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Miskovic-Wheatley J, Schlage J, Pehlivan MJ, Simone R, Koreshe E, Hunt C, Maguire S. Skills-based online self-help program for carers of people with an eating disorder (SupportED): A case series evaluation. Int J Eat Disord 2024; 57:423-436. [PMID: 38149436 DOI: 10.1002/eat.24112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To investigate the acceptability, feasibility, and preliminary effectiveness of "SupportED," a novel, online, self-paced skills-based program for carers/support people of those with lived and/or living experience of an eating disorder (ED). METHOD Carers of a loved one with an ED were invited to undertake a five-module skills-based (one core module, four optional modules) online program at their own pace. Modules cover general information about EDs, communication, practical skills, treatment engagement, and recovery. Participants completed demographics and were assessed using EDSIS, CASK, and DASS-21 for caregiver burden, skills, and distress, respectively, at program completion and 3-month follow-up. Feedback on the program and modules was also collected. RESULTS Most carers (65%; 82/126) completed the core module of the program, which is on par with other online learning programs. Nearly half of program completers responded to the 3-month follow-up (n = 39). On average, carers rated the program as relevant and useful and found the information validating and easy to understand, albeit a few carers found the program time-consuming and technically challenging. Intent-to-treat (ITT) linear mixed models demonstrated the preliminary effectiveness of the program for improving carer burden and skills, although the change in carer distress was non-significant. CONCLUSIONS Results of this case series evaluation suggest SupportED is an acceptable and feasible program for carers and may improve burden and support skill development. Although the online, self-paced format was highly rated, small improvements to improve acceptability were suggested. Reasons for a lack of impact on carer distress are discussed. PUBLIC SIGNIFICANCE This article describes a case series evaluation of "SupportED," an online skills-based support program for families, carers, and supporters of people with lived experience of an eating disorder. This is the first online carer support program that is designed to be inclusive of all carer types (e.g., partners, siblings) for all eating disorder presentations. Findings suggest the program's suitability and helpfulness for reducing carers' load and bolstering skills and knowledge.
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Affiliation(s)
- Jane Miskovic-Wheatley
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jasmin Schlage
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Melissa J Pehlivan
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rachel Simone
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Eyza Koreshe
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Caroline Hunt
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Maguire
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
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2
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Rodríguez Guarin M, Gempeler Rueda J, Castro SM, Ospina MM, Villanueva Betancourth C, Amórtegui JP, Vázquez L. Feasibility and acceptability of comprehensive virtual treatment in eating disorders: perspectives from patients, parents and therapists during the COVID-19 pandemic. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:337-344. [PMID: 38008675 DOI: 10.1016/j.rcpeng.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 07/13/2021] [Indexed: 11/28/2023]
Abstract
BACKGROUND Lockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). OBJECTIVE To evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. METHODS Fourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. RESULTS Virtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. CONCLUSIONS Adaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.
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Affiliation(s)
| | - Juanita Gempeler Rueda
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | - Sergio Mario Castro
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | - María Mercedes Ospina
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | | | - Juan Pablo Amórtegui
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
| | - Laura Vázquez
- Programa Equilibrio Para Trastornos Alimentarios, Afectivos y de Ansiedad, Bogotá, Colombia
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Khader Y, Yang X, Pan Z, Fan Y, Chen Y, Yu X, Zhou L. The Usability, Feasibility, Acceptability, and Efficacy of Digital Mental Health Services in the COVID-19 Pandemic: Scoping Review, Systematic Review, and Meta-analysis. JMIR Public Health Surveill 2023; 9:e43730. [PMID: 36634261 PMCID: PMC9930923 DOI: 10.2196/43730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND After the rapid spread of the novel SARS-CoV-2, the short-term and long-term mental health impacts of the pandemic on the public, in particular on susceptible individuals, have been reported worldwide. Although digital mental health services expand accessibility while removing many barriers to in-person therapy, their usability, feasibility, acceptability, and efficacy require continued monitoring during the initial phase of the pandemic and its aftermath. OBJECTIVE In this study, we aimed to understand what mental health services are offered, whether they are practical or acceptable, and to what extent digital mental health services are effective in