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Caminiti M, Mercogliano M, Cussotto F, Briganti GL, Genovese D, Priano W, Ricciotti GM, Bonaccorso N, Grassi F, Antonelli A, Girolametto G, Spatari G, Gianfredi V, Mariniello A, Marisei M, Minutolo G, Ancona A, De Nicolò V, Berselli N, Gallinoro V, Cosma C, Piunno G, Montagna V, Catalini A. Study Protocol for the Residents' Mental Health Investigation, a Dynamic Longitudinal Study in Italy (ReMInDIt). Healthcare (Basel) 2024; 12:1020. [PMID: 38786430 PMCID: PMC11121525 DOI: 10.3390/healthcare12101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
Medical residents constitute a vulnerable population susceptible to mental health disorders. In Italy, this was evident during the COVID-19 pandemic, when medical residents served on the front line and provided significant support to healthcare services. Therefore, the working group on "Public Mental Health" of the Medical Residents' Council of the Italian Society of Hygiene, Preventive Medicine, and Public Health (S.It.I.) designed the "Residents' mental health investigation, a dynamic longitudinal study in Italy" (ReMInDIt). This longitudinal study aims to assess the mental status of medical residents and to explore potential cause-effect relationships between risk/protective factors (identified among sociodemographic, residency program, and lifestyle characteristics) and mental health outcomes (anxiety and depressive symptoms). Data will be collected from a study population of 3615 residents enrolled in Italian residency programs in public health, occupational medicine, and forensic medicine through an online questionnaire that includes validated tools, requires 10 min for completion, and is disseminated by the residents' Councils. It will be followed by a follow-up administration after 12 months. The ReMInDIt study will play a significant role in generating evidence crucial for enhancing mental health services and promoting protective factors for the mental well-being of this important segment of healthcare professionals.
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Affiliation(s)
- Marta Caminiti
- School of Hygiene and Preventive Medicine, University of Perugia, 06100 Perugia, Italy;
| | | | - Federico Cussotto
- School of Hygiene and Preventive Medicine, Department of Sciences of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy;
| | - Giovanni Leonardo Briganti
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy;
| | - Dario Genovese
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro, 133, 90127 Palermo, Italy; (D.G.); (W.P.); (N.B.)
| | - Walter Priano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro, 133, 90127 Palermo, Italy; (D.G.); (W.P.); (N.B.)
| | - Giorgia Maria Ricciotti
- School of Hygiene and Preventive Medicine, Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60126 Ancona, Italy;
| | - Nicole Bonaccorso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro, 133, 90127 Palermo, Italy; (D.G.); (W.P.); (N.B.)
| | - Fabiano Grassi
- School of Hygiene and Preventive Medicine, Department of Public Health and Infectious Diseases, Sapienza University, P. A. Moro 5, 00161 Rome, Italy; (F.G.); (V.D.N.)
| | - Antonio Antonelli
- School of Hygiene and Preventive Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (A.A.)
| | - Gloria Girolametto
- School of Hygiene and Preventive Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padova, Italy;
| | - Gloria Spatari
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133 Milan, Italy;
| | | | - Mariagrazia Marisei
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Giuseppa Minutolo
- Food Hygiene, Nutritional Surveillance and Prevention, Department of Prevention, Provincial Healthcare Authority of Palermo, 90129 Palermo, Italy;
| | - Angela Ancona
- School of Hygiene and Preventive Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (A.A.)
| | - Valentina De Nicolò
- School of Hygiene and Preventive Medicine, Department of Public Health and Infectious Diseases, Sapienza University, P. A. Moro 5, 00161 Rome, Italy; (F.G.); (V.D.N.)
| | - Nausicaa Berselli
- Public Hygiene Service, Public Health Department, Local Health Authority of Modena, 41123 Modena, Italy;
| | - Veronica Gallinoro
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (V.G.); (C.C.)
