Effects of the MINDSTRONG© CBT-based program on depression, anxiety and healthy lifestyle behaviors in graduate health sciences students

Effects of Two Group Prenatal Care Interventions on Mental Health: An RCT

INTRODUCTION

Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined.

STUDY DESIGN

This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content.

SETTING/PARTICIPANTS

Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate.

INTERVENTION

Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting.

MAIN OUTCOME MEASURES

Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors.

RESULTS

There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased.

CONCLUSIONS

Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens.

TRIAL REGISTRATION

This study is registered with clinicaltrials.gov NCT03416010.

The relationship between healthy lifestyles and cognitive function in Chinese older adults: the mediating effect of depressive symptoms

BACKGROUND

Previous studies have proven the positive relationship between healthy lifestyles and cognitive function in older adults. However, the specific impacts and mechanisms require further investigation. Therefore, this study aimed to investigate whether healthy lifestyles and cognitive function were associated with Chinese older adults and whether depressive symptoms mediated their association.

METHODS

8272 valid samples were included using the latest data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Pearson's test was applied to investigate the relationship between the key variables. Regression models were employed to examine the mediating effects of healthy lifestyles, using Sobel's test and the bootstrap method to confirm path effects.

RESULTS

There was a significant correlation between healthy lifestyles, depressive symptoms, and cognitive function (p < 0.01). Healthy lifestyles directly impact cognitive function (β = 0.162, p < 0.01). Healthy lifestyles had a significant effect on depressive symptoms (β=-0.301, p < 0.01), while depressive symptoms have a significant impact on cognitive function (β=-0.108, p < 0.01). Depressive symptoms partially mediated the effect of healthy lifestyles on cognitive function (β = 0.032, p < 0.01). The Sobel and bootstrap tests confirmed the robustness of the regression analysis results.

CONCLUSION

Depressive symptoms mediate the relationship between healthy lifestyles and cognitive function. Our findings suggest that prevention strategies for cognitive impairment in older adults should focus on healthy lifestyles and mental health.

A brief intervention decreases student distress

PURPOSE OF THE ARTICLE

Health professions graduate students have experienced substantial increases in stress and anxiety in recent years. This can result in decreased academic performance, poor retention, and burnout. Interventions to help students cope are therefore a critical need for academic institutions. The current study sought to demonstrate the effectiveness of a brief multimodal intervention in reducing student distress.

METHOD

The study was a randomised controlled design that evaluated a brief intervention of cognitive-behavioural therapy, mindfulness, and healthy lifestyle choices. The Depression Anxiety Stress Scale-21 was administered to participants at baseline and two post-intervention time points. Control participants did not participate in any intervention. Participants were recruited from graduate students in first-year classes within the School of Health Professions at UT Southwestern Medical Center.

RESULTS

Analysis revealed an overall mild to moderate decline in Depression Anxiety Stress Scale-21 total scores over three assessment periods for both treatment and control groups, with no statistical differences noted between groups; however, the treatment group's scores declined approximately 6 weeks before the control participants' scores declined.

CONCLUSION

The pattern of change in the two groups suggests that our intervention facilitated the reduction in student anxiety more quickly than would have occurred normally and with sustained results.

Digital health technologies and major depressive disorder

There is an urgent need to improve the clinical management of major depressive disorder (MDD), which has become increasingly prevalent over the past two decades. Several gaps and challenges in the awareness, detection, treatment, and monitoring of MDD remain to be addressed. Digital health technologies have demonstrated utility in relation to various health conditions, including MDD. Factors related to the COVID-19 pandemic have accelerated the development of telemedicine, mobile medical apps, and virtual reality apps and have continued to introduce new possibilities across mental health care. Growing access to and acceptance of digital health technologies present opportunities to expand the scope of care and to close gaps in the management of MDD. Digital health technology is rapidly evolving the options for nonclinical support and clinical care for patients with MDD. Iterative efforts to validate and optimize such digital health technologies, including digital therapeutics and digital biomarkers, continue to improve access to and quality of personalized detection, treatment, and monitoring of MDD. The aim of this review is to highlight the existing gaps and challenges in depression management and discuss the current and future landscape of digital health technology as it applies to the challenges faced by patients with MDD and their healthcare providers.

State of Mental Health, Healthy Behaviors, and Wellness Support in Big 10 University Nursing and Health Sciences Faculty, Staff, and Students During COVID-19

BACKGROUND

Federal and national entities urge organizations to assess healthcare professionals' mental health and well-being as the COVID-19 pandemic has compounded the issue.

AIMS

This study aimed to (1) describe rates of mental health issues, healthy lifestyle behaviors, and perceptions of COVID-19's impact among Big 10 University nursing and health sciences faculty, staff, and students; (2) identify predictors of depression, anxiety, stress, and burnout; and (3) assess the relationships among perceived school wellness support, healthy lifestyle behaviors, physical/mental health, and mattering.

METHODS

A cross-sectional descriptive correlational design was used. Nursing and health science deans emailed invitations to faculty, staff, and students concerning an anonymous wellness assessment survey. Correlation coefficients tested associations among mental health indicators and wellness cultures. Multiple linear regression examined factors associated with mental health indicators.