response to the COVID-19 pandemic across high-income and low- and middle-income countries. METHODS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guideline. We implemented searches in PubMed (MEDLINE), Embase, PsycINFO, and Cochrane databases for studies that were published between December 2019 and November 2021 and that involved the use of digital mental health services. Two review authors screened, assessed, and extracted studies independently. The protocol was registered on the International Prospective Register of Systematic Reviews. RESULTS This review identified 7506 articles through database searching. In total, 65 (0.9%) studies from 18 countries with 67,884 participants were eligible for the scoping review. Of the 65 studies, 16 (24.6%) were included in the meta-analysis. A total of 15 (23.1%) studies measured the usability; 31 (47.7%) studies evaluated the feasibility; 29 (44.6%) studies assessed the acceptability; and 51 (78.5%) studies assessed the efficacy. Web-based programs (21/65, 32.3%), videoconferencing platforms (16/65, 24.6%), smartphone apps (14/65, 21.5%), and SMS text messaging (5/65, 7.7%) were the main techniques. Psychotherapy (44/65, 67.7%) followed by psychoeducation (6/65, 9.2%) and psychological support (5/65, 7.7%) were commonly used. The results of the meta-analysis showed that digital mental health interventions were associated with a small reduction in depressive symptoms (standardized mean difference=-0.49; 95% CI -0.74 to -0.24; P<.001) and a moderate reduction in anxiety symptoms (standardized mean difference=-0.66; 95% CI -1.23 to -1.0; P=.02) significantly. CONCLUSIONS The findings suggest that digital mental health interventions may be practical and helpful for the general population, at-risk individuals, and patients with preexisting mental disorders across high-income and middle-income countries. An expanded research agenda is needed to apply different strategies for addressing diverse psychological needs and develop integrated mental health services in the post-COVID-19 era. TRIAL REGISTRATION PROSPERO CRD42022307695; https://tinyurl.com/2jcuwjym.
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Affiliation(s)
- Yousef Khader
- The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhouChina
| | - Xinhu Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zihua Pan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Fan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanan Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin Yu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Vus V, Nakanishi Y, da Silva GTB. MAPPING MENTAL HEALTH INTERVENTIONS DURING THE COVID-19 PANDEMIC. A COMPARISON REVIEW OF CHINA AND WESTERN EUROPE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1819-1826. [PMID: 36089863 DOI: 10.36740/wlek202208102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: To map and compare mental health interventions during the Covid-19 pandemic in China and Western-Europe. The focus was specifically on the availability, duration, target group, content, setting, and outcomes of the interventions. PATIENTS AND METHODS Materials and methods: A scoping review was conducted by utilising several scientific databases. A total of 479 articles were found after removing the duplicate records. After screening, 36 articles were included in the study. Relevant intervention characteristics were systematically mapped, and compared within and among countries. CONCLUSION Conclusions: All interventions had shared aims to improve the psychological resilience and to reduce psychological distress. In particular, anxiety- and depression-related symptoms were commonly addressed. On average, interventions in China were larger scaled, had longer durations, and often used combinations of strategies such as therapies and exercises both in-person and remotely. Interventions in Western-Europe tend to be locally implemented on a smaller scale, and often used a single strategy. Most Chinese interventions targeted adolescents, while all interventions in Western-Europe were meant for adults. Most interventions were assessed using quantitative methods using various mental health scales, showing statistically significant effects in improving mental health.
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Affiliation(s)
- Viktor Vus
- INTERNATIONAL PLATFORM ON MENTAL HEALTH, INSTITUTE FOR SOCIAL AND POLITICAL PSYCHOLOGY NAES OF UKRAINE, KYIV, UKRAINE
| | - Yol Nakanishi
- ATHENA INSTITUTE, VRIJE UNIVERSITEIT, AMSTERDAM, THE NETHERLANDS
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Linardon J, Messer M, Rodgers RF, Fuller‐Tyszkiewicz M. A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field. Int J Eat Disord 2022; 55:3-38. [PMID: 34773665 PMCID: PMC8646470 DOI: 10.1002/eat.23640] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Research investigating the effects of COVID-19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature. METHOD Empirical research on COVID-19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings (n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID-19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic-related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID-19. RESULTS Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during-and due to-the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at-risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID-19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective. DISCUSSION Evidence for COVID-19 effects is mostly limited to participant self-report or retrospective recall, cross-sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.