| | - Claudia Cosma
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (V.G.); (C.C.)
| | - Gaia Piunno
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00161 Rome, Italy;
| | | | - Alessandro Catalini
- UOC Igiene degli Alimenti e Nutrizione, Dipartimento di Prevenzione, AST Macerata, 62100 Macerata, Italy;
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Wang W, Zhang J. Social Support, Psychological Strain, and Suicidality: Evidence from Chinese Universities. PSYCHOLOGY IN THE SCHOOLS 2024; 61:205-219. [PMID: 38505835 PMCID: PMC10948106 DOI: 10.1002/pits.23047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/28/2023] [Indexed: 03/21/2024]
Abstract
This study aimed to apply psychological strain theory to explore the relationship between psychological strain and suicidality among Chinese young adults with a moderating effect of perceived social support. A questionnaire was administered with the Multidimensional Scale of Perceived Social Support (MSPSS), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Psychological Strain Scale (PSS) among 13,250 college students across China. The main determinants of suicidal behavior were examined with multiple linear regression. Two steps of multiple regression were employed to define the moderating effect of social support. A positive relationship between psychological strain and suicidality was reported in the study, and social support was confirmed as a moderating factor between psychological strain and suicidal behavior.
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Affiliation(s)
- Wei Wang
- University of Delaware Department of Sociology and Criminal Justice, USA
| | - Jie Zhang
- Shandong University Center for Suicide Prevention Research, China, State University of New York Buffalo State University, USA
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Alele PE, Kiptoo J, Hill-Besinque K. Postgraduate medical trainees at a Ugandan university perceive their clinical learning environment positively but differentially despite challenging circumstances: a cross-sectional study. BMC MEDICAL EDUCATION 2023; 23:965. [PMID: 38102623 PMCID: PMC10724882 DOI: 10.1186/s12909-023-04933-7] [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: 08/14/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The clinical learning environment is an essential component in health professions' education. Data are scant on how postgraduate trainees in sub-Saharan Africa perceive their medical school learning environments, and how those perceptions contribute to their engagement during training, their emotional wellbeing, and career aspirations. This study examined perceptions of postgraduate medical trainees (residents) in a resource-limited setting, regarding their learning environment and explored perceptual contributions to their career engagement during training. The data reported contribute to understanding how clinical learning environments can be improved in low-resource settings in Uganda and elsewhere. METHODS This study was done at the Faculty of Medicine of Mbarara University of Science and Technology in Uganda. We used a descriptive cross-sectional design involving sequential mixed methods. Quantitative data were collected using the Postgraduate Hospital Educational Environment Measure (PHEEM). Qualitative data were collected using focus group discussions. RESULTS Ninety of the 113 eligible residents responded (79.6%). Of these, 62 (68.9%) were males, 51 (56.7%) were third-year trainees, and the majority (40%) of the residents were aged between 30 and 34 years. Overall PHEEM scored 98.22 ± 38.09; Role Autonomy scored 34.25 ± 13.69, Teaching scored 39.7 ± 13.81, and Social Support scored 24.27 ± 10.59. Gender differences occurred in the perceptions of teaching and social support. Cronbach's alpha coefficient was 0.94 for the overall PHEEM. Five major themes were identified from the qualitative data (trainee support, supervision environment, engagement with overall learning environment, preparation for future practice, and challenges that impede training). CONCLUSIONS Overall, this study suggests that postgraduate trainees at the institution perceived the clinical learning environment positively amidst challenges of limited resources. Trainees' insights provided data that propose improvements on a number of domains in the learning environment.
