Coping With Stress Strategies in HIV-infected Iranian Patients

Prevalence of anxiety, depression, and psychological distress among the general population during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic is a worldwide epidemic declared by the world health organization as a public health emergency of concern and consequently inducing huge mental health and psychological reactions.

AIMS

This study is aimed to summarize the existing data regarding anxiety, depression, and psychological distress during the covid-19 pandemic among the wider population so that effective intervention strategies will be initiated.

METHODS

Pieces of literature that assessed anxiety, depression, and psychological distress among the general population during the COVID pandemic period were systematically gathered. Data extraction in Microsoft excel was done by two independent reviewers using predefined criteria. The analysis was done using a stata-11 and random effect model. A sub-group and sensitivity analysis was done. Besides, the funnel plot and eggers publication bias test was tested.

RESULTS

Sixteen studies that assessed 78,225 participants were included. Nine studies were included in the meta-analysis for anxiety prevalence. The average prevalence of anxiety was found to be 38.12%. A sub-group analysis showed that anxiety was 33.33% in China and 47.70% in other countries (Italy, Turkey, and India). Anxiety prevalence in studies measured with the DASS-21 scale, GAD-7 scale, and other tools (SAS, HADS, and 5-point Likert scale) was 23.4%, 40.73%, and 44.47% respectively. The prevalence of anxiety in studies that assessed a sample size above 2,000 participants was 40.33%. The average prevalence of depression among included studies was 34.31% and a sub-group analysis showed that depression was higher in China (36.32%) than in other countries (28.3%). Moreover, six studies reported psychological distress and the average prevalence was 37.54%.

CONCLUSION

This study revealed that anxiety, depression, and psychological distress are potential public mental health problems of the global community that suggests the need for early recognition and initiation of interventions during the COVID-19 pandemic period.

Current Status and Associated Factors of Depression and Anxiety Among the Chinese Residents During the Period of Low Transmission of COVID-19

Background: The outbreak of coronavirus disease 2019 (COVID-19) has contributed to depression and anxiety among the general population in China. The purpose of this study is to investigate the prevalence and associated factors of these psychological problems among Chinese adults during the period of low transmission, which could reflect the long-term depression and anxiety of the COVID-19 outbreak. Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. Convenient sampling strategy was adopted to recruit participators. Participants were asked to filled out the questions that assessed questionnaire on the residents' depression and anxiety. Results: A total of 2,361 residents filled out the questionnaire. The mean age was 29.72 years (SD = 6.94) and majority of respondents were female (60.10%). Among the respondents, 421 (17.83%), 1470 (62.26%), and 470 (19.91%) were from eastern, central, and western China, respectively. 1704 (72.17%) consented COVID-19 information has been disclosed timely. 142 (6.01%) and 130 (5.51%) patients suffered from depression and anxiety symptoms. Furthermore, some influencing factors were found, including marital status, place of residence, employment status. Conclusion: This study revealed that anxiety and depression still are potential depression and anxiety for some residents, which suggested early recognition and initiation of interventions during the period of low transmission is still indispensable.

The Role of Socio-demographics in Adoption of Religious-Spiritual and Other Coping Strategies Among Muslim Chronic Patients with Hepatitis C in Pakistan

Coping has emerged as a vital indicator among patients in the chronic conditions. The current study examined the role of demographic characteristics (such as age, education, gender, marital status, residential background, family type and number of children) in adoption of coping (emotion-focused, problem-solving, religious-spiritual) strategies for nursing among hepatitis patients. A sample of 500 patients (of hepatitis C) was drawn from five most populous districts (Lahore, Faisalabad, Rawalpindi, Gujranwala and Multan) of Punjab, Pakistan, by using Epi Info software with an alpha level of 0.03. The data were collected using a well-structured multi-sectional interview schedule through multistage proportionate sampling technique. Descriptive analysis, regression analysis and reliability analysis were computed using SPSS (version 21.0). In the overall adoption of coping strategies, lower monthly household income, lower education, rural residences, nuclear family setting and married status were contributing to the adoption of higher coping strategies among Muslim chronic patients with hepatitis C. The results of socio-demographics are also discussed with other coping strategies (such as religious-spiritual coping strategies, problem-solving coping strategies, emotion-focused coping strategies and constructive coping strategies). It was the first quantitative study of adoption of coping strategies among Muslim hepatitis patients in Pakistan. The study highlighted the importance of socio-demographic resources to cope with chronic illness. The empirical findings would start a new discussion from hepatic, counseling and nursing perspective. For terminal patients, these socio-demographic characteristics can serve as a guideline to provide community sources of social support. Medical social workers and healthcare experts need to facilitate the efforts of patients to cope with chronic illness through revision of nursing policy according to the socio-demographic and spiritual-religious needs of the patients.