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Affiliation(s)
- Jake Linardon
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
| | - Mariel Messer
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Rachel F. Rodgers
- APPEAR, Department of Applied PsychologyNortheastern UniversityBostonMassachusettsUSA,Department of Psychiatric Emergency & Acute CareLapeyronie Hospital, CHRU MontpellierMontpellierFrance,Department of PsychologySapienza University of RomeRomeItaly
| | - Matthew Fuller‐Tyszkiewicz
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
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Dellafiore F, Arrigoni C, Nania T, Caruso R, Baroni I, Vangone I, Russo S, Barello S. The impact of COVID-19 pandemic on family caregivers' mental health: a rapid systematic review of the current evidence. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022154. [PMID: 35545977 PMCID: PMC9534216 DOI: 10.23750/abm.v93is2.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Older adults, especially in isolation and with cognitive decline/dementia, can become more anxious and stressed during the quarantine. All these symptoms negatively affect the psycho-physical health of their caregivers. This study aimed to synthesize the current evidence on the impact of the COVID-19 pandemic on caregivers' mental health. METHODS A rapid systematic review was conducted using the following databases: Pubmed/Medline, CINAHL, Scopus, and PsycInfo (PROSPERO registration number: CRD42020215485). The 'PRISMA' flow chart guided the selection of articles. The search was entirely performed up to September 15th, 2021. RESULTS The narrative synthesis has brought out two main themes that represent the current debate in literature: "Family caregivers COVID-19 related stress", and "(Mal)adaptive strategies to the "new" normality". CONCLUSIONS This study provides an evidence synthesis of the negative mental health impact experienced by caregivers of older adults during the COVID-19 pandemic.
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Affiliation(s)
- Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato (MI), Department of Psychology, EngageMinds HUB – Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato (MI)
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato (MI)
| | - Ida Vangone
- Department of Oncology and Hematology-Oncology, IEO IEO-European Institute of Oncology, Milan, Italy
| | - Sara Russo
- Nursing degree course, University of Pavia, section Istituti Clinici di Pavia e Vigevano S.p.A., Pavia, Italy
| | - Serena Barello
- Department of Psychology, EngageMinds HUB – Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
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Maunder K, McNicholas F. Exploring carer burden amongst those caring for a child or adolescent with an eating disorder during COVID-19. J Eat Disord 2021; 9:124. [PMID: 34602093 PMCID: PMC8487672 DOI: 10.1186/s40337-021-00485-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Carer burden amongst carers of youth with an eating disorder is substantial and if not addressed can lead to negative outcomes for the patient, carer and family. The Coronavirus Disease 2019 (COVID-19) pandemic has made caring for youth with an ED even more onerous and preliminary research is beginning to emerge demonstrating the profound negative impact the pandemic is having upon individuals with EDs and their carers. MAIN: In this review, we briefly summarize what is known about carer burden in families where a young person has an ED, consider the additional impact consequent to COVID-19 and highlight the need for interventions aimed at alleviating this. Pre-COVID-19 research identifies high levels of psychological and physical strain amongst those caring for a child with an ED. Themes are beginning to emerge as to why COVID-19 may further exacerbate carer burden: (1) reduced access to ED services; (2) increased physical vulnerability and exacerbation of psychiatric co-morbidity amongst youth with EDs; (3) increased practical demands placed on carers; and (4) social isolation and decreased social support. CONCLUSION The COVID-19 pandemic poses a specific threat to the mental health of youth with EDs and their carers. Given the salient role families play in caring for youth with an ED, attending to carer burden is imperative. Supporting carers through all phases of their child's ED journey by offering adaptive and flexible supportive services which accommodate time constraints, geographic barriers and possible COVID-19 spread is essential.
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Affiliation(s)
- Kristen Maunder
- School of Medicine and Medical Science, University College Dublin, Dublin 4, Belfield, Republic of Ireland. .,Department of Child and Adolescent Psychiatry, Our Lady's Children's Hospital Crumlin, Dublin 12, Crumlin, Republic of Ireland.
| | - Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Dublin 4, Belfield, Republic of Ireland.,Department of Child and Adolescent Psychiatry, Our Lady's Children's Hospital Crumlin, Dublin 12, Crumlin, Republic of Ireland.,Lucena Clinic Services, Rathgar, Rathfarnham, Dublin 6, Republic of Ireland
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Rodríguez Guarin M, Gempeler Rueda J, Castro SM, Ospina MM, Villanueva Betancourth C, Amórtegui JP, Vázquez L. Feasibility and Acceptability of Comprehensive Virtual Treatment in Eating Disorders: Perspectives from Patients, Parents and Therapists During the COVID-19 Pandemic. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00145-1. [PMID: 34561106 PMCID: PMC8455243 DOI: 10.1016/j.rcp.2021.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 06/26/2021] [Accepted: 07/13/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Lockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). OBJECTIVE To evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. METHODS Fourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. RESULTS Virtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. CONCLUSIONS Adaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.