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Affiliation(s)
- Paul E Alele
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Joshua Kiptoo
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Kathleen Hill-Besinque
- Department of Pharmacy Practice, School of Pharmacy, Chapman University, California, USA
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Shi H, Zhao H, He M, Ren Z, Wang S, Cui L, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. The mediating roles of coping styles and academic burnout in the relationship between stressors and depressive symptoms among Chinese postgraduates. PeerJ 2023; 11:e16064. [PMID: 37744225 PMCID: PMC10512960 DOI: 10.7717/peerj.16064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Background Since few studies have incorporated factors like stressors, coping styles, and academic burnout into the same model to analyze their impacts on depressive symptoms, this research attempts to establish an optimal structural model to explore the direct and indirect effects of these factors on depressive symptoms. Methods A total of 266 postgraduates completed questionnaires regarding coping styles, academic burnout, stressors, and depressive symptoms. The path analysis was applied for investigating the roles of coping styles and academic burnout in mediating the relationship between stressors and depressive symptoms. Results The total and direct effects of stressors on depressive symptoms were 0.53 and 0.31, respectively. The proportion of the direct effect of stressors on depressive symptoms to its total effect amounted to 58.50%. The indirect effects of academic burnout, positive coping style, and negative coping style on the association between stressors and depressive symptoms were 0.11, 0.04, and 0.03, taking up 20.75%, 7.55%, and 5.66% of the total effect, respectively. The serial indirect effect of positive coping style and academic burnout was 0.02, accounting for 3.77% of the total effect, while that of negative coping style and academic burnout was 0.02, taking up 3.77% of the total effect. Conclusions Coping styles and academic burnout chain jointly mediate the relationship between stressors and depressive symptoms among postgraduates. Thus, encouraging postgraduates to tackle stress positively may reduce the likelihood of the development of academic burnout and further reduce depressive symptoms.
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Affiliation(s)
- Hong Shi
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Yachen Wei
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, Jilin University School of Public Health, Changchun, China
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Odero SA, Mwangi P, Odhiambo R, Mumbua Nzioka B, Shumba C, Ndirangu-Mugo E, Abubakar A. Psychometric evaluation of PHQ-9 and GAD-7 among community health volunteers and nurses/midwives in Kenya following a nation-wide telephonic survey. Front Psychiatry 2023; 14:1123839. [PMID: 37324823 PMCID: PMC10264862 DOI: 10.3389/fpsyt.2023.1123839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
Background Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya. Methods Between June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach's alpha and MacDonalds' omega were used to evaluate the scale's internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools' divergent and convergent validity. Results The internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were significantly negatively correlated with resilience and work engagement, supporting divergent validity. The PHQ-9 and GAD-7 were also significantly positively correlated with resilience and work engagement, supporting divergent validity. Conclusion The PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.
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Affiliation(s)
| | - Paul Mwangi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | - Constance Shumba
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
| | | | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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Students stress patterns in a Kenyan socio-cultural and economic context: toward a public health intervention. Sci Rep 2023; 13:580. [PMID: 36631469 PMCID: PMC9834399 DOI: 10.1038/s41598-023-27608-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023] Open
Abstract
This study aimed at determining the prevalence of stress, different types of stress, their severity and their determinants in Kenyan university, college and high school students. The following tools were administered to 9741 students: (1) Researcher-designed socio-demographic tool, (2) Psychiatric Diagnostic Screening Questionnaire (PDSQ) for psychiatric disorders, (3) WERC Stress Screen for stress, (4) Washington Early Recognition Center Affectivity and Psychosis (WERCAP) screen for psychosis and affectivity, (5) Wealth Index Questionnaire for economic indicators. Descriptive analysis for the prevalence of different types of stress and inferential analysis for stress and independent variables were done. Significant variables (p < 0.05) were fitted into generalized linear model to determine independent predictors. The mean age of the respondents was 21.4 years (range 16-43). Money issues were the commonest stressors while alcohol and drug use were the least. The independent predictors of stress were females, college students and use of gas stove. In conclusion, up to 30% of the students suffer from mild to severe stress. The students experience a wide range of stressors. The most important stressors include money and finances, family related problems and concerns about their future. Our findings suggest a public health approach to create stress awareness in students.
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