A More Understanding about AIDS: Design and Assessment of Validity and Reliability of Several New Scales

Introduction: Given the high cost of AIDS, research on high-risk behaviors associated with AIDS is an essential requirement today. Therefore, the present study aimed to construct and standardize tests associated with AIDS-related risky behaviors. Methods: To assess the validity of the questionnaires, the experts' viewpoints from different domains were qualitatively and quantitatively included. Additionally, to assess the reliability of the questionnaires, a sample of 31 subjects was selected and then examined on two separate occasions in a fortnight's time. Then, the validity and reliability of the instruments were assessed in a sample of 475 subjects. Results: The results of exploratory factor analysis showed that for AIDS health literacy and AIDS risk perception questionnaires two factors are extractable; while for the questionnaires of self-efficacy in controlling risk behavior and controlling risk behavior associated with AIDS one factor is extractable. Finally, 14 items were approved for each of the AIDS health literacy and self-efficacy in controlling risk behavior questionnaires; while 13 items were approved for each of the controlling risk behavior associated with AIDS and AIDS risk perception questionnaires. Each of the four questionnaires had a good internal consistency (Cronbach's Alpha > 0.70). Interclass Correlation Coefficient (ICC) amounts related to the test-retest reliability were greater than 0.80, which indicates the reliability of the instruments. Conclusion: According to the results of the present study, it was concluded that all four AIDS-related questionnaires enjoyed acceptable validity and reliability.

Depression and Coping Are Associated with Failure of Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS

Sustained adherence to antiretroviral therapy (ART) is critical in the prevention of drug resistance, disease progression, and death. We aimed to assess the level of ART adherence among 112 people living with HIV/AIDS (PLWHA) and to determine associated factors with that. The socioeconomic aspects were evaluated by medical records; the adherence, depression, and coping by specific questionnaires. Although most patients have undetectable viral load (79%) and CD4⁺ T count >500 cells/mm³ (65%), two-third (66%) of them exhibited a lower adherence, which was directly associated with some signs of depression (p = .006) presented by 65% of them. Some risk factors to presence of depression were female gender (p = .008) and low income (p = .013). In addition, most participants who reported tobacco (33%) and alcohol (29%) consumption had a low or intermediate adherence score. Among the coping strategies, self-control (p = .029), social support (p = .006), problem solving (p = .013), and positive reappraisal (p = .049) led to an improvement in adherence.

Psychometric Properties of the Iranian Brief Version of the Transtheoretical Model Instrument in Terms of Hookah Tobacco Smoking Cessation

Background

Transtheoretical model (TTM) has been recognized as a common theoretical model in researches in terms of addictive behaviors. The aim of this study was to examine the psychometric properties of the Persian brief version of the TTM for hookah tobacco smoking cessation in a sample of Iranian rural adults who were in the preparation stage for hookah cessation.

Methods

This was a validation study on Iranian rural adult hookah smokers by the TTM instrument. First, to translate the questionnaire items from English to Persian, backward-forward procedure was used. Face and content validity of the instrument items were assessed. Confirmatory factor analysis (CFA) was performed to determine the construct validity of the instrument. For this aim, 300 participants completed the instrument. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were calculated to examine the internal consistency and reliability of the subscales of the instrument.

Findings

The content validity index (CVI) and content validity ratio (CVR) of the items were ≥ 0.80 and ≥ 0.60, respectively. Based on CFA, the data fitted the TTM model. root mean square error of approximation (RMSEA), the goodness of fit index (GFI), adjusted GFI, and comparative fit index (CFI) were 0.037, 0.960, 0.910, and 0.950, respectively. At this stage, 6 items were deleted. The ICC and Cronbach's alpha of the subscales ranged between 0.60-0.74 and 0.71-0.86, respectively. The final instrument with 29 items was confirmed.

Conclusion

The findings suggest that translating Persian brief version of the TTM instrument was a reliable and valid tool to identify the determinants of hookah smoking cessation among Iranian rural adults.

Spiritual care may impact mental health and medication adherence in HIV+ populations

OBJECTIVE

To explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations.

METHOD

A systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS), major depressive disorder (MDD) incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale.

RESULTS

The literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion) was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005) and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of illness, the role or need for medications, coping, and medication adherence. An illustrative model was designed based on the literature and data collection.

CONCLUSION

Spiritual assessment may help identify positive or negative influence on health. Spiritual interventions could be beneficial in promoting adherence and positive health outcomes. Further research is recommended.

The role of individual and personality factors in controlling risky behaviours related to AIDS: Proposing a causal model

BACKGROUND

Investigating previous studies show that personality traits have an important role in controlling risky behaviours related to AIDS; therefore, the aim of this study is to investigate the relationship between AIDS health literacy, personality traits and mental health and controlling risky behaviours related to AIDS through self-efficacy.

METHODS

The statistical population includes all the young people in western provinces of Iran, 2015. Data analysis was carried out for a sample of 756 participants (59% female).

RESULTS

The results show that except for the socializing trait, all the other variables are related to controlling risky behaviours. In addition, variables of health literacy related to AIDS, mental health, activity, impulsive sensation seeking and hostility have a direct relation to controlling risky behaviours. Also, the predicting behaviours can predict 62% of the variance in controlling risky behaviours related to AIDS. The analysis results show that health literacy has an indirect impact on controlling risky behaviours through self-efficacy. In other words, health literacy related to AIDS leads to controlling risky behaviours when self-efficacy is high for controlling risky behaviours.

CONCLUSION

Based on the results, it is recommended that the role of self-efficacy in controlling risky behaviours be considered as a strategy for preventing AIDS. Copyright © 2016 John Wiley & Sons, Ltd.