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Tao X, Chen D, Fan Y, Zhang L, Shan H, Wei Y, Yu X, Zhong T, Wang L, Chung SK, Yu Y, Xiao Y. A cross-sectional study for the mental health status and sleep quality among college students in Macao during the COVID-19 pandemic. PeerJ 2021; 9:e12520. [PMID: 34966578 PMCID: PMC8663623 DOI: 10.7717/peerj.12520] [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: 08/11/2021] [Accepted: 10/29/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives The main focus of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic on the mental health condition and sleep quality of college students in Macao. In addition, the students’ behaviours during the pandemic, such as drinking alcohol, taking sleeping pills, and seeking psychological counselling were analyzed. Method A cross-sectional survey of mental health and sleep quality status, as well as the possible behavioral risk factors, was conducted among the college students of Macao in August, 2020 during the COVID-19 pandemic. An online self-report questionnaire survey method was applied to assess the general demographics and related lifestyle behaviors of students. The general mental health condition and sleep quality were evaluated through the General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Index (PSQI) questionnaires, respectively. The main statistical methods included the Chi-square test, Bonferroni correction, and Pearson correlation. Data analysis was performed using SPSS Version 24.0. Results A total of 980 students were investigated in the study, of which 977 completed the survey. During the COVID-19 pandemic period, overall college students in Macao were psychologically well adjusted and reported good quality of sleep. However, female students were in poorer psychological condition than males (P < 0.05). Moreover, the students over 20 years of age had poorer sleep quality than students aged less than or equal to 20 (P < 0.05). The significant differences were found among the students in different study majors for the mental health status and sleep quality (both P < 0.05), which were associated with certain behaviors, such as drinking alcohol, taking sleeping pills, and seeking for help in psychological counselling during the COVID-19 pandemic period. Conclusions Poor mental health status could be either the consequence or cause of sleep disturbance, which might further affected physical health. Therefore, regular assessment of mental health condition and sleep quality of college students is particularly necessary during public health emergencies, such as the COVID-19 pandemic, and appropriate intervention should be provided to the students.
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Affiliation(s)
- Xiaoyu Tao
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Dong Chen
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Yawen Fan
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Lanxin Zhang
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Houqian Shan
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Yi Wei
- School of Public Administration, Jilin University, Changchun, Jilin, China
| | - Xi Yu
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Tian Zhong
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Ling Wang
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Sookja Kim Chung
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Yaqin Yu
- Faculty of Health Sciences, Zhuhai College of Science and Technology, Zhuhai, Guangdong, China
| | - Ying Xiao
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
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Rosenberg AR, Zhou C, Bradford MC, Salsman JM, Sexton K, O’Daffer A, Yi-Frazier JP. Assessment of the Promoting Resilience in Stress Management Intervention for Adolescent and Young Adult Survivors of Cancer at 2 Years: Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2136039. [PMID: 34817581 PMCID: PMC8613597 DOI: 10.1001/jamanetworkopen.2021.36039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Adolescents and young adults (AYAs) with cancer have a high risk of poor psychosocial outcomes. The Promoting Resilience in Stress Management (PRISM) intervention is one of few psychosocial interventions targeting younger people with cancer that has demonstrated efficacy in a randomized clinical trial. OBJECTIVE To explore 2-year trajectories of patient-reported well-being among AYA cancer survivors. The hypothesis was that AYAs who initially responded to PRISM would report sustained positive changes. DESIGN, SETTING, AND PARTICIPANTS This secondary analysis of data from a single-center, parallel, phase 2 randomized clinical trial was conducted from January 2015 to October 2016. Eligible participants were English-speaking AYAs between ages 13 and 25 years with cancer treated at a single, quaternary children's hospital in the US. Participants were randomly assigned (1:1) to PRISM or usual care. Data were analyzed between March 2021 and June 2021. INTERVENTION PRISM is a brief, skills-based coaching program targeting 4 resilience resources (stress management, goal setting, cognitive reframing, and meaning making). MAIN OUTCOMES AND MEASURES Patient-reported cancer-related quality of life (QoL) (PedsQL scale), hope (Hope scale), resilience (Connor-Davidson Resilience scale), and psychological distress (Kessler-6 scale) were collected at baseline, 6, 12, and 24 months. Data from AYAs who remained alive at 24 months were analyzed. Improvement was defined as a positive change in instrument scores between baseline and 6 months (ie, the end of the PRISM program) and used linear mixed effects regression to assess changes over time. RESULTS A total of 57 AYAs were included in analysis at 24 months (62% of 92 