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Ali AM, Alkhamees AA, Hallit S, Al-Dwaikat TN, Khatatbeh H, Al-Dossary SA. The Depression Anxiety Stress Scale 8: investigating its cutoff scores in relevance to loneliness and burnout among dementia family caregivers. Sci Rep 2024; 14:13075. [PMID: 38844485 PMCID: PMC11156668 DOI: 10.1038/s41598-024-60127-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/19/2024] [Indexed: 06/09/2024] Open
Abstract
The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, 21527, Alexandria, Egypt
| | | | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Tariq N Al-Dwaikat
- Department of Community and Mental Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Haitham Khatatbeh
- Department of Nursing, Faculty of Nursing, Jerash University, Jerash, Jordan
| | - Saeed A Al-Dossary
- Department of Psychology, College of Education, University of Ha'il, 1818, Ha'il, Saudi Arabia
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Kharroubi SA, Al-Akl N, Chamate SJ, Abou Omar T, Ballout R. Assessing the Relationship between Physical Health, Mental Health and Students' Success among Universities in Lebanon: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:597. [PMID: 38791811 PMCID: PMC11121208 DOI: 10.3390/ijerph21050597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Achieving high academic success is known to be influenced by many factors including, but not limiting to, physical and mental health. The present study aimed to assess the relationship between physical health, mental health, and university students' success, and to explore the associations between these factors and their academic achievement. METHODS A cross-sectional, self-administered online survey was used to collect data from college students in three different universities in Lebanon during the Fall 2023 semester. Mental health was evaluated using validated screening tools for depression, anxiety, and stress, specifically the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7), and Cohen's Perceived Stress Scale (PSS), respectively. Additionally, general questions regarding physical health and lifestyle factors were incorporated into the questionnaire. Academic achievement was measured using students' grade point average (GPA). RESULTS A total of 261 students completed the self-administered online survey. The results revealed that approximately 42% and 36% of students were experiencing moderate to severe symptoms of depression and anxiety, respectively, and 75.1% of students exhibited symptoms of moderate stress. The majority of participants (99.2%) did not report any physical disability. Chi-square analysis revealed a significant association between mental health status (depression, anxiety, and stress) and GPA level (p = 0.03, p = 0.044, p = 0.015, respectively). Multiple logistic regression models identified eight correlates of GPA and highlighted the relationship between physical health and student success. For instance, students who considered themselves moderately active had lower odds of achieving a higher GPA than those who considered themselves active (OR = 0.41, p = 0.045). CONCLUSIONS This is the first investigation into Lebanese university students' academic success in relation to lifestyle and mental health profiles. The findings indicate that implementing public health programs and interventions targeting mental health and lifestyle behaviors is essential for enhancing student success.
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Affiliation(s)
- Samer A. Kharroubi
- Office of Student Affairs, American University of Beirut, P.O. BOX 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon; (N.A.-A.); (S.-J.C.); (T.A.O.)
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon;
| | - Nayla Al-Akl
- Office of Student Affairs, American University of Beirut, P.O. BOX 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon; (N.A.-A.); (S.-J.C.); (T.A.O.)
- Department of Landscape Design and Ecosystem Management, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon
| | - Sarah-Joe Chamate
- Office of Student Affairs, American University of Beirut, P.O. BOX 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon; (N.A.-A.); (S.-J.C.); (T.A.O.)
| | - Tarek Abou Omar
- Office of Student Affairs, American University of Beirut, P.O. BOX 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon; (N.A.-A.); (S.-J.C.); (T.A.O.)
