalation and retention of dust particles in the lungs (, ). Annual deaths from the disease have exceeded 21,000 each year since 2015 (). China bears the highest global burden of pneumoconiosis, experiencing both the greatest health loss () and the highest incidence rate among all countries () The progression of pneumoconiosis is rather slow, typically spanning a decade or longer (, ). Importantly, the disease continues to advance even after exposure to dust particles has ceased (). To date, no curative is available for pneumoconiosis (). Consequently, as the disease progresses, patients experienced reduced lung function, severe breathing problems, and decreased physical exercise tolerance (, ). Such physical and functional impairments can give rise to negative emotions (e.g., anxiety, fear, and depression) (, ) and socioeconomic challenges (e.g., financial strain, housing instability, and intimate relationship difficulties) (). Many studied have pointed out that pneumoconiosis patients require equal attention to both their socioeconomic status and psychological well-being (, ). Accordingly, the psychosocial problems of pneumoconiosis patients have become a major focus of current research. Psychosocial distress is a multifactorial unpleasant experience of psychological, social, spiritual and/or physical nature that may interfere with the ability to cope effectively with diseases, its physical symptoms, and its treatment (). The Distress Thermometer (DT) is a brief, widely-used screening tool designed to quickly assess psychosocial distress, including an 11-point visual analog scale. If the patient’s distress level is >4, the medical team looks at the Problem List questionnaire to identify key issues of concern and asks further questions to determine the best resources to address the patient’s concerns. Originally, DT is commonly used for quickly identifying the psychosocial problems of cancer patients and giving corresponding intervention measures to improve the life quality (). Due to its brief and easy to complete, the DT has been increasingly applied outside the field of cancer care (). However, to our knowledge, no study has assessed the psychosocial distress in pneumoconiosis patients. Thus, in this study, we employed the DT Scale and its Problem List to assess the level of psychosocial distress among patients with pneumoconiosis and analyze its associated factors for intervention and rehabilitation treatment. The cross-sectional study was conducted between July 2022 and March 2023 in Hunan province, China. Patients with pneumoconiosis were recruited by convenience sampling in Hunan Prevention and Treatment Institute for Occupational Diseases. The inclusion criteria for participants were: (a) a clinical diagnosis certificate of pneumoconiosis (GBZ 70–2015) () (see for detailed criteria), (b) can communicate normally; (c) without receiving psychological treatment; (d) no illness of vital organs such as tumor. Written informed consent was obtained from each participant before enrollment. The study was approved by the Hunan Prevention and Treatment Institute for Occupational Diseases Ethics Committee (Approval number: LS2021122401).