RESULTS

Faculty, staff, and students responded (N = 1345). Findings indicated that most respondents were not getting adequate sleep, meeting physical activity recommendations, or eating the daily recommended number of fruits/vegetables. Fourteen to 54.9 % of participants reported depression, anxiety, and burnout. Overall, students, faculty and staff at colleges that operated under a strong wellness culture had better outcomes.

CONCLUSION

Wellness cultures impact the mental and physical health of faculty, staff, and students.

Steps toward a resilient future nurse workforce

INTRODUCTION

The psychosocial needs of nursing students are a pressing matter as mental health disorders may affect nursing students' journeys as professional nurses.

LITERATURE REVIEW

Psychological distress and burnout in nurses are threats to worldwide health care, as the stress associated with the COVID-19 pandemic could lead to an unstable future global nurse workforce.

DISCUSSION

Resiliency training can positively impact nurse stress, mindfulness, and resilience, as resilient nurses are better able to manage their response to stress and adversity which will contribute to positive patient outcomes.

IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE

Educating faculty on resilience will aid nurse educators to create new student instructional approaches to improve mental health wellness.

CONCLUSIONS

Supportive faculty behaviors, self-care techniques, and resilience-building infused throughout the nursing curriculum may promote the effective transitioning of students into practice, providing the necessary foundation for improving workplace stress management and increasing longevity and satisfaction in the profession.

An Adaptation of the COPE Intervention for Adolescent Bullying Victimization Improved Mental and Physical Health Symptoms

OBJECTIVE

One in five children report experiencing bullying. Bullying in childhood affects the physical and emotional health and functioning of youth with immediate consequences, including depression, anxiety, somatic complaints, and suicidal ideation. Schools overwhelmingly are tasked with addressing bullying; however, school-based programs are often focused on preventing bullying from occurring. There is a paucity of evidence-based interventions for adolescents who have directly experienced bullying and suffer from adverse health outcomes, especially when they present to the mental health setting.

METHODS

This pre-experimental study examined the feasibility, acceptability, and preliminary effects of the MINDSTRONG to Combat Bullying Program for adolescents who have experienced bullying with concurrent mental health symptoms.

RESULTS

Twenty adolescents and their parent dyads enrolled in the MINDSTRONG to Combat Bullying program. Significant reductions were found over time in adolescent self-reported depressive, anxiety and somatic symptoms as well as bullying victimization frequency, with large positive effect sizes for the intervention. Significant increases in adolescent personal beliefs also were found.

CONCLUSIONS

Although several of the intervention sessions needed to be rescheduled and many of the adolescents did not complete their weekly skills building homework, MINDSTRONG to Combat Bullying was found to be a highly acceptable intervention for adolescents that was effective in reducing physical and mental health symptoms as well as perceptions of bullying victimization.

Specific coping styles and its relationship with psychological distress, anxiety, mental health, and psychological well-being among student nurses during the second wave of the COVID-19 pandemic

PURPOSE

To identify specific coping skills that contribute to relieving anxiety and stress while supporting student nurses' mental health and psychological well-being.

DESIGN AND METHOD

This is a cross-sectional online survey involving 261 students nurses from private and government-owned nursing schools in the Central Philippines.

RESULTS

Resilience was associated with reduced stress and anxiety and better mental health and psychological well-being. Mental disengagement was associated with lower anxiety and stress levels. Spiritual and not scientific sources of support were associated with lower stress and increased psychological well-being and mental health.

PRACTICE IMPLICATIONS

Nurse faculty should foster functional coping skills in student nurses to enhance their ability to endure negative psychological and mental health outcomes related to the pandemic.

The state of mental health and healthy lifestyle behaviors in nursing, medicine and health sciences faculty and students at Big 10 Universities with implications for action

BACKGROUND

High rates of mental health conditions and poor healthy lifestyle behaviors are reported in nurses, other clinicians, and health science students but have not been compared across different professions.

PURPOSE

The purpose of this study was threefold: (1) describe rates of mental health problems and healthy lifestyle behaviors across the Big 10 health professional faculty and students, (2) compare the health and healthy lifestyle behaviors of the Big 10 health sciences faculty and students across health sciences' professions, and (3) identify factors predictive of depression, stress, and anxiety.

METHODS

Faculty and students from eight health science colleges at the Big 10 Universities responded to the study survey, which included: demographics, healthy lifestyle behavior questions, and three valid/reliable mental health scales. Descriptive statistics described the findings and multiple linear regression identified factors associated with mental health conditions.

RESULTS

Eight-hundred and sixty-nine faculty and 1087 students responded. Approximately 50% of faculty and students reported 7 h of sleep/night, a third achieved 150 min of physical activity/week; 5.5%-9.9% screened positive for depression; and 11.5%-25.5% had anxiety. Age, sleep, and physical activity were associated with lower depression and anxiety.

CONCLUSIONS

University leadership must build wellness cultures that make healthy lifestyle behaviors easy to engage in and enhance mental well-being.

Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model

AIM

Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology-oriented model detailing the potential links between nursing students': (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well-being; (d) interpersonal well-being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students' perceptions of their campus climate as supportive of mental health and well-being.

DESIGN

A correlational, cross-sectional design was employed.

METHOD

Nursing students (N = 933) were selected from the national 2017-2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well-being (flourishing), interpersonal well-being (belonging), and academic distress.

RESULTS

Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate.

CONCLUSION

Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate.

IMPACT

Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school.