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Affiliation(s)
| | - Juanita Gempeler Rueda
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | - Sergio Mario Castro
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | - María Mercedes Ospina
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | | | - Juan Pablo Amórtegui
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
| | - Laura Vázquez
- Programa Equilibrio para trastornos alimentarios, afectivos y de ansiedad, Bogotá, Colombia
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9
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Bertuzzi V, Semonella M, Bruno D, Manna C, Edbrook-Childs J, Giusti EM, Castelnuovo G, Pietrabissa G. Psychological Support Interventions for Healthcare Providers and Informal Caregivers during the COVID-19 Pandemic: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136939. [PMID: 34203529 PMCID: PMC8297206 DOI: 10.3390/ijerph18136939] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
Background: During the COVID-19 pandemic, healthcare providers and informal caregivers were at an increased risk of adverse mental health effects. This systematic review provides a summary of the available evidence on the content and efficacy of the psychological support interventions in increasing mental health among healthcare providers and informal caregivers during the COVID-19 pandemic. Methods: PubMed, Google Scholar, PsychINFO, and Scopus databases were systematically searched for relevant articles, and the methodological quality of selected articles was assessed using the Quality Assessment Tool for Quantitative Studies. Results: A search of electronic databases identified five reports based on inclusion and exclusion criteria. All psychological support interventions for caregivers were delivered digitally. Despite the large heterogeneity of the selected studies, the findings support the efficacy of mental health interventions in reducing distress and burnout, while promoting self-efficacy and well-being in both healthcare providers and informal caregivers. Conclusion: Since mental health problems are expected to increase during, and as a result of, the COVID-19 pandemic, and digital tools might offer a range of mental health treatments to meet the unique and immediate needs of people, further research is needed to test the cost-effectiveness of digital psychological interventions.
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Affiliation(s)
- Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
| | | | - Denise Bruno
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
| | - Chiara Manna
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
| | - Julian Edbrook-Childs
- Evidence-Based Practices Unit, University College London and Anna Freud National Centre for Children and Families, London N1 6EB, UK;
| | - Emanuele M. Giusti
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy
- Correspondence: (E.M.G.); (G.P.)
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy
- Correspondence: (E.M.G.); (G.P.)
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Dumitrașcu MC, Șandru F, Carsote M, Petca RC, Gheorghisan-Galateanu AA, Petca A, Valea A. Anorexia nervosa: COVID-19 pandemic period (Review). Exp Ther Med 2021; 22:804. [PMID: 34093760 DOI: 10.3892/etm.2021.10236] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/16/2021] [Indexed: 12/14/2022] Open
Abstract
Anorexia nervosa is an eating disorder characterized by restrictive eating and an intense fear of gaining weight. It is a disease with an increasing incidence during the last few decades, and represents a complex psychiatric condition which includes secondary amenorrhea, nutritional and metabolic damage, and impaired endocrine panel up to bone loss as well as cardiac, gastrointestinal and hematological complications. This is a narrative review which includes an update on this eating disorder from the perspective of an endocrine panel of anomalies, especially of the skeleton, considering the pressure of the recent global COVID-19 pandemic changes. Practically affecting every organ, anorexia nervosa needs to be taken into consideration during the pandemic period because of the higher risk of relapse due to new living conditions, social distancing, self-isolation, changes in food access, more intense use of social media platforms, disruption of daily habits, and more difficult access to healthcare practitioners. The lack of physical activity in addition to vitamin D deficiency related to low sun exposure or to the use of facial masks may also be connected to further bone damage related to this disease.