randomized). Twenty-six participants (46%) were female; 36 (63%) were between ages 13 and 17 years; and 20 (35%) identified as part of a racial or ethnic minority group (4 [7%] Asian, 11 [19%] Hispanic or Latino, 16 [28%] mixed race or other). PRISM was associated with improved QoL, hope, resilience, and distress between baseline and 6 months, and these associations were sustained for QoL over 12 months (β = 7.4; 95% CI, 0.8 to 14; P = .03) and hope throughout the study period (12 months: β = 6.2; 95% CI, 2.7 to 9.6; P < .001; 24 months: β = 4.6; 95% CI, 1 to 8.3; P = .01). Of those whose scores improved between baseline and 6 months, PRISM participants more commonly reported sustained improvements in QoL (16 of 21 participants [76%] vs 8 of 17 [47%]), hope (14 of 24 participants [58%] vs 6 of 14 [43%]), resilience (9 of 18 participants [50%] vs 4 of 14 [29%]), and distress (14 of 19 participants [74%] vs 6 of 19 [32%]) at 24 months compared with usual care. CONCLUSIONS AND RELEVANCE These results suggest that PRISM was associated with sustained improvements in psychosocial outcomes as reported by adolescents and young adults. Those who responded to PRISM in the first 6 months reported continued well-being 2 years later. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02340884.
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Affiliation(s)
- Abby R. Rosenberg
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, Washington
- Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Miranda C. Bradford
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
- Biostatistics, Epidemiology, and Analytics in Research Program, Seattle Children’s Research Institute, Seattle, Washington
| | - John M. Salsman
- Wake Forest School of Medicine and Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, North Carolina
| | - Katie Sexton
- Department of Medical Education, University of Washington School of Medicine, Seattle
| | - Alison O’Daffer
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
| | - Joyce P. Yi-Frazier
- Palliative Care and Resilience Lab, Seattle Children’s Research Institute, Seattle, Washington
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle
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Kalisch R, Köber G, Binder H, Ahrens KF, Basten U, Chmitorz A, Choi KW, Fiebach CJ, Goldbach N, Neumann RJ, Kampa M, Kollmann B, Lieb K, Plichta MM, Reif A, Schick A, Sebastian A, Walter H, Wessa M, Yuen KSL, Tüscher O, Engen H. The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies. Front Psychol 2021; 12:710493. [PMID: 34539510 PMCID: PMC8444985 DOI: 10.3389/fpsyg.2021.710493] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time windows of inter-individually comparable stressor exposure relative to which the maintenance or recovery of mental health can be determined. To address this pertinent issue, we propose to frequently and regularly monitor stressor exposure (E) and mental health problems (P) throughout a study's observation period [Frequent Stressor and Mental Health Monitoring (FRESHMO)-paradigm]. On this basis, a subject's deviation at any single monitoring time point from the study sample's normative E-P relationship (the regression residual) can be used to calculate that subject's current mental health reactivity to stressor exposure ("stressor reactivity," SR). The SR score takes into account the individual extent of experienced adversity and is comparable between and within subjects. Individual SR time courses across monitoring time points reflect intra-individual temporal variability in SR, where periods of under-reactivity (negative SR score) are associated with accumulation of fewer mental health problems than is normal for the sample. If FRESHMO is accompanied by regular measurement of potential resilience factors, temporal changes in resilience factors can be used to predict SR time courses. An increase in a resilience factor measurement explaining a lagged decrease in SR can then be considered to index a process of adaptation to stressor exposure that promotes a resilient outcome (an allostatic resilience process). This design principle allows resilience research to move beyond merely determining baseline predictors of resilience outcomes, which cannot inform about how individuals successfully adjust and adapt when confronted with adversity. Hence, FRESHMO plus regular resilience factor monitoring incorporates a dynamic-systems perspective into resilience research.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center of Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center of Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Kira F. Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Ulrike Basten
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Andrea Chmitorz
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Faculty of Social Work, Health Care and Nursing Science, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Karmel W. Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Christian J. Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Nele Goldbach
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Rebecca J. Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Miriam Kampa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
- Department of Psychology, Bender Institute of Neuroimaging, Justus Liebig University, Gießen, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michael M. Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexandra Sebastian
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Kenneth S. L. Yuen
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Haakon Engen
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Psychology, University of Oslo, Oslo, Norway
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