Community integration, self-esteem, and perceived stigma in a Nigerian sample with epilepsy

Insomnia and anxiety among COVID-19 patients in China: the chain mediating effect of psychological capital and self-esteem

BACKGROUND

The outbreak of Corona Virus Disease (COVID-19) in 2019 has continued until now, posing a huge threat to the public's physical and mental health, resulting in different degrees of mental health problems. As a vulnerable segment of the public, anxiety is one of the most common mental health problems among COVID-19 patients. Excessive anxiety aggravates the physical and psychological symptoms of COVID-19 patients, which is detrimental to their treatment and recovery, increases financial expenditure, affects family relations, and adds to the medical burden.

OBJECTIVE

This study aimed to explore the role of psychological capital and self-esteem in the relationship between insomnia and anxiety, thereby shedding light on the mechanism of the effect of insomnia on anxiety in COVID-19 patients.

METHODS

A cross-sectional study was conducted from April to May 2022 in Fangcang hospital in Shanghai, China. The self-administered questionnaires were distributed to 718 COVID-19 patients via cell phone using the Internet platform "Questionnaire Star", which included Athens Insomnia Scale, Psychological Capital Questionnaire, Self-esteem Scale, Self-Rating Anxiety Scale, gender, age, marital status, education. Data analysis was performed using descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analysis, ordinary least-squares regression, and bootstrap method.

RESULTS

Education background had significant impact on anxiety in COVID-19 patients (F = 7.70, P < 0.001). Insomnia, psychological capital, self-esteem and anxiety were significantly correlated, respectively (P < 0.001). And Regression analysis showed that insomnia had a direct negative predictive effect on psychological capital (β = -0.70, P < 0.001) and self-esteem (β = -0.13, P < 0.001). Psychological capital had a direct positive predictive effect on self-esteem (β = 0.12, P < 0.001). Insomnia had a direct positive predictive effect on anxiety (β = 0.61, P < 0.001). Both psychological capital and self-esteem had significant negative predictive effects on anxiety (β = -0.06, P < 0.05; β = -0.72, P < 0.001). The results showed that the mediating effect of psychological capital and self-esteem was significant, and the mediating effect value was 0.21. First, the indirect effect consisting of insomnia - psychological capital - anxiety was 0.04, showing that psychological capital had a significant mediating effect. Second, the indirect effect consisting of insomnia-self-esteem-anxiety had a value of 0.10, indicating that self-esteem had a significant mediating effect. Third, the indirect effect consisting of insomnia-psychological capital-self-esteem-anxiety had a value of 0.06, suggesting that psychological capital and self-esteem had a significant chain mediating effect between insomnia and anxiety.

CONCLUSIONS

Insomnia had a significant positive predictive effect on anxiety. Insomnia was first associated with a decrease in psychological capital, followed by a sequential decrease in self-esteem, which in turn was associated with increased anxiety symptoms in COVID-19 patients. Therefore, focusing on improving the psychological capital and self-esteem of patients can help alleviate the anxiety caused by insomnia in COVID-19 patients. It is recommended that patients and health care professionals increase the psychological capital and Self-esteem of COVID-19 patients through various methods to counter the effects of insomnia on anxiety.

Validity and reliability of the Chinese version of the epilepsy stigma scale

OBJECTIVE

This study was conducted to test the validity and reliability of the Chinese version of the epilepsy stigma scale (ESS), which aims to better understand the stigma of patients with epilepsy (PWEs), lays the foundation for future investigation and explores appropriate strategies to mitigate PWEs' stigma in Chinese culture.

METHODS

The scale was translated following standard procedures. For psychometric validation, the Chinese version of the ESS was administered to 214 PWEs above the age of 16 who were diagnosed with epilepsy by two trained epileptologists and were taking anti-seizure drugs for at least a month. All of the patients were recruited from Xiangya Hospital of Central South University of China from August 2021 to September 2021.

RESULTS

The Cronbach's alpha coefficient was 0.893 for the entire scale, 0.903 for felt stigma, and 0.688 for enacted stigma. Exploratory and confirmatory factor analyses were conducted and showed that the scale was grouped under two dimensions, and the results of confirmatory factor analysis support the structure.

CONCLUSION

The Chinese version of the ESS is a valid and reliable tool to assess epilepsy-related stigma in Chinese culture.

Validation of an iCare Health Monitor smartphone application in the assessment of vital signs among stroke survivors in a poor-resource country

Background

Frequent and accurate monitoring of blood pressure (BP) is a vital part of stroke management. There is therefore the need for availability of simple, portable and accurate devices for monitoring BP at any point in time.

Objective

To determine the validity and reliability of the iCare Health Monitor (iCHM) smartphone application in the measurement of BP, heart rate (HR) and respiratory rate (RR) amongst stroke survivors in Anambra State.

Methods

This was a cross-sectional survey involving 86 stroke survivors (64.0% males; mean age = 65.23 ± 12.10 years) consecutively recruited from three conveniently selected centres in Anambra State. BP, PR and RR were assessed using both the standardised methods and iCHM. The parameters were reassessed with the iCHM after few minutes. Convergent validity and test-retest reliability of the iCHM were determined using Pearson product moment correlation and intra-class correlation coefficient respectively at an alpha level of 0.05.

Results

The convergent validity of the iCHM was excellent in measuring systolic BP (SBP) ( r = 0.96; p < 0.01), diastolic BP (DBP) ( r = 0.93; p < 0.01), HR ( r = 0.96; p < 0.01) but moderate in measuring RR ( r = 0.74; p < 0.01). The test-retest reliability of the iCHM was excellent in assessing SBP (ICC = 0.95; p < 0.01), DBP (ICC = 0.94; p < 0.01) and HR (ICC = 0.92; p < 0.01) but poor in assessing RR (ICC = 0.35; p = 0.03). Also, the iCHM displayed clinically insignificant bias.

Conclusion

The iCHM is a valid and reliable tool for assessing BP and HR (but not RR) among stroke survivors. Its use is therefore recommended especially in poor-resource countries where gadgets for assessing BP and PR might not easily be affordable and available.

Depression severity mediates the impact of perceived stigma on quality of life in patients with epilepsy

OBJECTIVE

To determine whether and the extent to which depression severity mediates the impact of perceived stigma on quality of life in patients with epilepsy (PWE).

METHODS

A consecutive cohort of 165 PWE was invited to participate in this study. Each participant completed the Kilifi Stigma Scale of Epilepsy (KSSE), Depression Inventory for Epilepsy (NDDI-E), and Quality of Life in Epilepsy Inventory (QOLIE-31). Mediation analysis was employed to assess whether depression severity mediates the relationship between perceived stigma and quality of life.

RESULTS

Perceived stigma was positively associated with depression severity and negatively associated with quality of life in PWE. The mediation analysis confirmed that perceived stigma had an indirect effect on the quality of life through the mediating variable of depression severity in PWE (B = -0.576, SE = 0.097, Bootstrap95% CI = -0.784 to -0.405). The indirect effects of perceived stigma on quality of life through depression severity accounted for 57.7% of the total effects of perceived stigma on quality of life.

CONCLUSION

This study provided evidence that depression severity mediates the impact that perceived stigma has on quality of life, indicating that assessment of and interventions targeting depression may be appropriate for PWE.