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Affiliation(s)
- Mihai Cristian Dumitrașcu
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Obstetrics and Gynecology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Florica Șandru
- Department of Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.,Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mara Carsote
- Department of Endocrinology, 'C. I. Parhon' National Institute of Endocrinology, 011863 Bucharest, Romania.,Department of Endocrinology 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Razvan Cosmin Petca
- Department of Urology, 'Prof. Dr. Th. Burghele' Clinical Hospital, 050659 Bucharest, Romania.,Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ancuta Augustina Gheorghisan-Galateanu
- Department of Endocrinology, 'C. I. Parhon' National Institute of Endocrinology, 011863 Bucharest, Romania.,Department of Molecular and Cellular Biology, and Histology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Aida Petca
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Obstetrics and Gynecology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania
| | - Ana Valea
- Department of Endocrinology, Clinical County Hospital, 400000 Cluj-Napoca, Romania.,Department of Endocrinology, 'I. Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Si MY, Xiao WJ, Pan C, Wang H, Huang YM, Lian J, Mak WWS, Leng ZW, Su XY, Tang QP, Jiang Y, Feng LZ, Yang WZ, Wang C. Mindfulness-based online intervention on mental health and quality of life among COVID-19 patients in China: an intervention design. Infect Dis Poverty 2021; 10:69. [PMID: 34001277 PMCID: PMC8127244 DOI: 10.1186/s40249-021-00836-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder (PTSD), depression, and anxiety among patients with COVID-19. Based on the previous mindfulness-based interventions proved to be effective, this protocol reports a design of a randomized controlled trial aiming to explore the efficacy and possible mechanism of a mindful living with challenge (MLWC) intervention developed for COVID-19 survivors in alleviating their psychological problems caused by both the disease and the pandemic. METHODS In April 2021, more than 1600 eligible participants from Hubei Province of China will be assigned 1:1 to an online MLWC intervention group or a waitlist control group. All participants will be asked to complete online questionnaires at baseline, post-program, and 3-month follow-up. The differences of mental health status (e.g. PTSD) and physical symptoms including fatigue and sleeplessness between the COVID-19 survivors who receiving the online MLWC intervention and the control group will be assessed. In addition, the possible mediators and moderators of the link between the MLWC intervention and target outcomes will be evaluated by related verified scales, such as the Five Facets Mindfulness Questionnaire. Data will be analyzed based on an intention-to-treat approach, and SPSS software will be used to perform statistical analysis. DISCUSSION The efficacy and potential mechanism of MLWC intervention in improving the quality of life and psychological status of COVID-19 survivors in China are expected to be reported. Findings from this study will shed light on a novel and feasible model in improving the psychological well-being of people during such public health emergencies. Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000037524; Registered on August 29, 2020, http://www.chictr.org.cn/showproj.aspx?proj=60034 .
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Affiliation(s)
- Ming-Yu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Wei-Jun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Chen Pan
- Department of Clinical Psychology, The Third Xiangya Hospital of Central South University, No. 138 Tongzipo Road, Yuelu, Changsha, Hunan, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Yi-Man Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Jun Lian
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Winnie W S Mak
- Diversity and Well-Being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | - Zhi-Wei Leng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Xiao-You Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China.
| | - Qiu-Ping Tang
- Department of Clinical Psychology, The Third Xiangya Hospital of Central South University, No. 138 Tongzipo Road, Yuelu, Changsha, Hunan, China.
| | - Yu Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Lu-Zhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China.
| | - Wei-Zhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China
| | - Chen Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 DongDanSanTiao, Dongcheng, Beijing, China.,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
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12
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Zeiler M, Wittek T, Kahlenberg L, Gröbner EM, Nitsch M, Wagner G, Truttmann S, Krauss H, Waldherr K, Karwautz A. Impact of COVID-19 Confinement on Adolescent Patients with Anorexia Nervosa: A Qualitative Interview Study Involving Adolescents and Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4251. [PMID: 33923791 PMCID: PMC8074137 DOI: 10.3390/ijerph18084251] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 12/19/2022]
Abstract
COVID-19-related restrictions may have a serious impact on patients with eating disorders. We conducted semistructured interviews with female adolescent patients with anorexia nervosa (AN) (n = 13, 13-18 years) currently receiving inpatient or outpatient treatment and their parents (n = 10). We asked for their experiences during COVID-19 confinement regarding everyday life, AN symptoms, and treatment. We used thematic analysis to interpret the data. The main themes identified from the patients' interviews involved restrictions of personal freedom (i.e., leading to tension between patients and family members, reduced motivation to work on recovery), interruption of the treatment routine (emerging risks through self-monitored weight, challenges/opportunities of teletherapy), changes in AN symptoms (more exposure to triggering situations), COVID-19-related fears, and compulsions but also potential opportunities (less stress, better family relationships). The parents discussed changes in daily routines as negative (challenges in maintaining day structures) and positive (more family time, "slowing down"). They expressed reservations about reduced outpatient monitoring and increased teletherapy and discussed challenges in keeping contact with the child and clinicians during inpatient treatment. Moreover, the parents discussed deteriorations and improvements in the patients' psychopathology. Clinical implications from these in-depth insights include the importance of strengthening communication between changing staff cohorts, patients, and parents; motivational work; and joint weight monitoring with the therapist.