| | - Rouba Ballout
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon;
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Neuman J, Ina EA, Huq SO, Blanca A, Petrosky SN. Cross-Sectional Analysis of the Effect of Physical Activity, Nutrition, and Lifestyle Factors on Medical Students' Academic Achievement. Cureus 2024; 16:e56343. [PMID: 38633916 PMCID: PMC11022033 DOI: 10.7759/cureus.56343] [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: 02/06/2024] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Unhealthy dietary habits, decreased physical activity, poor sleep quality, and increasing levels of stress and burnout have all been identified as major concerns of medical students. Due to the rigorous environment of medical school, maintaining a well-balanced and nutritious diet is often replaced by more convenient and nutrient-poor options. Improper dietary habits and a sedentary lifestyle both play an essential role in the development of type II diabetes, obesity, hypertension, and hyperlipidemia. These unhealthy trends commonly stem from the innate drive for medical students to achieve at the highest level, sacrificing healthy lifestyle choices to maximize studying. Unfortunately, this dynamic creates a paradox where students create an unhealthy lifestyle to increase academic achievement; however, these destructive living conditions lead to a diminished sense of well-being. As a result, greater rates of burnout, comorbidities, and other maladaptive tendencies diminish success in school. OBJECTIVE The objective of this study is to investigate the effects of lifestyle habits such as nutrition, physical activity (PA), and stress on academic performance (grade point average: GPA) among first- and second-year students at Nova Southeastern University, Kiran C. Patel College of Osteopathic Medicine (KPCOM). METHODS A cross-sectional study was conducted on medical students (n = 161) under institutional review board (IRB) approval. The students voluntarily completed a self-reported survey containing questions about diet, exercise (frequency and type), stress, and self-reported GPA. About 800 students were invited to complete the survey between June 15, 2022, and June 28, 2022. A simple lifestyle indicator questionnaire (SLIQ) score was determined for each student based on their diet, PA, and stress responses. RESULTS The results showed a significant positive correlation between SLIQ score and high academic achievement. A significant positive association was found between the low academic-achieving (LAA)(2.00-2.99 GPA) vs the high (3.60-4.00 GPA) academic-achieving (HAA) cohorts for physical activity (p = 0.012) as well as diet (p = 0.043). Further, the HAA cohort reported higher satisfaction with their mental and physical health (74% and 54%, respectively) as compared to the LAA cohort (29% each). CONCLUSION This study demonstrated positive correlations between diet and physical activity with high academic achievement. The HAA cohort recorded the highest rates of fruit/vegetable and home-cooked meal consumption and the greatest participation in light, moderate, and heavy exercise when compared to the middle academic-achieving (MAA) (3.00-3.59 GPA) and LAA cohorts. Interestingly, the HAA students also recorded the highest rates of satisfaction with their mental and physical health. As a result, there is a need to promote healthier lifestyle trends among medical students with a focus on diet and physical activity.
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Affiliation(s)
- Jeffrey Neuman
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Emily A Ina
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Shakil O Huq
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Alex Blanca
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Stephanie N Petrosky
- Nutrition, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
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Barakat M, Salim NA, Malaeb D, Dabbous M, Sakr F, Hallit S, Fekih-Romdhame F, Obeid S. Mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. BMC Public Health 2024; 24:352. [PMID: 38308268 PMCID: PMC10836016 DOI: 10.1186/s12889-024-17812-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This study examined the mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. METHODS A total of 769 female participants enrolled in this cross-sectional study (mean age 21.58 ± 3.20 years). A self-administered questionnaire was distributed among university female students. The questionnaire consisted of Mindful Eating Behaviors Scale, ORTO-R, Depression Anxiety Stress Scale, and Arabic version of Academic Self-Efficacy Scale. RESULTS The results showed that psychological distress fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less psychological distress (β= -0.31, p =.05), with more psychological distress significantly associated with lower academic self-efficacy (β= -0.32, p =.09). Focused eating fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less focused eating (β=-0.09, p =.04), with more focused eating significantly associated with better academic self-efficacy (β = 1.40, p =.10). Orthorexia nervosa was not directly associated with academic self-efficacy in both models. CONCLUSION This study shed light on important connections between orthorexia nervosa, psychological distress, mindful eating behaviors, and academic self-efficacy within the Lebanese context. The findings will have practical implications for both educational institutions and healthcare providers striving to support young female adults' overall well-being and academic success.
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Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- Middle East University Research Unit, Middle East University, Amman, Jordan
| | - Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Amman, Jordan
- Prosthodontic Department, Jordan University Hospital, Amman, Jordan
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon.
| | - Feten Fekih-Romdhame
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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