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Affiliation(s)
- Michael Zeiler
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Tanja Wittek
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Leonie Kahlenberg
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Eva-Maria Gröbner
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Martina Nitsch
- Department for Research and Development, Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, 2700 Wiener Neustadt, Austria; (M.N.); (K.W.)
| | - Gudrun Wagner
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Stefanie Truttmann
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Helene Krauss
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
| | - Karin Waldherr
- Department for Research and Development, Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, 2700 Wiener Neustadt, Austria; (M.N.); (K.W.)
| | - Andreas Karwautz
- Eating Disorder Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (T.W.); (L.K.); (E.-M.G.); (G.W.); (S.T.); (H.K.); (A.K.)
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13
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Yaffa S, Adi EL, Itai P, Marit JM, Doron G, Daniel S. Treatment of eating disorders in adolescents during the COVID-19 pandemic: a case series. J Eat Disord 2021; 9:17. [PMID: 33568207 PMCID: PMC7874990 DOI: 10.1186/s40337-021-00374-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are among the most difficult psychiatric disorders to treat in normal conditions. They are likely even more difficult to manage in at-risk conditions such as the COVID-19 pandemic. Currently there is limited evidence about the particular needs and recommended treatment of adolescents with EDs during the COVID-19 outbreak, in particular regarding the use of telemedicine and the involvement of the family in long distance-treatment. AIMS We sought to discuss the advantages and problems associated with the use of multi-professional long-distance telemedicine treatment in the management of adolescents with EDs and their families during the COVID-19 outbreak. METHODS We gathered data about the treatment of adolescents with EDs in our pediatric ED-treatment center in Israel during the COVID-19 outbreak in the first 10 months of 2020, and compared it to the respective period in the past five years (2015-2019). Second, we described the management of four young females with anorexia nervosa (AN), treated in the ambulatory, daycare and inpatient facilities of our center during the COVID-19 pandemic. FINDINGS Slightly less patients were treated in our center during the COVID-19 pandemic than in the respective period in the past five years. These patients received at that time considerably more treatment sessions from all treatment providers (psychiatrists, clinical nutritionists and psychotherapists). This was related, in part, to the extensive use of telemedicine during that period (more than as third of all sessions were carried out with telemedicine in comparison to no use of long-distance treatment in the previous years). The condition of the four adolescents with AN was compromised at the start of the COVID-19 quarantine. The use of multi-disciplinary long-distance telemedicine treatment resulted in an improvement in the condition in three of the four adolescents, living in well-organized families, with the motivation and ability to adjust to the new conditions, but not in one adolescent whose family experienced more problems. These families might require the use of face-to-face interventions even during pandemic conditions. CONCLUSION The choice of the mode of treatment for adolescents with EDs during pandemic times (telemedicine vs. face-to-face) should consider the functioning of the family.
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Affiliation(s)
- Serur Yaffa
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Enoch-Levy Adi
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Pessach Itai
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Joffe-Milstein Marit
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Gothelf Doron
- Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Stein Daniel
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.
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14
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Guo L, Wu M, Zhu Z, Zhang L, Peng S, Li W, Chen H, Fernández-Aranda F, Chen J. Effectiveness and influencing factors of online education for caregivers of patients with eating disorders during COVID-19 pandemic in China. EUROPEAN EATING DISORDERS REVIEW 2020; 28:816-825. [PMID: 32852142 PMCID: PMC7461399 DOI: 10.1002/erv.2783] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022]
Abstract
Objective The goals were twofold: To estimate the depression and anxiety levels among caregivers of patients with eating disorders (ED) in China during the COVID‐19 pandemic when compared with a control group, and to assess whether an online education program was effective in decreasing the anxiety and depression of the caregivers of patients with ED, and associated factors. Method Caregivers of patients with ED (n = 254) and a comparison group of non‐ED caregivers (N = 254) were recruited at baseline. Additionally, caregivers of patients with ED were invited into a free 4‐week online education program, with an additional online group as support. Depression and anxiety levels were assessed at baseline and after the intervention. Results Caregivers of patients with ED showed significantly higher levels of depression and anxiety than the comparison group of non‐ED caregivers. The online education program showed no significant effect on decreasing depression and anxiety levels of caregivers of patients with ED overall. Caregivers who had older loved ones and not living with them were more likely to decrease their depression levels. Caregivers of patients with longer illness duration were less likely to decrease their anxiety levels. Discussion These results showed that caregivers of ED patients suffered more serious psychological distress during the pandemic. A more structured and intensive online intervention with a limited number of participants might be required to address caregivers' distress in post‐COVID‐19 China.
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Affiliation(s)
- Lei Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengting Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhuoying Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sufang Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Han Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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